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Researchers have found that women with bipolar disorder who have regular menstrual cycles are more likely to report severe premenstrual symptoms than those with irregular cycles, according to preliminary research being presented at the 2026 ECNP Congress in Munich.

The study, led by researchers in Norway and international collaborators, surveyed 267 women of reproductive age with bipolar disorder. It found that women with regular menstruation (62% of the sample) were more likely than those with irregular menstruation (38% of the sample) to report premenstrual symptoms such as irritability, anger, relationship difficulties, physical symptoms and significant distress or interference with work, activities or relationships during every or almost every premenstrual phase in the last year.

The researchers also found that women with regular cycles were less likely to use hormonal contraceptives than women with irregular cycles. Most of the women in the sample (93%) had tried hormonal contraceptives, but a larger proportion of women with regular menstruation had stopped because of side effects and expressed more reluctance to use hormones.

Lead researcher Dr. Sofie Ragnhild Aminoff (of Oslo University Hospital) said, "This was an unexpected finding and raises important questions about whether some women with bipolar disorder may be especially sensitive to hormonal contraceptives, while others might potentially benefit from them."

Bipolar disorder is a serious mental health condition involving episodes of depression and elevated or irritable mood, as well as periods with no or few symptoms.

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