How SSRIs Affect Periods

Selective serotonin reuptake inhibitors (SSRIs) are a category of antidepressants that may affect menstrual (period) bleeding, with unintended effects akin to missed periods or heavy bleeding. Examples of common SSRIs are Celexa (citalopram), Prozac (fluoxetine), Lexapro (escitalopram), and Zoloft (sertraline).

Scientists are still determining why and the way SSRIs affect menstruation, but these drugs appear to have an effect on certain hormones.

In this text, learn more about how SSRIs affect periods and the right way to manage these changes.

Effect of SSRIs on Periods

SSRIs can affect your period in various ways; they could cause you to miss periods or have heavier bleeding than usual.

One study found that menstrual disorders were more common amongst individuals who take antidepressants (24.6%) in comparison with individuals who don’t take antidepressants (12.2%).

Delayed or Absent Periods

Some people taking SSRIs may experience delayed or absent periods (amenorrhea).

Both Zoloft, whose primary ingredient is sertraline, and Lexapro, a brand of escitalopram, have been related to amenorrhea. However, a lot of the research on this topic comprises case studies of people, so it is difficult to attract conclusions and appears to be a rare occurrence.

Researchers theorize that antidepressants are linked to amenorrhea on account of the hormone prolactin, which helps regulate the menstrual cycle (amongst other functions).

SSRIs could cause abnormally high levels of prolactin (hyperprolactinemia) and result in amenorrhea. However, the link between antidepressants and amenorrhea on account of prolactin is weak; more research is required.

Heavy Bleeding

You can even experience heavier-than-normal periods on account of SSRIs.

Multiple case studies have linked Prozac, whose primary ingredient is fluoxetine, with heavy menstrual bleeding. In these case reports, latest heavy menstrual bleeding occurred while using fluoxetine but subsided when the medication was discontinued.

Intermenstrual Bleeding

There are also some reports of SSRIs and intermenstrual bleeding (metrorrhagia), which is vaginal bleeding that happens outside the expected period.

One case study of a 34-year-old woman who began Zoloft found that she had sudden, mid-cycle vaginal bleeding on her third day of treatment. Her bleeding stopped inside 24 hours of discontinuing Zoloft.

In one other case study of a 54-year-old woman who was postmenopausal (had undergone menopause, the time during which menstrual periods have stopped for 12 straight months) and commenced Lexapro, she experienced heavy vaginal bleeding for every week, which subsided a number of days after discontinuing Lexapro.

Types of SSRIs Most Likely to Affect Periods

Antidepressants affecting your period is a comparatively unusual occurrence, although additional large-group studies are needed to completely understand its impact, including the risks related to each style of SSRI or serotonin-norepinephrine reuptake inhibitor (SNRI).

The most extensive study to this point on SSRIs and abnormal bleeding was a 2012 study that examined 1,432 women, with a control group and an antidepressant group.

In that study, menstrual disorders were most related to the next antidepressants:

• Paxil
• Effexor XR (venlafaxine)
• Zoloft
• A mix of the above with Remeron (mirtazapine)

Not everyone who takes SSRIs will experience a change of their periods. In the previous study, the incidence of antidepressant-induced menstrual disorders was 14.5%.

Coming Off SSRIs and Menstruation Effects

If you are experiencing abnormal uterine bleeding, seek the advice of together with your prescribing healthcare provider. Coming off SSRIs may help resolve heavy bleeding or amenorrhea, as shown in various case studies.

However, suddenly quitting antidepressants could be dangerous. Always do that under the guidance of a healthcare provider who can offer alternative medications and instruction for the safest solution to lower or discontinue your dosage.

How to Manage SSRI Side Effects

SSRIs have unintended effects beyond affecting menstrual bleeding. These include:

• Anxiety
• Blurred vision
• Diarrhea or constipation
• Dry mouth
• Headache
• Loss of appetite
• Loss of libido
• Nausea
• Sleep problems
• Sweating

Most unintended effects subside after a number of weeks of taking the medication. If you struggle to tolerate unintended effects, work together with your healthcare provider. They may adjust your dosage, the time of day you’re taking your medication, or the medication itself to scale back unintended effects.

Is It My Antidepressant or Something Else?

While it is necessary to contemplate the medication you’re taking and its possible unintended effects, there could also be one other explanation for changes in your periods.

Stress, weight reduction, vitamins or supplements, contraceptive pills or devices, and various conditions, akin to polycystic ovary syndrome (PCOS, during which ovaries produce an abnormally high amount of androgens) and adenomyosis (tissue normally lining the uterus grows into the muscular wall of the uterus), and more, can all affect your periods.

Antidepressants and PMDD

Premenstrual dysphoric disorder is a mood disorder that happens in the course of the two weeks leading as much as your period, referred to as the luteal phase of the menstrual cycle. It is more severe than premenstrual syndrome (PMS), and symptoms include depression, mood swings, hopelessness, irritability, anxiety, and more.

Antidepressants are considered a first-line treatment for PMDD and more severe cases of PMS. Unlike treatment for general depression, antidepressants could be prescribed intermittently for PMDD and PMS. This implies that you’re taking the medication in the course of the luteal phase but not during other phases, and it could actually help reduce unintended effects and withdrawal symptoms.

Summary

Antidepressants have been linked to abnormal uterine bleeding, including missed periods, heavy periods, or bleeding between periods. However, the research on this topic is sparse and primarily limited to case studies. It is, subsequently, difficult to conclude how likely an SSRI is to have this side effect or what sorts of SSRI are more likely than others to have this side effect.

If you’re taking an SSRI and experience menstrual abnormalities, make sure to let your healthcare provider know in order that they could make an appropriate assessment and suggestion.