Although the rate is equal among the genders, women are more likely to develop Bipolar II disorder. While manic episodes are milder than in men, they still alternate with depression. Women are also at higher risk for rapid cycling of symptoms, which some believe may be linked to fluctuations in reproductive hormones, or the activity of the thyroid gland. Women are more frequently misdiagnosed as having depression only, and then prescribed antidepressant medication. This often exacerbates the rapid cycling of symptoms.
The hormonal changes of perimenopause and menopause frequently worsen symptoms of bipolar disorder, and hormone therapy might help. Additionally, changes in medication regimens may become necessary during this time to offset the influence of hormonal disruptions.