Menstrual psychosis

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Menstrual psychosis is a form of psychosis with a brief, sudden onset related to the menstrual cycle. The symptoms can be dramatic and include delirium, mania or mutism. They generally resolve fully. Most psychiatrists do not recognise the condition. It is rare, with only 80 established cases reported in medical literature. It is thought to be linked with postpartum psychosis.


This is a rare form of severe mental illness, with the following characteristics:[1]

  • Sudden onset in a previously asymptomatic person.
  • Brief duration, with full recovery.
  • Psychotic symptoms that can include confusion or hallucinations, mutism and stupor, delusions, or manic state. These are distinct from premenstrual tension, premenstrual syndrome, premenstrual (late luteal phase) depression or dysphoric disorder or menstrual mood disorder.
  • Occurrence in rhythm with the menstrual cycle.

It shares clinical features with, and presents similarly to, postpartum psychosis.[1] Researchers Deuchar and Brockington proposed that a sudden drop in levels of estrogen in the brain could be the trigger for both conditions.[2]


The condition is rare, with only 80 established cases reported in medical literature and incomplete evidence of a further 200.[1]


Abnormal behaviour linked to menstruation was first noticed in the 19th century and, as early as 1825, menstrual mood disorder was used to acquit a mother convicted of infanticide.[3] The first descriptions of psychosis appeared about 1850.[4] In 1902, forensic psychiatrist and sexologist Richard v. Krafft-Ebing published a monograph with many case descriptions and a temporal classification.[5]


  1. ^ a b c Brockington IF (2011). "Menstrual psychosis: a bipolar disorder with a link to the hypothalamus". Current Psychiatry Reports 13 (3): 93–97. doi:10.1007/s11920-011-0191-5. PMID 21424263. 
  2. ^ Deuchar N, Brockington IF (1998). "Puerperal and menstrual psychoses: the proposal of a unitary etiological hypothesis". J Psychosom Obstet Gynaecol. 19 (2): 104–10. PMID 9638603. 
  3. ^ Hitzig J E (1827)Mord in einem durch Eintreten des Monatsflusses herheifuehrten unfreien Zustande. Zeitschrift fuer Criminal-rechts-pflege in den Preussischen Staaten 12: 239-331.
  4. ^ Brière de Boismont (1851). Recherches bibliographiques et cliniques sur la folie puerpérale, précédées d'un aperçu sur les rapports de la menstruation et de l'aliénation mentale. Annales Médico-psychologiques 2nd series 3: 574-610.
  5. ^ v. Krafft-Ebing R (1902). Psychosis Menstrualis. Eine Klinisch-forensische Studie. Stuttgart, Enke