---
title: Can mood symptoms like mania and psychosis change across the menstrual cycle in bipolar disorder?
description: In one detailed case, yes: a woman with bipolar I disorder had psychosis-like symptoms when estrogen was low and hypomania when estrogen was high, and a targe
url: https://niyora.com/research/papers/protection-against-hormone-mediated-mood-symptoms-2017/
---

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- Can mood symptoms like mania and psychosis change across the menstrual cycle in bipolar disorder?

Case report, 2017

# Can mood symptoms like mania and psychosis change across the menstrual cycle in bipolar disorder?

In one detailed case, yes: a woman with bipolar I disorder had psychosis-like symptoms when estrogen was low and hypomania when estrogen was high, and a targeted treatment approach for this pattern worked for her.

 Early or limited evidence

One woman with bipolar I disorder and severe premenstrual mood symptoms.

## What they did

This is a single case report. Doctors described one woman with bipolar I disorder who had severe mood symptoms that changed with her menstrual cycle, and they tried a treatment aimed at this pattern.

## What they found

When estrogen was expected to be low, she had mood instability, confusion, and psychosis-like symptoms similar to postpartum psychosis. When estrogen was expected to be high, she had hypomania instead. The treatment approach aimed at her cycle-related symptoms worked.

## What it means for you

This suggests that for some women, bipolar-related mood symptoms may be tied to hormone changes across the cycle, and that treatment aimed at this pattern can help. Because this is only one woman's experience, it cannot show whether this would work for other women, and no larger controlled studies have tested this approach.

1

women described in this case

## About the study

Original title Protection against hormone-mediated mood symptoms Authors Susser LC, Hermann AD Journal Archives of women's mental health Year 2017 Study design Case report What was tested A treatment approach aimed at her menstrual-cycle related mood symptoms. Read the paper [doi.org/10.1007/s00737-016-0702-9](https://doi.org/10.1007/s00737-016-0702-9)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Menstrual psychosis](https://niyora.com/research/topics/condition-menstrual-psychosis/)[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/)

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Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

## Related studies

Case report, 2013

Can severe mood changes around a period be an early sign of bipolar disorder?

Study, 2024

Can PMDD cause psychosis that returns with each menstrual cycle?

Cohort study, 2023

Are PMS symptoms linked to genetic factors for psychiatric disorders?

Systematic review, 2022

Do mental health disorders get worse during the menstrual cycle?

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?

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