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Review, 2011

What is menstrual psychosis and how is it connected to the menstrual cycle?

Menstrual psychosis is a rare illness that looks like manic depressive (bipolar) disorder but comes on in a pattern linked to the menstrual cycle. The review suggests this link involves the hypothalamus, but this is based on case evidence, not a controlled study.

Early or limited evidence People with menstrual psychosis, from about 80 well-documented and 200 other possible cases in the literature.

What they did

This is a review article. The author looked back over the existing literature on menstrual psychosis, including about 80 well-documented cases and about 200 other possible cases, and summarised the typical symptoms and treatments reported.

What they found

Symptoms usually look like manic depressive (bipolar) disorder. Diagnosis needs careful dating of when episodes start compared to menstrual bleeding. Usual psychiatric drugs can shorten an episode but do not stop it coming back. Thyroid hormone and clomiphene were reported as more effective at preventing recurrence. Women with this illness often have abnormal periods, such as cycles without ovulation, luteal phase problems, or missed periods, and episodes can even start before a girl's first period. The author suggests the hypothalamus is where the cycle and the bipolar tendency interact.

What it means for you

This condition is very rare and different from PMS or PMDD. The review is based on collected case reports rather than a controlled trial, so the treatment ideas (thyroid hormone, clomiphene) are suggestions from observation, not proven in rigorous trials.

80

cases with substantial evidence

200

other possible cases reviewed

About the study

Original title
Menstrual psychosis: a bipolar disorder with a link to the hypothalamus
Authors
Brockington IF
Journal
Current psychiatry reports
Year
2011
Study design
Review
What was tested
No new treatment tested; review compares usual psychiatric drugs with thyroid hormone and clomiphene from case reports.

Topics