--- title: Does premenstrual symptom worsening change how bipolar disorder develops over time? description: Yes. Women with bipolar disorder who reported premenstrual symptom worsening had more mood episodes and relapsed sooner, though other patterns in their illnes url: https://niyora.com/research/papers/longitudinal-follow-up-of-bipolar-disorder-in-women-with-premenstrual-2011/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does premenstrual symptom worsening change how bipolar disorder develops over time? Cohort study, 2011 # Does premenstrual symptom worsening change how bipolar disorder develops over time? Yes. Women with bipolar disorder who reported premenstrual symptom worsening had more mood episodes and relapsed sooner, though other patterns in their illness may partly explain this. Moderate study design 293 women with bipolar disorder (191 with premenstrual exacerbation, 65.2%) ## What they did 293 women with bipolar disorder of reproductive age were followed for 1 year. 191 women (65.2%) reported premenstrual worsening of symptoms and 102 did not. Researchers tracked how many mood episodes they had and, for women who started in recovery, how long until they relapsed. ## What they found Women with premenstrual worsening had more mood episodes (mostly depressive) and a shorter time until relapse. When researchers adjusted for other mood patterns, the relapse difference was no longer significant. They had more depressive and mood elevation symptoms overall. ## What it means for you Premenstrual worsening may be a sign of more severe bipolar disorder. This applies only to women with bipolar disorder, not to PMS or PMDD in general. The study was observational, so we cannot say the menstrual cycle causes worse illness. 293 women with bipolar disorder 65.2% had premenstrual exacerbation 1 year follow-up ## About the study Original title Longitudinal follow-up of bipolar disorder in women with premenstrual exacerbation: findings from STEP-BD Authors Dias RS, Lafer B, Russo C et al. Journal The American journal of psychiatry Year 2011 Study design Cohort study Participants 191 What was tested None Read the paper [doi.org/10.1176/appi.ajp.2010.09121816](https://doi.org/10.1176/appi.ajp.2010.09121816) ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual exacerbation (PME)](https://niyora.com/research/topics/condition-pme/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Anxiolytics and other psychotropics](https://niyora.com/research/topics/treatment-anxiolytics/)[Bipolar disorder](https://niyora.com/research/topics/comorbidity-bipolar/)[Schizophrenia and psychosis](https://niyora.com/research/topics/comorbidity-psychosis/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Study, 2026 Do anxiety and depression get worse before your period if you already have a mental health condition? Survey study, 2026 What is the true rate of PMDD, and does it worsen mental health conditions? Review, 2025 How does the menstrual cycle affect psychiatric symptoms like depression and anxiety? Review, 1993 What mood disorders affect women and how should they be treated? Review, 2002 What treatments work best for PMS and PMDD? Review, 2002 What are the reproductive-related mood disorders and how are they connected? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗