Clinical Course of Bipolar Disorder During the Menopausal Transition: Comparison with Reproductive Age and Post Menopausal Women: A Master's Thesis

Introduction: The late menopausal transition is a time of increased risk of depression in the general population. Nonetheless, mood course during the late menopausal transition in women with bipolar disorder in relatively unknown. Methods: Mood state data in 519 reproductive age women (5989 clinic visits), 116 late menopausal transition (perimenopausal) women (2046 visits), and 133 postmenopausal women (1,437 visits) with bipolar disorder who were receiving optimized naturalistic treatment in the multisite STEP-BD study over an average of 19.8±15.5 months were analyzed for proportion of clinic visits with syndromal depression, mood elevation and euthymia between the three groups. History of postpartum and perimenstrual mood exacerbation as well as hormone therapy use were evaluated as potential predictors of mood. Results: No significant difference in the proportion of clinic visits with syndromal depression was found between reproductive age (18.1%), perimenopausal (18.1%) and postmenopausal (19.3%) women. Reproductive age women had significantly greater proportion of visits with syndromal mood elevation (5.3%) compared to perimenopausal (4.1%, Z=2.1, p<0.05) and postmenopausal (3.0%, Z=4.1, p<0.001) women. Reproductive age women also had significantly greater proportion of clinic visits in a euthymic state (29.2%) compared to postmenopausal (26.0%, Z=2.7,p<0.01) and non-signifcantly greater than perimenopausal (28.0%). Thirteen women who transitioned from perimenopause