Polycystic ovarian syndrome and bipolar symptoms
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Polycystic ovarian syndrome and bipolar symptoms

Q: We have a 17 yo daughter who is exhibiting all the classic bipolar symptoms. She has as yet not been diagnosed by a psychiatrist as bipolar though our GP thinks this is the case. Last year she had recurring physical problems and blood tests showed an extremely eleveated level of prolactin (2054) also elevated levels of other hormones which may have indicated polycystic ovarian disease. After CT scan to rule out pituatiry tumor and tests to rule out polycystic ovarian disease, no further treatment or follow up tests have been done due to our daughters lack of faith in the medical profession. Could this hormonal 'problem' be symptomatic or causal of bipolar? N.B we are in Australia and our mental health support programs are different and do not appear as well advanced as the USA's in offering support to family and appear to wait until physical danger is imminent or actually occuring before hospitalization can occur for this age group. Thank you for any information you can provide.

Dear Andrew --
I fear you are really correct about some connection between bipolar disorder and polycystic ovarian syndrome (PCO), but just a year or two too soon for a good answer.  I sent you some information about the work of Herzog and colleagues at the Harvard Neuroendocrine program.  Until I heard him talk about his research on epilepsy, showing the profound role that estrogen and progesterone play in modulating temporal lobe activity (and thus susceptibility to seizures there), I was only dimly aware of the importance of these reproductive hormones on bipolar symptoms.

I just repeated my search on PCO and mood: still nothing explicit, but lots of very suggestive articles consistent with my working hypothesis that PCOS as a syndrome is related to some of the forms of "bipolar disorder" I see.  That's why I'm working on a separate website where I can try to present some of these hunches and the data behind them.  That's planned for about 6 months from now ( to be found at hormonesandmood.com when I get to writing it).  Until then, keep your ears open for evidence suggesting a mood effect from the metformin (Glucophage) treatment of PCOS: I've tried it now in one patient and seen a very dramatic improvement, including better enough to try to work some for the first time in years, for a woman with PCOS features and bipolar-like features, where mood stabilizers were somewhat helpful, but nothing like this.  

So, congratulations on your good observing: I hope something more coherent emerges soon in terms of an answer to your question.

Dr. Phelps


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