Can Periods Impact Bipolar Disorder? Expert Shares The Impact of Hormonal Fluctuations

Periods bring about different physical and emotional changes, which makes it a challenging time for most women. Navigating these shifts can be an even bigger challenge for those with underlying mental health conditions. The natural ebb and flow of reproductive hormones during the menstrual cycle can largely impact mood regulation. For women living with bipolar disorder, these hormonal fluctuations can lead to worse mood swings and even trigger new depressive and manic episodes. 

To understand this better, we reached out to Dr Sharadhi C, Consultant Psychiatry, Aster CMI Hospital, Bangalore.

Can Periods Affect Bipolar Disorder?

Let us straightaway address the main question: can menstruation impact bipolar disorder? Dr Sharadhi says that hormonal changes during the menstrual cycle can affect mood in many women; but for those living with bipolar disorder, these changes may make emotional symptoms more intense. 

The expert further explains, “Levels of the hormones oestrogen and progesterone rise and fall throughout the month, and these hormones can influence brain chemicals such as serotonin and dopamine, which helps regulate mood.”

So what are some of the tell-tale signs? Dr Sharadhi answers that some women notice: 

• Worsening depression.
• Irritability.
• Anxiety.
• Mood swings in the days before or during their periods. 

“In people with bipolar disorder, these hormonal shifts may increase the risk of depressive episodes, trigger hypomania or mania in some cases, or make existing symptoms harder to control, even when they are taking regular treatment,” adds Dr Sharadhi.

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How Hormonal Fluctuations Impact Bipolar Disorder

Dr Sharadhi says that the impact of hormonal fluctuations is different for every woman, and not everyone with bipolar disorder experiences the same pattern of symptoms. The expert explains further, “Some women may notice that their mood becomes consistently worse before their periods, while others may experience changes only occasionally.” 

She adds, “Stress, lack of sleep, certain medications, and other health conditions can also influence how severe these symptoms become. Keeping a daily mood diary along with menstrual cycle tracking can help identify patterns over several months. This information allows doctors to understand whether hormone-related changes are contributing to mood episodes and helps them decide if adjustments in treatment or lifestyle measures are needed.”

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What Study Says About The Impact of Periods on Bipolar Disorder

In a 2014 study, published in the medical journal Bipolar Disorders, researchers attempted to understand whether natural hormonal changes during a woman's menstrual cycle can impact bipolar disorder. As part of the study, a team of scientists examined dozens of previous medical studies and case reports published up to 2013. 

The researchers discovered that for a specific group of women, the days leading up to a period can absolutely trigger a worsening of bipolar symptoms. Many of the women analysed in these studies experienced severe premenstrual syndrome (PMS), which is often diagnosed as premenstrual dysphoric disorder (PMDD). During this premenstrual phase, these individuals often experienced severe depression and mood swings. 

The study also discovered that some women experienced manic or abnormally high energy episodes right before their periods began. In fact, over half of the women in various studies reported that their mood changes were directly tied to their monthly cycles. This strong connection implies that some women with bipolar disorder are uniquely sensitive to natural shifts in their reproductive hormones. 

The research confirmed that periods can thus significantly impact bipolar disorder. However, more research is still needed to understand and better treat these cyclical mood changes. 

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Tips to Manage Bipolar Disorder During Periods

Dr Sharadhi says that managing bipolar disorder during the menstrual cycle requires a combination of:

• Medical care
• Healthy habits
• Emotional support
• Women should continue taking prescribed medicines without stopping or changing doses on their own, even if symptoms temporarily worsen around their periods.
• Regular sleep, balanced meals, physical activity, stress management, and avoiding alcohol or recreational drugs can also help reduce mood instability. 

“If mood changes become severe, interfere with daily life, or lead to thoughts of self-harm, it is important to seek medical attention immediately. Working closely with a psychiatrist can help develop a personalised treatment plan that supports both mental health and hormonal wellbeing,” concludes the expert.

ALSO READ- Mental Health Matters: Expert Explains Role Of Mood Stabilisers For Bipolar Depression

Conclusion

The link between bipolar disorder and period indicates how women’s reproductive hormones impact our brain chemistry and emotional stability. While the days leading up to a period can increase symptoms of depression or mania, tracking these cyclical changes can help women manage their mental health better. Maintaining healthy lifestyle habits, following prescribed medications, and communicating openly with healthcare providers are some of the essential steps you can take to deal with the extreme changes led by periods. By acknowledging this hormonal link, women with bipolar disorder can ensure a more balanced mental wellbeing all month long.