Do you observe worsening irritability, mood symptoms, or increased rates of suicidal ideation in patients with Bipolar Disorder who are using hormone birth control including hormone-releasing IUD?

Actually, my experience is the opposite. Many of my patients use OCs or some form of HRT to keep affective lability low. This is true, especially in the perimenopause.

I see benefits of OCP/hormonal IUD's for some patients (theoretically those who tolerate synthetic progesterones better?). I definitely see worsening of mood/anxiety/irritability for OCP's moreso than hormonal IUD's on average, but again, there is huge variation with some doing better with monophasi...