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New Study Reveals Link Between Bipolar Disorder and PCOS

A recently published study revealed a connection between bipolar disorder and PCOS (polycystic ovarian syndrome).

The likely factor linking these seemingly disparate conditions is the presence of insulin resistance, affecting both disorders.

Additionally, certain medications, like valproate, contribute to weight gain and heightened insulin resistance, while there are also alterations in signals from the hypothalamic-pituitary axis.

Bipolar Disorder and PCOS: Key points of the study:

  • Untreated bipolar disorder (BD) patients are three times more likely to develop polycystic ovary syndrome (PCOS) compared to healthy controls.
  • Long-term use of valproate in BD patients is associated with a nearly fourfold increase in the likelihood of PCOS.
  • Younger age and higher insulin resistance are linked to the development of PCOS in BD patients.
  • BD patients, whether on medication or not, show higher rates of PCOS, suggesting an association with BD itself.
  • Close monitoring is crucial for BD patients using valproate to detect and manage PCOS effectively.

Bipolar Disorder and PCOS:

Bipolar disorder (BD) is a psychological condition characterized by extreme mood swings, encompassing episodes of elevated energy and euphoria (mania) and periods of deep depression [ref].

It is a disorder influenced by genetic, environmental, and neurobiological factors. Individuals with BD frequently experience disruptions in sleep, energy levels, and cognitive functions.

PCOS, on the other hand, is a metabolic condition affecting young females. It is characterized by:

  • Menstrual irregularities
  • Features of androgen excess (facial hair, frontal baldness, men-like voice), and 
  • Cysts in the ovaries

Bipolar disorder (BD) is a significant mental health condition linked to PCOS. Research indicates that individuals diagnosed with BD are more likely to have PCOS compared to those without a BD diagnosis. [ref].

This stresses the importance of assessing BD patients for possible PCOS symptoms.

In 1993, a study found that individuals with bipolar disorder (BD) showed elevated levels of serum testosterone and serum androstenedione.

Additionally, the occurrence of polycystic ovarian morphology (PCOM) was higher in BD patients. [ref].

These characteristics were similar to those of PCOS, and a 2016 study further highlighted the link by noting that BD patients experience intense mood swings corresponding to fluctuations in hormonal levels, reinforcing the connection to PCOS [ref].

Researchers looked at bipolar disorder (BD) patients who haven’t taken medication, comparing them to healthy individuals and those with long-term BD medication.

They found that drug-naïve BD patients are more likely to have polycystic ovary syndrome (PCOS). Valproate, a medication for BD, is linked to a higher chance of PCOS.

This means medical professionals should closely watch BD patients, especially those using valproate, for PCOS development. Monitoring and investigation are crucial [ref].

This publication from the Journal of Affective Disorders sheds light on how these two conditions can be related on the basis of medication.


Study’s methodology and findings

In this research, scientists studied three groups:

  • 72 people with bipolar disorder (BD) not taking any medicine,
  • 98 healthy individuals, and
  • 72 BD patients using long-term medication.

Furthermore, they checked menstrual cycles, measured hormones, and metabolic indicators, and did pelvic ultrasound tests for each subject.

After looking at things like age and background, they found that BD patients not using medication were more likely to have PCOS compared to healthy individuals.

When they looked at BD patients using valproate medication for a long time, they found a stronger connection with PCOS.

Age, insulin resistance, and use of valproate were factors linked to PCOS in BD patients. This suggests that valproate medication, age, and insulin resistance are connected to developing PCOS in people with bipolar disorder.


Studies Linking PCOS and Bipolar Disorder

The link between these health conditions has been studied for decades, and each study shows a new connection.

A study from 2002 found that women with BD who received valproate had a high chance of being affected by menstrual disturbances and PCOS [ref].

Another study from 2018 concluded that patients with bipolar-affected disorders had a clear link to PCOS without any pharmacotherapy. This can be due to changes in the hypothalamic–pituitary–gonadal axis [ref].

Moreover, individuals with bipolar disorder faced increased chances of experiencing metabolic syndrome, a condition twice as prevalent in those with polycystic ovary syndrome (PCOS) compared to healthy individuals [ref].


Valproate and Bipolar Disorder:

Valproate is a medicine often used to help people with bipolar disorder. It is primarily used as a mood stabilizer in patients with volatile mood swings.

Since BD patients go through periods of very high and energetic moods (mania) and low and sad moods (depression), this drug helps to keep these mood swings more stable [ref], and it works by affecting gamma-aminobutyric acid (GABA) in the brain [ref].

Though the exact mechanism of valproate is uncertain, it appears to affect specific brain chemicals, making it a useful medication for balancing the highs and lows of bipolar disorder.

Valproate induces weight gain, posing a concern for women with PCOS. Notably, weight loss stands as the foremost treatment for the majority of women dealing with PCOS.

It’s important to note that valproate can have side effects, especially posing risks for pregnant individuals due to potential birth defects [ref].

So, before using valproate or any medication for bipolar disorder, it is crucial to talk to a doctor.

They can help decide if the benefits of the medication outweigh any potential risks and ensure the best choice for each person’s situation.


The bottom line

Indeed, there’s a clear link between these conditions. That’s why individuals with either health issue should undergo a thorough assessment for potential symptoms.

The new study is revolutionary in the field of affected disorders and only adds more to the knowledge.

Patients affected by bipolar disorder must be made aware of the possible chances of PCOS diagnosis and how their medications can play a big role in it as well.


What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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