Bipolar Premenstrual Mood Exacerbation Linked

After multiple research studies it has been determined that premenstrual mood exacerbation may be a clinical marker in predicting the display of severe bipolar symptoms in women of reproductive age. The American Journal of Psychiatry reports that women who have both bipolar disorder and experience premenstrual mood exacerbation, PME, tend to have a worse course of illness, a shorter time in which relapse occurs and increased severity of symptoms than women who do not report PME.

Mood Exacerbation

Women with premenstrual exacerbation and bipolar disorder typically had more severe depressive and mood elevation symptoms over the course of a year with women reporting a greater symptom burden.  Women with PME and a bipolar diagnosis also exhibited more depressive mood episodes overall than women without reported PME. Study data showed that although there were considerably more depressive mood episodes with PME, women did not exhibit more episodes of mania or hypomania when compared to those women who did not suffer from premenstrual exacerbation.

Bipolar Relapse Time

For women with bipolar disorder and PME the median time to relapse was 4.5 months compared to 8.5 months who were diagnosed with bipolar disorder but who did not suffer from PME. This is a significant finding that indicates mental health professionals working with women need to track their menstrual cycle as well as the appearance and severity of premenstrual exacerbation in order to provide optimum care and treatment before, during and after the menstrual cycle. PME points to a more severe course of bipolar disorder suggesting further evaluation and the need for an adjustable treatment plan.

Complications to Treatment Plan

The Department of Psychiatry at Brigham and Women’s Hospital report that hormonal changes associated with the menstrual cycle and menopause can complicate the treatment and course of disease. It is possible for hormonal changes to impact mood as well as impact the way mood stabilizing medications used in treatment of bipolar disease work.  Working with a psychiatrist who understands PME and its relationship with bipolar disorder is necessary for consistent treatment and management of the disorder. Call Dr. Darvin Hege for a confidential appointment today.

About Darvin Hege

Dr. Darvin Hege, MD, PC, is based in Atlanta, Georgia, and certified by the American Board of Psychiatry and Neurology, and the American Society of Addiction Medicine. He is an Emory Hospital residency trained psychiatrist who has been practicing psychiatry for more than 25 years. He maintains over 50 hours of AMA certified education each year to stay informed of advances in psychiatry.

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