Regular periods, but worse symptoms: Women with bipolar disorder may be losing out on gynecological care

by European College of Neuropsychopharmacology

edited by Gaby Clark, reviewed by Robert Egan

Gaby Clark

Scientific Editor

Meet our editorial team
Behind our editorial process

Robert Egan

Senior Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

trusted source

proofread

The GIST Add to Preferred Sources

Researchers have found that women with bipolar disorder who have regular menstrual cycles are more likely to report severe premenstrual symptoms than those with irregular cycles, according to preliminary research being presented at the 2026 ECNP Congress in Munich.

The study, led by researchers in Norway and international collaborators, surveyed 267 women of reproductive age with bipolar disorder. It found that women with regular menstruation (62% of the sample) were more likely than those with irregular menstruation (38% of the sample) to report premenstrual symptoms such as irritability, anger, relationship difficulties, physical symptoms and significant distress or interference with work, activities or relationships during every or almost every premenstrual phase in the last year.

The researchers also found that women with regular cycles were less likely to use hormonal contraceptives than women with irregular cycles. Most of the women in the sample (93%) had tried hormonal contraceptives, but a larger proportion of women with regular menstruation had stopped because of side effects and expressed more reluctance to use hormones.

Lead researcher Dr. Sofie Ragnhild Aminoff (of Oslo University Hospital) said, "This was an unexpected finding and raises important questions about whether some women with bipolar disorder may be especially sensitive to hormonal contraceptives, while others might potentially benefit from them."

Bipolar disorder is a serious mental health condition involving episodes of depression and elevated or irritable mood, as well as periods with no or few symptoms. A majority of women with bipolar disorder experience some kind of premenstrual disturbance (either premenstrual symptoms or premenstrual exacerbations of the bipolar disorder), but reproductive mental health in women with severe mental illness remains an understudied area.

Around 1% to 2% of women have bipolar disorder, meaning that there are approximately 235,000 women with BD who are of childbearing age in a large European country such as the U.K., France or Italy, with even more in Germany.

Aminoff said, "I have met many women with bipolar disorder who described changes in mood, psychotic symptoms or suicidal thoughts varying with their menstrual cycle. These experiences can have a real impact on daily life, but clinicians currently have very limited guidance on how best to help."

She added, "Our main message is that premenstrual symptoms in women with bipolar disorder need to be taken seriously. We need more research and clearer clinical guidelines so that women and the health care system can make better-informed decisions about treatment, contraception and mood-stabilizing medication."

"These findings may have important clinical implications. Many women with bipolar disorder report that their premenstrual symptoms are not taken seriously, and few receive the treatment they need. Assessment of and information about premenstrual symptom burden, alongside tailored hormonal contraception and mood-stabilizing medication, should be standard care, but unfortunately this does not appear to be the case."

The authors stress that the findings are preliminary and come from an online survey, and that the work has not yet been submitted to a peer-reviewed journal.

Aminoff added, "These results highlight the need for closer collaboration between psychiatry and gynecology, and for research that looks not only at mental health symptoms but also at hormonal contraception and reproductive health."

Commenting, professor Louise Howard (professor emerita in women's mental health, King's College London) said, "It is great to see preliminary research into the reproductive health of women with bipolar disorder being presented at this conference. This has been an understudied area for too long, and the relevance of menstrual cycle regularity to symptoms and potential interventions such as hormonal contraception is poorly understood and deserves further investigation."

Dr. Clare Dolman, co-chair of the Bipolar Commission and ambassador for Bipolar UK, added, "I totally agree with Aminoff's take-home message from this research that premenstrual symptoms in women with bipolar disorder need to be taken more seriously. Not only can they exacerbate bipolar symptoms, but sensitivity to hormonal change can be a marker for potentially dangerous relapse at other times such as pregnancy, childbirth and perimenopause. We badly need more research in this area; women's mental health generally has been ignored for too long."

Neither Howard nor Dolman was involved in this work; these are independent comments.

Key medical concepts

Bipolar Disorder

Clinical categories

PsychiatryWomen's healthPsychology & Mental healthObstetrics & gynecologyReproductive health Provided by European College of Neuropsychopharmacology Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

Citation: Regular periods, but worse symptoms: Women with bipolar disorder may be losing out on gynecological care (2026, October 10) retrieved 11 October 2026 from https://medicalxpress.com/news/2026-10-regular-periods-worse-symptoms-women.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.