The onset of puberty is a tough and confusing time for many adolescents, but it was even more so for one unlucky teen in the US who was diagnosed with a suspected rare case of menstrual psychosis.

The teenage girl was hospitalised half a dozen times after experiencing recurrent episodes of acute manic and psychotic symptoms around menarche, doctors reported.

Family history was significant for anxiety and bipolar disorder, while several relatives also had dysphoric mood during menstruation.

During each admission, they noted a consistent pattern of aggression, agitation, labile mood, disorganised thinking and behaviours, hallucinations, poor sleep and paranoia before return to baseline mental status prior to discharge.