Evaluation of late onset bipolar illness during menopause.

OBJECTIVE The purpose of this paper is to review the literature on bipolar illness and to discuss its relevance to the evaluation and treatment of bipolar illness during menopause. The hypothesis is that there is a group of patients who may present with commonly reported symptoms of menopause who are in fact, suffering from an underlying bipolar illness. METHOD The literature pertaining to gender differences in bipolar illness as well as the effect of major life events associated with the onset of bipolar illness is closely examined. RESULTS There is enough evidence to support the hypothesis that women in particular are vulnerable to bipolar illness of the rapid cycling type. Exacerbations of a previous existing condition or late-onset bipolar illness may be associated with major stressors and life events such as that experienced during menopause. CONCLUSIONS Gender differences in the course of bipolar illness and the greater prevalence of rapid cycling among bipolar women may in fact be a major consideration in the evaluation and treatment of symptoms during menopause.