Bipolar Disorder in Women: Menstrual Cycle, Perinatal Period, and Menopause Transition

It is well established that there are gender differences in the presentation and natural history of bipolar disorder. A woman’s reproductive life marks a number of major hormone shifts that we are growing to understand as important to the course and treatment of bipolar disorder. This chapter reviews the course and treatment of bipolar disorder across a woman’s reproductive life – from menstruation to pregnancy to the menopausal transition. There is a focus on current evidence for pharmacologic treatment, and other novel areas are also discussed, including psychoeducation and new information looking at hormone therapy as a potential adjunctive treatment for comorbid premenstrual dysphoric disorder.