267 women, and the pattern the researchers did not expect to find
What happened
Researchers have found that women with bipolar disorder who have regular monthly periods report worse premenstrual symptoms than those whose periods are irregular. That is the opposite of what the team expected, and it was presented on 10 October 2026 at the 39th European College of Neuropsychopharmacology Congress in Munich. The work was led by Dr Sofie Ragnhild Aminoff of Oslo University Hospital, with colleagues from other countries. They ran an online survey over ten weeks in spring 2025, distributed through the Norwegian Bipolar Association and professional networks. In total, 267 women of reproductive age with bipolar disorder took part. Of those, 166 had regular menstruation and 101 had irregular menstruation. The women with regular cycles made up 62% of the group. They more often reported severe premenstrual symptoms, including irritability, difficulties in relationships and general distress, than the women with irregular cycles. There was a second finding about medicines. Across the whole group, 93% of the women had tried hormonal contraception at some point. But the women with regular cycles were less likely to be using it now. A larger share of them had stopped because of side effects, and they were more reluctant to use hormones again. Dr Aminoff said the finding was unexpected, and that it "raises important questions about whether some women" with bipolar disorder may be especially sensitive to hormonal contraceptives.
Why this matters
Bipolar disorder affects roughly one in every hundred people over a lifetime. A large share of those are women of reproductive age, and many of them take medicines daily for years. The interaction between hormones and mood has been talked about by patients for a very long time. It has been studied much less. That gap was flagged at the congress by two independent experts. Professor Louise Howard of King's College London said the area has been "under-studied for too long". Dr Clare Dolman, of the Bipolar Commission and the charity Bipolar UK, pointed out that hormonal sensitivity "can be a marker for potentially dangerous relapse" at other hormonal times of life, such as pregnancy. That second point is the one with teeth. If a woman reacts strongly to hormonal shifts each month, that may be useful information about how she will fare at other moments when hormones change sharply. Pregnancy and the period after birth are the clearest examples, and they are already known to be high-risk times for people with bipolar disorder. So this is not only about premenstrual symptoms. It is about whether a monthly pattern that a woman already knows about could help her and her clinicians plan ahead.
What the evidence actually says
This is early research and it should be read as such. The findings were presented at a conference. They have not yet been submitted to a peer-reviewed journal, and the researchers themselves describe them as preliminary. The study design also has real limits. It was an online survey, which means everything is self-reported: the women described their own cycles, their own symptoms and their own experience of contraception. Nobody measured hormone levels. Surveys distributed through a patient association also tend to reach people who are more engaged with their condition, which may not represent everyone. And because this is observational, it cannot show which way the arrow points. Women with regular cycles might be more sensitive to hormones. Or women who notice strong monthly symptoms might be more likely to stop hormonal contraception, and stopping might be why their cycles are regular. The study cannot separate those two explanations. What it does show is that in this group of 267 women, a clear pattern existed, and it was not the pattern the researchers predicted. That is worth following up, and that is exactly what Dr Aminoff is arguing for. In her words, "premenstrual symptoms in women with bipolar disorder need to be taken seriously." Nothing in this study says hormonal contraception is unsafe for women with bipolar disorder. It says some women may be more sensitive to it than others, and that we do not yet know who.
Qurexa perspective
Most of what we do is unglamorous: getting the right medicines to the right person on time, month after month. One thing we see is how much of medicine management happens at home, between appointments. A woman tracking her mood against her cycle, deciding whether to carry on with a contraceptive that does not suit her, working out whether this month is worse than last month, is doing clinical work without a clinic. If that is you, two things are genuinely useful. The first is a reliable supply, so you are never making decisions about your medicines because you have run out. The second is a pharmacist. Community pharmacists can talk through side effects and interactions, and they are far easier to reach than a GP appointment. We can help with the first. For the second, please use the pharmacy you already have.
Practical advice
If you have bipolar disorder and you think your cycle affects your mood, the single most useful thing you can do is write it down. Keep a simple record for three months: the date your period starts, and a daily score out of ten for mood, irritability and sleep. Two columns and a date. That is enough. Three months of that turns a vague feeling into evidence. It is also something a psychiatrist or GP can act on in a way they cannot act on "I think it gets worse before my period". If you are considering starting, changing or stopping hormonal contraception, talk to a clinician first rather than stopping on your own. The same goes for mood stabilisers, which should never be stopped suddenly without advice. If you are planning a pregnancy, raise it early. Several medicines used in bipolar disorder need careful planning around pregnancy, and the time to have that conversation is well before conception, not after. And if you want support from people who understand the condition from the inside, Bipolar UK runs peer support services and an eCommunity at bipolaruk.org.
What to know
Preliminary research presented in Munich on 10 October 2026 surveyed 267 women of reproductive age with bipolar disorder. Those with regular periods, 166 of the group, more often reported severe premenstrual symptoms than the 101 with irregular periods. They were also less likely to be using hormonal contraception now, and more often had stopped it because of side effects. This is conference research, not yet peer-reviewed, based on self-reported survey answers. It cannot show cause and effect, and it does not show that hormonal contraception is unsafe in bipolar disorder. If your mood seems to follow your cycle, track it for three months and take that record to your clinician. Do not start, change or stop hormonal contraception or mood medicines without advice. Sources: European College of Neuropsychopharmacology, "Regular periods, but worse symptoms: Women with bipolar disorder losing out on gynaecological care", 10 October 2026, https://www.eurekalert.org/news-releases/1146790 ; 39th ECNP Congress, Munich, 10-13 October 2026, https://www.ecnp.eu/congress2026/ ; Bipolar UK, support and information, https://www.bipolaruk.org/ ; NHS, "Bipolar disorder", https://www.nhs.uk/mental-health/conditions/bipolar-disorder/ This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. Never stop or change prescribed medicine for bipolar disorder without speaking to your clinical team first. If you are in crisis, call 111 or, in an emergency, 999.
Related articles
Six hours, not never: the ICU filter notice the MHRA issued today
The UK's medicines and devices regulator has issued a new safety notice to hospitals, and it is about timing. On 13 October 2026 the Medicines and Healthcare p…
Eight pages to a minister: what the data guardian says trust is worth
On 12 October 2026, the government published a letter about who should be trusted with NHS patient data. It was written by Dr Nicola Byrne, the National Data G…
Update: the tests came back, and it was not plague
This is a follow-up to a story we covered on 5 October, when nearly 200 people were being monitored after the death of a laboratory worker in Siberia. There has…