Will perimenopause worsen my wife's bipolar disorder?

Question

Hello doctor,

My ex-wife has bipolar II disorder and mostly struggles with depressive episodes. We share custody of our 12-year-old daughter, and I have noticed she is becoming more withdrawn lately; she is missing her medication and isolating herself. She is also going through perimenopause, which I think could be making things worse.

Could hormonal changes during perimenopause be triggering or worsening her depressive episodes in bipolar disorder? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is clear that you care deeply about your ex-wife and your daughter’s well-being, which is really important.

Yes, hormonal changes during perimenopause (the time before menopause) can affect mood, especially in women with bipolar disorder type II, where depression is more common than mania. As estrogen levels go up and down, it can make mood swings and depressive episodes worse. These hormone shifts can also affect how well her bipolar medications work.

If your ex-wife is also missing her medication and becoming more withdrawn, this can make things more difficult for her emotionally and mentally.

It would be very helpful for her to see both a psychiatrist and a gynecologist. When doctors work together to manage both hormones and mental health, it often leads to better results. Sometimes, adjusting medication or using hormone therapy (if appropriate) can make a big difference.

Encouraging her to stay on track with treatment and reconnect with her healthcare team is a good first step. A family counselor or therapist could also support both of you in co-parenting during this time.

I hope this helps.

Please revert in case of further queries.

Thank you.