How Bipolar Disorder Symptoms Affect Women Uniquely

Bipolar disorder symptoms are similar in females and males, but they may affect women differently. Although bipolar disorder occurs in similar frequency across both genders, studies suggest that there are certain aspects of the condition that affect men and women uniquely. For example, female hormones, along with pregnancy and childbirth, may influence symptoms and treatments, while late-onset bipolar disorder is often associated with menopause. Let’s explore how bipolar disorder symptoms affect women and why there is such variation between the sexes when it comes to this condition.

Bipolar Disorder Symptoms in Females: How Are Women Affected?

Bipolar disorder symptoms in females can differ greatly from the symptoms of bipolar experienced by males. Alongside environmental factors, there are simple biological differences that influence the way the condition manifests and is treated. While it’s easy to think that men and women are in the same boat when it comes to mental health, there is extensive evidence that a woman’s experience with bipolar disorder can be entirely different from a man’s.

Research suggests that in women, hormones play a substantial role in the development and severity of bipolar disorder. Here are some of the ways in which bipolar disorder symptoms are different in women:

• Women with bipolar I disorder are at very high risk for postpartum mania and psychosis, so careful monitoring is required
• Women are more likely to have symptoms of depression than mania
• Women are also more likely to have rapid cycling, which is defined as having four or more episodes of mania or depression per year
• Women with mood disorders experience more severe symptoms of premenstrual syndrome (PMS)
• Women may need to alter medical treatment for bipolar disorder if they are pregnant or trying to conceive. Very few bipolar medications have been tested on pregnant women, for obvious reasons, so the safety of some drugs is still unknown. If you are concerned about becoming pregnant while taking medication for bipolar disorder, ask your doctor for advice. Never stop taking your medication abruptly.

Treatment for Bipolar Disorder Symptoms in Women

Treatment for bipolar disorder symptoms in women depends on the type and severity of symptoms. Women in full bipolar I mania may require hospitalization, for example, while women who experience cyclothymic disorder or bipolar type II (characterized by depression and “hypomania” – a milder form of mania) may find their moods are stabilized by regular bipolar medication. In most cases, long-term treatment is required to manage bipolar symptoms.

Treatment for all types of bipolar disorder usually consists of medication and therapy. Common medications for bipolar disorder symptoms in women include:

• Antipsychotics, such as quetiapine (Seroquel), lurasidone (Latuda), aripiprazole (Abilify), olanzapine (Zyprexa), ziprasidone (Geodon) and risperidone (Risperdal). These medications help with symptoms of mania and are used to prevent psychosis.
• Mood stabilizers, including lithium and lamotrigine. These are used to prevent or delay episodes of mania or hypomania and treat symptoms of depression.

If bipolar disorder symptoms worsen at particular times in your cycle, or during pregnancy or menopause, your doctor may recommend complementary treatment to help you manage the effects of hormonal fluctuations.

Use of Bipolar Medications During Pregnancy

Some medications may not be safe for use in pregnancy, or else your dose may need to be adjusted. It’s important to talk to your doctor if you are currently pregnant or trying to conceive and taking bipolar medications ("Mood Stabilizers in Pregnancy: Are They Safe?").

Doctors usually recommend that treatment be continued during pregnancy but risks to the baby’s health and development are strongly considered.

Generally speaking, doctors prefer prescribing older drugs such as haloperidol (Haldol) and lithium, as well as antidepressants, to manage bipolar symptoms during pregnancy. These drugs not only have a proven track record and but they have more safety data than the newer medications for bipolar disorder.

Some of the newer atypical antipsychotic medications have been studied during pregnancy and at this time have demonstrated no known risks for birth defects or developmental abnormalities. Whereas, some drugs, such as valproic acid (Depakote) and carbamazepine (Tegretol), have been shown to be harmful to babies and contribute to birth defects. If a woman taking valproic acid discovers she is pregnant, the doctor may change her medication or adjust the dosage and prescribe folic acid to help prevent birth defects affecting the development of the baby's brain and spinal cord.

When it comes to carbamazepine during pregnancy, most doctors will not recommend it unless there are no other options. Carbamazepine poses risks to the unborn baby. In addition, it can cause liver failure and a blood disorder in the mother, especially if started after conception.

One other important point to be aware of. Some bipolar medications taken in late pregnancy may cause the baby to experience abnormal muscle movements (twitch-like symptoms) or withdrawal symptoms at birth. The antipsychotic medications to be aware of include: Abilify, Haldol, Risperdal, Seroquel, and Zyprexa.  After birth, most of the time, these symptoms will disappear within a few hours or days. Some babies, however, will have to remain in the hospital for follow-up monitoring and treatment.

As a general rule of thumb, doctors try to limit the amount of medication a developing baby is exposed to during pregnancy. Even though some medications have no known risks to the fetus, it doesn’t mean there aren’t unknown risks. By keeping dosages to a minimum and trying not to add on new drugs, the doctor hopes to limit these unknown risks.

See also "Bipolar Depression Symptoms in Women"

article references