Perimenstrual psychosis among female adolescents: Two case reports and an update of the literature

Daniel Stein, Rachel Blumensohn, Eliezer Witztum

Research output: Contribution to journalArticlepeer-review


Objectives and Methods: Perimenstrual psychosis is an uncommon disorder, not included under the accepted classifications of functional psychoses. Our aim was to describe two Israeli female adolescents who fit this diagnosis. Results: Both youngsters developed an acute psychosis a few days before menstruation, which subsided several days after bleeding, only to reappear in the same form in subsequent cycles. An extensive medical work-up did not show any significant disturbances, with the exception of anovulatory cycles in one youngster. Psychotropic treatment had no effect on the course of the psychosis. Treatment with a combined progesterone/estrogen contraceptive agent in one patient resulted in full recovery within several cycles. The second patient showed a spontaneous remission within four cycles. Follow-up for two to three years indicated a complete remission, with no need to reintroduce any psychotropic agent. Conclusions: Perimenstrual psychosis may represent a cycloid disorder or an atypical affective disorder, associated with anovulation. The use of psychotropic treatment is considered inconclusive, whereas hormonal agents may prove effective.

Original languageEnglish
Pages (from-to)169-179
Number of pages11
JournalInternational Journal of Psychiatry in Medicine
Issue number2
StatePublished - 2003
Externally publishedYes


  • Adolescence
  • Affective disorder
  • Hormonal agents
  • Menstruation
  • Psychosis


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