Chronic mental illness and the menstrual cycle

The purpose of this study was to explore the relationship between chronic mental illness, menstrual cycle phases, and psychiatric hospitalization. A detailed menstrual history was obtained from each participating subject. Women who were pregnant, postmenopausal, or who were prescribed hormonal contraception were excluded from the study. Factors precipitating admission, such as a suicide attempt, were identified. All women had a documented history of chronic mental illness, defined in this study as two prior psychiatric hospitalizations. Based on the menstrual history, the phase of the women's cycle at time of hospitalization was calculated. Diagnoses and the reasons for admission were correlated with the menstrual cycle phase. Thirty-three women participated in the study. Seventeen (52%) of those women were admitted during the late luteal/early menstrual phase. Women with schizophrenia whose behavior precipitating the admission was characterized as nonsuicidal and nonaggressive were admitted exclusively during the postovulatory phase. On the basis of findings of this study, the authors conclude that the postovulatory phase of the menstrual cycle may be a time of increased risk for women with chronic mental illness, especially schizophrenia. Prophylactic interventions might minimize admissions.