I used to have terrible mixed episodes for about 3-4 days prior to getting my period. The agitation would stop when my period started, but then I would feel very emotional, clingy, and almost paranoid for the next couple days. I couldn't take medication for it because I'm already on psych meds. I was eating right, exercising, sleeping well, no drinking, smoking, limited caffeine... nothing worked. It became so debilitating my OB/GYN recommended that I take my oral birth control pills continuously in order to avoid the cycle completely. It was either that or I was going to ask for a hysterectomy, I could not handle feeling suicidal 3-4 days per month. It's been wonderful, no more monthly crazies! I wish I had done this years ago!

FYI - I had to do a lot of research on my own. Neither the medical nor psychiatric community know much about treating mood d/o when they're exacerbated by hormone changes. Unfortunately the only thing I found that worked was to stop my menstrual cycle.