Friday, May 17, 2013

Should I Take Hormone Replacement Therapy If I Have Bipolar Disorder?


My advice is, proceed with caution and ask the team who are looking after you.

To get the treatment right for bipolar disorder and find a regime which suits you, may have taken many years. You do not want to upset this delicate balance.

Equally, the symptoms of the menopause can be severe and there is some evidence that the change in hormone levels may make your bipolar disorder worse and you may experience a worsening especially of depression symptoms.

How oestrogen affects you mood is not completely understood, although it does appear that oestrogen tends to make people feel 'brighter'. On the other hand, life events such as children leaving home, divorce, change in social circumstances may be the contributor to your low mood rather than hormone changes.

HRT (hormonal replacement therapy) is synthetic oestrogen +/- synthetic progesterone. Each of these hormones or combinations may have different psychological effects in different people and even the route - whether transdermal (patches and body cream/gel) or tablets have different influences on mood.

Topical oestrogen (cream, gels) can be applied to directly to the vagina, which can help local symptoms of vaginal dryness and urinary problems and it is not absorbed well therefore should not upset your psychological state.

Herbal remedies are often suggested - phytoestrogens (plant-based oestrogen-like compounds) are found in soya, however the effects of either soya supplements or high intakes of soya foods are not available on bipolar disorder. The same goes for red clover and the other herbal remedies, so once again I would suggest you speak to your doctor.

There is very little controlled research on the use of HRT in patients with bipolar disorder, therefore I think it will be hard to predict how your bodies will react to HRT so you need to think carefully.

If you are really well on your medications and your symptoms of hot flushes etc are not that bad, then why upset a good thing! However, if you are experiencing menopausal symptoms or even a worsening in your psychological state, it may be worth a supervised trial.

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