Menstrual Psychosis - Course

Course

Many cases start early in reproductive life, and it is of great interest that some girls have developed monthly psychoses before the menarche. This phenomenon has also been seen in diabetes, epilepsy, migraine and hypersomnia. Some recover at the first menstrual bleed, but most continue to have a periodic psychosis in timing with the menstrual cycle. Another epoch of increased susceptibility is after childbirth, when the menstrual cycle is starting up again. In some women an established pattern of menstrual episodes has continued, month by month, even though the menses have stopped. Occasional patients have experienced monthly psychoses that occur only during amenorrhoea. There is, however, no evidence of an increase at the menopause.

In most patients, menstrual psychosis is a self-limiting disorder, affecting only a small proportion of the 400 menstrual cycles of a woman's life. Since menstruation is only one of many triggers of bipolar episodes, it is not surprising that some women, at other times of their lives, suffer prolonged manic phases, or a chaotic manic depressive illness, without evidence of a menstrual link.