OBJECTIVE: Times of rapid decline in reproductive hormones have been associated with mood episode onset, and the menopausal transition confers an increased risk of depression. Mood state in women with bipolar disorder during the rapid decline in reproductive hormones resulting from surgical menopause has not been reported.

METHODS: The case of a 46-year-old woman with bipolar disorder presenting to her psychiatrist after total abdominal hysterectomy with bilateral salpingo-oophorectomy is described.

RESULTS: A manic episode was diagnosed, with onset 10 days after surgical menopause.

CONCLUSIONS: Surgical menopause may place a woman with bipolar disorder at greater risk of mood episodes. In particular, risk of mania must be considered.