Reproductive and metabolic abnormalities associated with bipolar disorder and its treatment.
Women with mood disorders, especially bipolar disorder (BD), have been shown to have high rates of reproductive and metabolic dysfunction. The available data on the functional, anatomic, and clinical neuroendocrine abnormalities in women with BD suggest a two-tiered relationship with mood pathology. First, many of the medications commonly used in the treatment of BD can have deleterious effects on blood levels of reproductive hormones and consequently on the hypothalamic-pituitary-gonadal (HPG) axis and reproductive function. Studies that have specifically addressed the association between psychotropic medications and menstrual abnormalities, polycystic ovary syndrome, and overall reproductive endocrine function in women with BD have found high rates of HPG irregularities in women with BD. Second, there is evidence of reproductive dysfunction in women with BD prior to treatment. In addition, many of the psychotropic medications used in the treatment of BD are associated with weight gain, insulin resistance, and dyslipidemia. These metabolic side effects further compound the neuroendocrine system dysregulation in women with BD. Current understanding of the reproductive and metabolic function in women with BD points to vulnerability, which in turn increases the risk of later-life cardiovascular disease and diabetes, among other morbidities, for women with BD.
Center for Neuroscience in Women's Health, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723, USA.
Heather A
HA
Kenna
Bowen
B
Jiang
Natalie L
NL
Rasgon
D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D050171:Dyslipidemias / Q000453:epidemiology* / Q000378:metabolism* / Q000503:physiopathology; D004700:Endocrine System Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D020738:Leptin / Q000378:metabolism; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D008598:Menstruation / Q000187:drug effects*; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
D020738:Leptin; D011619:Psychotropic Drugs; D016651:Lithium Carbonate; D014635:Valproic Acid