Yeah, the studies I've read have shown that hormones play a part in exacerbating peri-menopausal symptoms in some women with bipolar, not most. It's a complex issue. Plus it's weighing the risks versus benefits.

When I took bc for heavy periods, my blood pressure rocketed. I did not want to go on bp meds, and I suspected the bc. My doc said it was my weight, but I stopped the bc, and within a month my bp was back to low normal.

HRT can increase the risk of mania and anxiety for some women, but with those concerns in mind, it might be worth a try if symptoms aren't responding to regular treatments.