Bipolarity is more common in hormonally abnormal women like those with PCOS & hyper-insulinemia. Bipolar disorder involves being mired in a state of depression, then shifting abruptly all the way to mania.

 This isn't a case of moodiness or unstable mood swings, it is excessive stability that switches from one extreme to the other, from all black to all white, without much grayness. Unlike unipolar depression, bipolarity is not more prevalent in women than men. However the women who are vulnerable to bipolarity are more likely to be hormonally abnormal, with insulin resistance and PCOS. Women with PCOS have excessive androgen levels & the excess is erratic, coming in fits & spurts, whereas estradiol may be in short supply or subject to repeated dips. Testing & hormonal modification & stabilization can be extremely helpful in bipolar women. This involves reductions in excessive, erratic testosterone levels & the restoration of the anti-androgenic or counter-androgenic influences of estradiol & progesterone. The anti-estrogenic drug Tamoxifen can head off incipient attacks of mania before they become full-blown and thyroxine in high dosage has a significant anti-manic effect. In contrast the other thyroid hormone T3 & the sex hormones testosterone & DHEA can trigger manic episodes.