COURSE OF PSYCHIATRIC-DISORDERS ACROSS THE MENSTRUAL-CYCLE

Women of reproductive age with psychiatric disorders may experience a fluctuating course of illness over the menstrual cycle. Some data sugg est an exacerbation of symptoms during the premenstrual and menstrual phases. She usefulness of such reports is limited, however, by the lac k of prospective assessments and the small. number of patients involve d. Additionally, many reports do not specify whether the exacerbations reflect an intensification of the underlying psychiatric disorder or a new onset of symptoms that occur only during certain phases of the m enstrual cycle. Because symptomatic intensification has been repented for illnesses including schizophrenia, bipolar disorder, depression, a nxiety disorders, bulimia nervosa, and substance abuse, the data bring attention to the importance of assessing the relationship between a f emale patient's symptomatic exacerbation and the menstrual-cycle phase in which it occurs. We present a review of the literature on the cour se of psychiatric symptoms across the menstrual cycle and discuss the potential effects of estrogen and progesterone on these symptoms.