Lay Summary

Is the perimenopause a time of increased risk of recurrence in women with a history of bipolar affective postpartum psychosis? Blackmore et al. (2008) AWMH 11, 75-78

It has been suggested that some women susceptible to postpartum psychosis (PP) may be vulnerable to episodes of illness at other times of major hormonal fluctuation.  These times include menarche (onset of periods), pre-menstrually, and during the perimenopause (the time from the onset of menopausal symptoms, such as hot flushes and irregular periods, until the menopause itself).  This theory was investigated by studying the perimenopause of women with a history of PP.

Seventeen postmenopausal women who had previously experienced at least one episode of PP were interviewed.  Of these women, five (about 30%) reported experiencing an affective episode that they linked with the perimenopause.  It was striking that four of the five women had remained well during the years between childbirth and the perimenpause, and that two of the women had episodes triggered by hysterectomy and ovariectomy (which may lead to a more sudden change in hormonal status than a normal menopause).

 Although only a few women were interviewed, the study supports the possibility that the perimenopause is a period of risk for women who have suffered PP.  Further studies are needed to explore the potential risk period more fully.