Gonadal hormones in borderline personality disorder: implications for understanding symptoms and supporting treatment

To review the literature on the impact of gonadal hormones on features of borderline personality disorder.

Oestrogen flux and absolute sex hormone levels are known to be associated with various mood states in women. We investigated whether this was particularly relevant for borderline symptoms in women with or without borderline personality disorder (BPD).

Systematic literature review.

There is some evidence that borderline symptoms are more severe during certain phases on the menstrual cycle in non-clinical samples of women. There is also a small evidence base that suggests that women with BPD show symptom exacerbation during the late luteal phase of their menstrual cycle.

More work is required to establish the nature and mechanisms of interactions between gonadal hormones and symptom expression in BPD patients, and therapeutic endeavours need stringent empirical testing.