Dear Dr. Phelps,

I have read a question on this site which made me want to add my comments.  The question was one regarding a possible relationship between bipolar disorder and polycystic ovarian syndrome.

I was diagnosed at age 18 with PCOs (only got my period once age 15 1/2 without the use of birth control, and never fully developed until after I went on the pill.)  I was depressed during summers between college, and finally dropped out my senior year, when I was diagnosed with bipolar II disorder (anorexia was also prevalent).

I am now 27, and have been struggling this past year with finding a medication which helps me.  (I was on Paxil/clonapin for 2 1/2 years, but that pooped out August 2001.) I have been on about 10 different medications since November 2001, and have not been successful finding one that works.  I am seeing an endocronologist on October 9 (to see if there is any thyroidal disturbance contributing to my depression), and I would like to propose to him that there may be a link between my PCO and my bipolar illness.  Do you have any information supporting this, or could you point me in the right direction?  Also, do you know of any other treatment besides birth control which can help treat PCOs? And would it help treat my treatment resistant bipolar illness?

Sincerely,
Tori
 

Dear Tori -- 
Everything I've learned so far about PCOS and mood symptoms in general is summarized in my Hormones and Mood section of my website; I will be updating that as psychiatry learns more about this connection.  Read the section on "metabolic syndrome", of which PCOS is thought to be one version.  Will treating PCOS help your bipolar disorder?  Very good question.  The answer isn't in yet, in fact research on this has just begun.  My hunch is yes, but it doesn't seem to work for as many people with PCOS-like symptoms as I would expect it to; about 1 in 6 in the folks I've started on Glucophage (about which you'll be reading; generic name is metformin) so far.  

Dr. Phelps