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Abstract
Hippocrates attributed women's high emotionality - hysteria - to a 'wandering womb'.
Although hysteria diagnoses were abandoned along with the notion that displaced wombs
cause emotional disturbance, recent research suggests that elevated levels of oxytocin
occur in both bipolar disorder and endometriosis, a gynecological condition involving
migration of endometrial tissue beyond the uterus. We propose and evaluate the hypothesis
that elevated oxytocinergic system activity jointly contributes to bipolar disorder
and endometriosis. First, we provide relevant background on endometriosis and bipolar
disorder, and then we examine evidence for comorbidity between these conditions. We
next: (1) review oxytocin's associations with personality traits, especially extraversion
and openness, and how they overlap with bipolar spectrum traits; (2) describe evidence
for higher oxytocinergic activity in both endometriosis and bipolar disorder; (3)
examine altered hypothalamic-pituitary-gonadal axis functioning in both conditions;
(4) describe data showing that medications that treat one condition can improve symptoms
of the other; (5) discuss fitness-related impacts of endometriosis and bipolar disorder;
and (6) review a pair of conditions, polycystic ovary syndrome and autism, that show
evidence of involving reduced oxytocinergic activity, in direct contrast to endometriosis
and bipolar disorder. Considered together, the bipolar spectrum and endometriosis
appear to involve dysregulated high extremes of normally adaptive pleiotropy in the
female oxytocin system, whereby elevated levels of oxytocinergic activity coordinate
outgoing sociality with heightened fertility, apparently characterizing, overall,
a faster life history. These findings should prompt a re-examination of how mind-body
interactions, and the pleiotropic endocrine systems that underlie them, contribute
to health and disease.