Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder

The Relationship Between Endometriosis and Bipolar Disorder

Key Points

Highlight:

• Uterine activity and psychological health are linked via complex and oxytocin-dependent effects.

Importance :

• Endometriosis and bipolar disorder provide a paradigmatic example of how comorbid diseases can arise from the altered activity of a pleiotropic system.
• The oxytocin system may elucidate the causes of women's increased susceptibility to conditions that involve joint mind-body disturbances.

Hypotehsis :

• The elevated oxytocin activity jointly mediates risk of bipolar disorder and endometriosis in women.

What's done here:

• Describe evidence for higher oxytocinergic activity in both endometriosis and bipolar disorder.
• Review oxytocinergic activity in a pair of conditions, polycystic ovary syndrome (PCOS) and autism, which have opposite characteristics to endometriosis and bipolar disorder.

Data:

• Elevated oxytocinergic activity appears to increase major characteristics of endometriosis and bipolar disorders.
• Women with endometriosis express elevated levels of some bipolar spectrum traits such as impulsiveness (p= 0.09) and transpersonal identification (p = 0.08).
• Autisim and PCOS suggest reduced oxytocinergic activity. 

Limitations:

• Much of the evidence is correlative and indirect.
• The endometriosis and bipolar disorder are mediated by a range of causal factors which are independent of the oxytocinergic system.
• Need to be further clarified in larger samples of women, with appropriate controls for pain, using a broader range of questionnaires

Lay Summary

Despite a Hysteria (from Greek hysterikos, meaning ‘of the womb’) was dismissed as causing mental illness, recent evidence links oxytocin with diverse and correlated psychological and physical symptoms and conditions that more frequently affect women than men. This article proposes the novel hypothesis that elevated oxytocin activity jointly mediates risk of bipolar disorder and endometriosis in women.

The elevated oxytocinergic activity appears to increase uterine movement, interpersonal distress, and relationship anxiety especially in women, which are the significant characteristics of endometriosis and bipolar disorders. Also, the women with endometriosis have significantly increased levels of bipolar spectrum traits; such as impulsiveness and transpersonal identification. Although not all published studies present a significant correlation, one research controlled pain level has shown an increased prevalence of bipolar disorder in endometriosis patients.

Additionally, the reduced oxytocinergic activity in polycystic ovary syndrome (PCOS) and autism, which have opposite characteristics to endometriosis and bipolar disorder, suggests the significance of oxytocin in uterine activity and psychological health.

However, these preliminary trends need to be further clarified in larger samples of women, with appropriate controls for pain, using a broader range of questionnaires that quantify oxytocin-mediated, bipolar spectrum personality features.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/28919554