Polycystic Ovarian Syndrome and Bipolar symptoms

Q: I was surfing for information and came accross your website. I recently have been diagnosed with PCOS "symptoms" by an endocrinologist in my area. What is the liklihood that bi polar and PCOS go hand in hand? I am asking since I have symptoms and not the syndrome. I am 28 years old and started having problems when I was 24-25 yrs old. It took me 2 years to convince my family doctor for a referral. I get severe mood swings, excelerated/coarse hair growth on face/neck, and excessive weight gain which I am unable to lose. Could you please get back to me with info/opinion? I will wait to hear from you...

Dear Jody --
I'm sure you're right there's some sort of connection between these two.  Something roughly like:

  •  if you get PCOS you can get mood instability symptoms that look like "bipolar disorder" but aren't;  or
  • if you have bipolar disorder and get PCOS your bipolar symptoms will get worse or harder to treat. 

I've never worked with a patient who looked like "pure PCOS" with no mood symptoms until some massive weight gain (I've seen plenty of women with that story alone, mind you) whose symptoms could be treated away with metformin (Glucophage), the current recommended treatment for PCOS.  But then I haven't really been using glucophage for very long in this kind of picture -- there could have been at least several such women I just missed for not knowing to look. 

So, if your symptoms resolve with treatment for PCOS, great!  (write me back at [email protected] to tell me about it).  But if they don't, then you might have some underlying bipolar stuff too and would need then to read about bipolar II and proceed with that treatment, avoiding any additional weight gain from medications (no small challenge; but then there is topiramate to consider).  Read up on all that on my website, if you haven't already (www.psycheducation.org , the bipolar II section).

Good question, thanks.

Dr. Phelps

Published January, 2001