University of Massachusetts Medical School, Worcester, MA, USA.
Department of Psychiatry, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, 55 Lake Avenue, North, Worcester, MA, 01655, USA.
Curr Psychiatry Rep. 2019 Nov 25;21(12):130. doi: 10.1007/s11920-019-1111-3.
We review recent data on bipolar disorder in menopausal-aged women, particularly in women undergoing the menopausal transition (MT). We discuss evidence on the severity of symptoms in bipolar women during the MT. Moreover, we address two factors in bipolar disorder and menopausal research: standardized menopausal staging and women's conceptualization of their menopausal and bipolar symptoms.
While there are few studies within the last 5 years on bipolar women undergoing the MT, new evidence suggest that mood symptoms in women worsen with progression through the MT. Consistent use of the standardized menopausal staging system can facilitate understanding of the timing of worsening symptoms. Moreover, whether women conceptualize their symptoms as arising from their MT or bipolar disorder can influence whether they seek hormonal therapy or psychiatric treatment, respectively. The MT is a potential time for mood instability in vulnerable women, which can manifest as first-onset development of bipolar disorder or increased symptom severity in women with pre-existing bipolar disorder. Adoption of a standardized menopausal staging may offer novel frameworks for understanding of the role of the MT in bipolar disorder.
我们回顾了绝经年龄女性（尤其是处于绝经过渡期的女性）中双相障碍的最新数据。我们讨论了双相女性在绝经过渡期症状严重程度的证据。此外，我们还探讨了双相障碍和绝经研究中的两个因素：标准化的绝经分期和女性对其绝经和双相症状的概念化。
尽管过去 5 年中关于处于绝经过渡期的双相女性的研究较少，但新证据表明，女性的情绪症状随着绝经过渡期的进展而恶化。一致使用标准化的绝经分期系统有助于理解症状恶化的时间。此外，女性是否将其症状归因于绝经过渡期或双相障碍可能会影响她们分别寻求激素治疗或精神科治疗。绝经过渡期是脆弱女性情绪不稳定的潜在时期，可能表现为首发双相障碍或已有双相障碍女性的症状严重程度增加。采用标准化的绝经分期可能为理解绝经过渡期在双相障碍中的作用提供新的框架。
