7.5 Menopausal Psychosis and Hormone Therapy: Impact of Transitional Periods in Schizophrenia, Bipolar

Renegade Psych

In this segment, Dr. Wood and I reveal what we know about the exacerbation of psychotic symptoms in female patients with known schizophrenia or bipolar disorder during hormonal transitional periods, including menopause, postpartum, and monthly menstrual cycles. It adds to the common sense evidence of the importance of considering the role of estrogen and progesterone (among others) in pre-existing psychiatric illness, and as a primary cause of things like first-episode of psychosis during menopause. We review several studies and discuss the protective role estrogen may play in helping to explain why men have the onset of bipolar and schizophrenia on average 5 years earlier than women. Jenny and I strongly question what we were taught as a somewhat 'magical' second peak of mental illness that also exists in females approaching the menopausal transition, and agree there is likely a better organic cause of exacerbating an underlying predisposition to mental illness, as opposed to suddenly developing it out of the blue. We also talk about how the use of hormones may potentially allow women approaching the age of menopause decrease the amount of antipsychotic and other medication use, and more directly address the cause of the exacerbated mental state. ENJOY!

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