Schizophrenia during Menopausal Transition

This article is a review of three cases of menopausal transition first episode psychosis that occurred at our institution. Possible explanations for this second wave of schizophrenia during the menopausal transition and early menopause may be from hormonal changes, specifically hypoestrogenism, that can be the catalyst in women with an underlying risk for schizophrenia. Other mental illnesses, such as preexisting unipolar depression and bipolar affective disorder can worsen during menopausal transition. Other hypoestrogenic periods, including postpartum and menstruation, have been shown to have increased risk of psychosis onset or symptom exacerbation for some women. This highlights a possible hormonal connection between menopausal transition and schizophrenia onset. Additionally, the physiologic changes that occur during this period, including hot flushes (vasomotor symptoms) and sleep deprivation may be particular stressors that exacerbate mental illness. Possible women’s health interventions may have a particular benefit in women with new onset psychosis during menopausal transition or menopause.