Table of ContentsView AllTable of ContentsSSRIs and PeriodsWhich Affect Periods More?Tapering Off of SSRIsSide EffectsOther FactorsAntidepressants and PMDD

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Table of Contents

SSRIs and Periods

Which Affect Periods More?

Tapering Off of SSRIs

Side Effects

Other Factors

Antidepressants and PMDD

Selective serotonin reuptake inhibitors(SSRIs) are a class of antidepressants that can affect menstrual (period) bleeding, with side effects such as 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 how SSRIs affect menstruation, but these drugs appear to have an impact on certain hormones.In this article, learn more about howSSRIsaffect periods and how to manage these changes.Filmstax / Getty ImagesWhat Can Affect Your PeriodEffect of SSRIs on PeriodsSSRIs can affect your period in various ways; they can cause you to miss periods or have heavier bleeding than usual.One study found that menstrual disorders were more common among people who take antidepressants (24.6%) compared to people who do not take antidepressants (12.2%).Delayed or Absent PeriodsSome people taking SSRIs may experience delayed or absent periods (amenorrhea).Both Zoloft, whose main ingredient is sertraline, andLexapro, a brand of escitalopram, have been associated with amenorrhea.However, most of the research on this topic comprises case studies of individuals, so it is hard to draw conclusions and seems to be a rare occurrence.Researchers theorize that antidepressants are linked to amenorrhea due to the hormoneprolactin, which helps regulate the menstrual cycle (among other functions).SSRIs can cause abnormally high levels of prolactin (hyperprolactinemia) and lead to amenorrhea.However, the link between antidepressants and amenorrhea due to prolactin is weak; more research is needed.Heavy BleedingYou can also experience heavier-than-normal periods due to SSRIs.Multiple case studies have linkedProzac, whose main ingredient is fluoxetine, with heavy menstrual bleeding.In these case reports, new heavy menstrual bleeding occurred while using fluoxetine but subsided when the medication was discontinued.Intermenstrual BleedingThere are also some reports of SSRIs and intermenstrual bleeding (metrorrhagia), which is vaginal bleeding that occurs outside the expected period.One case study of a 34-year-old woman who started Zoloft found that she had sudden, mid-cycle vaginal bleeding on her third day of treatment.Her bleeding stopped within 24 hours of discontinuing Zoloft.In another case study of a 54-year-old woman who was postmenopausal (had gone through menopause, the time in which menstrual periods have stopped for 12 straight months) and started Lexapro, she experienced heavy vaginal bleeding for a week, which subsided a few days after discontinuing Lexapro.Types of SSRIs Most Likely to Affect PeriodsAntidepressants affecting your period is a relatively uncommon occurrence, although additional large-group studies are needed to fully understand its impact, including the risks associated with each type of SSRI orserotonin-norepinephrine reuptake inhibitor(SNRI).The most extensive study to date 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 associated with the followingantidepressants:PaxilEffexor XR (venlafaxine)ZoloftA combination of the above with Remeron (mirtazapine)Not everyone who takes SSRIs will experience a change in their periods. In the previous study, the incidence of antidepressant-induced menstrual disorders was 14.5%.Coming Off SSRIs and Menstruation EffectsIf you’re experiencing abnormal uterine bleeding, consult 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 can be dangerous.Always do this under the guidance of a healthcare provider who can offer alternative medications and instruction for the safest way to lower or discontinue your dosage.Seek Help for DepressionIf you think you may be in a position to harm yourself or someone else, call911or your local emergency number ASAP. There are also several treatment resources and support groups that can be sought through theSubstance Abuse and Mental Health Services Administration(SAMHSA) National Hotline at800-662-HELP (4357).If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.How to Manage SSRI Side EffectsSSRIs have side effects beyond affecting menstrual bleeding. These include:AnxietyBlurred visionDiarrhea or constipationDry mouthHeadacheLoss of appetiteLoss of libidoNauseaSleep problemsSweatingMost side effects subside after a few weeks of taking the medication.If you struggle to tolerate side effects, work with your healthcare provider. They may adjust your dosage, the time of day you take your medication, or the medication itself to reduce side effects.Benefits vs. DrawbacksWhen dealing with side effects from SSRIs, it’s important to consider the benefits and drawbacks of what led you to take the medication in the first place. Some people take SSRIs to cope withpremenstrual dysphoric disorder(PMDD) or other female reproductive conditions such asendometriosis.Is It My Antidepressant or Something Else?While it is important to consider the medication you take and its possible side effects, there may be another cause of changes in your periods.Stress, weight loss, vitamins or supplements, contraceptive pills or devices, and various conditions, such aspolycystic ovary syndrome(PCOS, in which ovaries produce an abnormally high amount of androgens) andadenomyosis(tissue normally lining the uterus grows into the muscular wall of the uterus), and more, can all affect your periods.Antidepressants and PMDDPremenstrual dysphoric disorder is a mood disorder that occurs during the two weeks leading up to your period, known as theluteal phaseof the menstrual cycle. It ismore 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 can be prescribed intermittently for PMDD and PMS.This means that you take the medication during the luteal phase but not during other phases, and it can help reduce side effects and withdrawal symptoms.SummaryAntidepressants 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, therefore, difficult to conclude how likely an SSRI is to have this side effect or what types of SSRI are more likely than others to have this side effect.If you are taking an SSRI and experience menstrual abnormalities, be sure to let your healthcare provider know so they can make an appropriate assessment and recommendation.

Selective serotonin reuptake inhibitors(SSRIs) are a class of antidepressants that can affect menstrual (period) bleeding, with side effects such as 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 how SSRIs affect menstruation, but these drugs appear to have an impact on certain hormones.

In this article, learn more about howSSRIsaffect periods and how to manage these changes.

Filmstax / Getty Images

Young Asian woman reading medical instructions before taking medicine.

What Can Affect Your Period

Effect of SSRIs on Periods

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

One study found that menstrual disorders were more common among people who take antidepressants (24.6%) compared to people who do not take antidepressants (12.2%).

Delayed or Absent Periods

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

Both Zoloft, whose main ingredient is sertraline, andLexapro, a brand of escitalopram, have been associated with amenorrhea.However, most of the research on this topic comprises case studies of individuals, so it is hard to draw conclusions and seems to be a rare occurrence.

Researchers theorize that antidepressants are linked to amenorrhea due to the hormoneprolactin, which helps regulate the menstrual cycle (among other functions).

SSRIs can cause abnormally high levels of prolactin (hyperprolactinemia) and lead to amenorrhea.However, the link between antidepressants and amenorrhea due to prolactin is weak; more research is needed.

Heavy Bleeding

You can also experience heavier-than-normal periods due to SSRIs.

Multiple case studies have linkedProzac, whose main ingredient is fluoxetine, with heavy menstrual bleeding.In these case reports, new 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 occurs outside the expected period.

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

In another case study of a 54-year-old woman who was postmenopausal (had gone through menopause, the time in which menstrual periods have stopped for 12 straight months) and started Lexapro, she experienced heavy vaginal bleeding for a week, which subsided a few days after discontinuing Lexapro.

Types of SSRIs Most Likely to Affect Periods

Antidepressants affecting your period is a relatively uncommon occurrence, although additional large-group studies are needed to fully understand its impact, including the risks associated with each type of SSRI orserotonin-norepinephrine reuptake inhibitor(SNRI).

The most extensive study to date 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 associated with the followingantidepressants:

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

Coming Off SSRIs and Menstruation Effects

If you’re experiencing abnormal uterine bleeding, consult 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 can be dangerous.Always do this under the guidance of a healthcare provider who can offer alternative medications and instruction for the safest way to lower or discontinue your dosage.

Seek Help for DepressionIf you think you may be in a position to harm yourself or someone else, call911or your local emergency number ASAP. There are also several treatment resources and support groups that can be sought through theSubstance Abuse and Mental Health Services Administration(SAMHSA) National Hotline at800-662-HELP (4357).If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.

Seek Help for Depression

If you think you may be in a position to harm yourself or someone else, call911or your local emergency number ASAP. There are also several treatment resources and support groups that can be sought through theSubstance Abuse and Mental Health Services Administration(SAMHSA) National Hotline at800-662-HELP (4357).If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.

If you think you may be in a position to harm yourself or someone else, call911or your local emergency number ASAP. There are also several treatment resources and support groups that can be sought through theSubstance Abuse and Mental Health Services Administration(SAMHSA) National Hotline at800-662-HELP (4357).

If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.

How to Manage SSRI Side Effects

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

Most side effects subside after a few weeks of taking the medication.If you struggle to tolerate side effects, work with your healthcare provider. They may adjust your dosage, the time of day you take your medication, or the medication itself to reduce side effects.

Benefits vs. DrawbacksWhen dealing with side effects from SSRIs, it’s important to consider the benefits and drawbacks of what led you to take the medication in the first place. Some people take SSRIs to cope withpremenstrual dysphoric disorder(PMDD) or other female reproductive conditions such asendometriosis.

Benefits vs. Drawbacks

When dealing with side effects from SSRIs, it’s important to consider the benefits and drawbacks of what led you to take the medication in the first place. Some people take SSRIs to cope withpremenstrual dysphoric disorder(PMDD) or other female reproductive conditions such asendometriosis.

Is It My Antidepressant or Something Else?

While it is important to consider the medication you take and its possible side effects, there may be another cause of changes in your periods.

Stress, weight loss, vitamins or supplements, contraceptive pills or devices, and various conditions, such aspolycystic ovary syndrome(PCOS, in which ovaries produce an abnormally high amount of androgens) andadenomyosis(tissue normally lining the uterus grows into the muscular wall of the uterus), and more, can all affect your periods.

Premenstrual dysphoric disorder is a mood disorder that occurs during the two weeks leading up to your period, known as theluteal phaseof the menstrual cycle. It ismore 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 can be prescribed intermittently for PMDD and PMS.This means that you take the medication during the luteal phase but not during other phases, and it can help reduce side 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, therefore, difficult to conclude how likely an SSRI is to have this side effect or what types of SSRI are more likely than others to have this side effect.

If you are taking an SSRI and experience menstrual abnormalities, be sure to let your healthcare provider know so they can make an appropriate assessment and recommendation.

16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Health Service.Overview - selective serotonin reuptake inhibitors (ssris). December 8, 2021.U.S. Food & Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information. 12/23/2014.Uguz F, Sahingoz M, Kose SA, et al.Antidepressants and menstruation disorders in women: a cross-sectional study in three centers.Gen Hosp Psychiatry. 2012;34(5):529-533. doi:10.1016/j.genhosppsych.2012.03.014Selvaraj V, Hour S, Gunasekar P, Gray C, Smith JF.Escitalopram-induced amenorrhea and false positive urine pregnancy test.Korean J Fam Med. 2017;38(1):40-42. doi:10.4082/kjfm.2017.38.1.40Ekinci N, Güneş S, Kalinli M, Ekinci Ö.Sertraline-related amenorrhea in an adolescent.Clin Neuropharmacol. 2019;42(3):99-100. doi:10.1097/wnf.0000000000000336Park YM.Serum prolactin levels in patients with major depressive disorder receiving selective serotonin-reuptake inhibitor monotherapy for 3 months: a prospective study.Psychiatry Investig. 2017;14(3):368-371. doi:10.4306%2Fpi.2017.14.3.368Fourman LT, Fazeli PK.Neuroendocrine causes of amenorrhea—an update.The Journal of Clinical Endocrinology & Metabolism. 2015;100(3):812-824. doi: 10.1210/jc.2014-3344Zhuo C, Chen G, Lin C, et al.Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder.Front Psychiatry. 2022;13:1012644. doi:10.3389/fpsyt.2022.1012644Türkoğlu S, Türkoğlu G.Vaginal bleeding and hemorrhagic prepatellar bursitis in a preadolescent girl, possibly related to fluoxetine.Journal of Child and Adolescent Psychopharmacology. 2015;25(2):186-187. doi:10.1089/cap.2014.0124Shaheen M.Fluoxetine induced menorrhagia.BJPsych Open. 2023;9(Suppl 1):S128. doi:10.1192%2Fbjo.2023.358Asan Ö, Göka E.Intermenstrual vaginal bleeding due to sertraline treatment, a case report and review of the literature.PBS. 2019;(0):1. doi:10.5455/PBS.20181006062238Yadav A, Bharat BS, Montrose S.Abnormal uterine bleed in a postmenopausal woman with the use of escitalopram.Cureus. 2022;14(3). doi:10.7759%2Fcureus.23432National Health Service.Stopping or coming off antidepressants. August 3, 2021.National Health Service.Side effects - selective serotonin reuptake inhibitors (ssris). December 8, 2021.Reilly TJ, Wallman P, Clark I, Knox CL, Craig MC, Taylor D.Intermittent selective serotonin reuptake inhibitors for premenstrual syndromes: a systematic review and meta-analysis of randomised trials.J Psychopharmacol. 2023;37(3):261-267. doi:10.1177%2F02698811221099645Marjoribanks J, Brown J, O’Brien PMS, Wyatt K.Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Gynaecology and Fertility Group, ed.Cochrane Database of Systematic Reviews. 2013. doi:10.1002/14651858.CD001396.pub3

16 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Health Service.Overview - selective serotonin reuptake inhibitors (ssris). December 8, 2021.U.S. Food & Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information. 12/23/2014.Uguz F, Sahingoz M, Kose SA, et al.Antidepressants and menstruation disorders in women: a cross-sectional study in three centers.Gen Hosp Psychiatry. 2012;34(5):529-533. doi:10.1016/j.genhosppsych.2012.03.014Selvaraj V, Hour S, Gunasekar P, Gray C, Smith JF.Escitalopram-induced amenorrhea and false positive urine pregnancy test.Korean J Fam Med. 2017;38(1):40-42. doi:10.4082/kjfm.2017.38.1.40Ekinci N, Güneş S, Kalinli M, Ekinci Ö.Sertraline-related amenorrhea in an adolescent.Clin Neuropharmacol. 2019;42(3):99-100. doi:10.1097/wnf.0000000000000336Park YM.Serum prolactin levels in patients with major depressive disorder receiving selective serotonin-reuptake inhibitor monotherapy for 3 months: a prospective study.Psychiatry Investig. 2017;14(3):368-371. doi:10.4306%2Fpi.2017.14.3.368Fourman LT, Fazeli PK.Neuroendocrine causes of amenorrhea—an update.The Journal of Clinical Endocrinology & Metabolism. 2015;100(3):812-824. doi: 10.1210/jc.2014-3344Zhuo C, Chen G, Lin C, et al.Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder.Front Psychiatry. 2022;13:1012644. doi:10.3389/fpsyt.2022.1012644Türkoğlu S, Türkoğlu G.Vaginal bleeding and hemorrhagic prepatellar bursitis in a preadolescent girl, possibly related to fluoxetine.Journal of Child and Adolescent Psychopharmacology. 2015;25(2):186-187. doi:10.1089/cap.2014.0124Shaheen M.Fluoxetine induced menorrhagia.BJPsych Open. 2023;9(Suppl 1):S128. doi:10.1192%2Fbjo.2023.358Asan Ö, Göka E.Intermenstrual vaginal bleeding due to sertraline treatment, a case report and review of the literature.PBS. 2019;(0):1. doi:10.5455/PBS.20181006062238Yadav A, Bharat BS, Montrose S.Abnormal uterine bleed in a postmenopausal woman with the use of escitalopram.Cureus. 2022;14(3). doi:10.7759%2Fcureus.23432National Health Service.Stopping or coming off antidepressants. August 3, 2021.National Health Service.Side effects - selective serotonin reuptake inhibitors (ssris). December 8, 2021.Reilly TJ, Wallman P, Clark I, Knox CL, Craig MC, Taylor D.Intermittent selective serotonin reuptake inhibitors for premenstrual syndromes: a systematic review and meta-analysis of randomised trials.J Psychopharmacol. 2023;37(3):261-267. doi:10.1177%2F02698811221099645Marjoribanks J, Brown J, O’Brien PMS, Wyatt K.Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Gynaecology and Fertility Group, ed.Cochrane Database of Systematic Reviews. 2013. doi:10.1002/14651858.CD001396.pub3

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Health Service.Overview - selective serotonin reuptake inhibitors (ssris). December 8, 2021.U.S. Food & Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information. 12/23/2014.Uguz F, Sahingoz M, Kose SA, et al.Antidepressants and menstruation disorders in women: a cross-sectional study in three centers.Gen Hosp Psychiatry. 2012;34(5):529-533. doi:10.1016/j.genhosppsych.2012.03.014Selvaraj V, Hour S, Gunasekar P, Gray C, Smith JF.Escitalopram-induced amenorrhea and false positive urine pregnancy test.Korean J Fam Med. 2017;38(1):40-42. doi:10.4082/kjfm.2017.38.1.40Ekinci N, Güneş S, Kalinli M, Ekinci Ö.Sertraline-related amenorrhea in an adolescent.Clin Neuropharmacol. 2019;42(3):99-100. doi:10.1097/wnf.0000000000000336Park YM.Serum prolactin levels in patients with major depressive disorder receiving selective serotonin-reuptake inhibitor monotherapy for 3 months: a prospective study.Psychiatry Investig. 2017;14(3):368-371. doi:10.4306%2Fpi.2017.14.3.368Fourman LT, Fazeli PK.Neuroendocrine causes of amenorrhea—an update.The Journal of Clinical Endocrinology & Metabolism. 2015;100(3):812-824. doi: 10.1210/jc.2014-3344Zhuo C, Chen G, Lin C, et al.Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder.Front Psychiatry. 2022;13:1012644. doi:10.3389/fpsyt.2022.1012644Türkoğlu S, Türkoğlu G.Vaginal bleeding and hemorrhagic prepatellar bursitis in a preadolescent girl, possibly related to fluoxetine.Journal of Child and Adolescent Psychopharmacology. 2015;25(2):186-187. doi:10.1089/cap.2014.0124Shaheen M.Fluoxetine induced menorrhagia.BJPsych Open. 2023;9(Suppl 1):S128. doi:10.1192%2Fbjo.2023.358Asan Ö, Göka E.Intermenstrual vaginal bleeding due to sertraline treatment, a case report and review of the literature.PBS. 2019;(0):1. doi:10.5455/PBS.20181006062238Yadav A, Bharat BS, Montrose S.Abnormal uterine bleed in a postmenopausal woman with the use of escitalopram.Cureus. 2022;14(3). doi:10.7759%2Fcureus.23432National Health Service.Stopping or coming off antidepressants. August 3, 2021.National Health Service.Side effects - selective serotonin reuptake inhibitors (ssris). December 8, 2021.Reilly TJ, Wallman P, Clark I, Knox CL, Craig MC, Taylor D.Intermittent selective serotonin reuptake inhibitors for premenstrual syndromes: a systematic review and meta-analysis of randomised trials.J Psychopharmacol. 2023;37(3):261-267. doi:10.1177%2F02698811221099645Marjoribanks J, Brown J, O’Brien PMS, Wyatt K.Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Gynaecology and Fertility Group, ed.Cochrane Database of Systematic Reviews. 2013. doi:10.1002/14651858.CD001396.pub3

National Health Service.Overview - selective serotonin reuptake inhibitors (ssris). December 8, 2021.

U.S. Food & Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information. 12/23/2014.

Uguz F, Sahingoz M, Kose SA, et al.Antidepressants and menstruation disorders in women: a cross-sectional study in three centers.Gen Hosp Psychiatry. 2012;34(5):529-533. doi:10.1016/j.genhosppsych.2012.03.014

Selvaraj V, Hour S, Gunasekar P, Gray C, Smith JF.Escitalopram-induced amenorrhea and false positive urine pregnancy test.Korean J Fam Med. 2017;38(1):40-42. doi:10.4082/kjfm.2017.38.1.40

Ekinci N, Güneş S, Kalinli M, Ekinci Ö.Sertraline-related amenorrhea in an adolescent.Clin Neuropharmacol. 2019;42(3):99-100. doi:10.1097/wnf.0000000000000336

Park YM.Serum prolactin levels in patients with major depressive disorder receiving selective serotonin-reuptake inhibitor monotherapy for 3 months: a prospective study.Psychiatry Investig. 2017;14(3):368-371. doi:10.4306%2Fpi.2017.14.3.368

Fourman LT, Fazeli PK.Neuroendocrine causes of amenorrhea—an update.The Journal of Clinical Endocrinology & Metabolism. 2015;100(3):812-824. doi: 10.1210/jc.2014-3344

Zhuo C, Chen G, Lin C, et al.Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder.Front Psychiatry. 2022;13:1012644. doi:10.3389/fpsyt.2022.1012644

Türkoğlu S, Türkoğlu G.Vaginal bleeding and hemorrhagic prepatellar bursitis in a preadolescent girl, possibly related to fluoxetine.Journal of Child and Adolescent Psychopharmacology. 2015;25(2):186-187. doi:10.1089/cap.2014.0124

Shaheen M.Fluoxetine induced menorrhagia.BJPsych Open. 2023;9(Suppl 1):S128. doi:10.1192%2Fbjo.2023.358

Asan Ö, Göka E.Intermenstrual vaginal bleeding due to sertraline treatment, a case report and review of the literature.PBS. 2019;(0):1. doi:10.5455/PBS.20181006062238

Yadav A, Bharat BS, Montrose S.Abnormal uterine bleed in a postmenopausal woman with the use of escitalopram.Cureus. 2022;14(3). doi:10.7759%2Fcureus.23432

National Health Service.Stopping or coming off antidepressants. August 3, 2021.

National Health Service.Side effects - selective serotonin reuptake inhibitors (ssris). December 8, 2021.

Reilly TJ, Wallman P, Clark I, Knox CL, Craig MC, Taylor D.Intermittent selective serotonin reuptake inhibitors for premenstrual syndromes: a systematic review and meta-analysis of randomised trials.J Psychopharmacol. 2023;37(3):261-267. doi:10.1177%2F02698811221099645

Marjoribanks J, Brown J, O’Brien PMS, Wyatt K.Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Gynaecology and Fertility Group, ed.Cochrane Database of Systematic Reviews. 2013. doi:10.1002/14651858.CD001396.pub3

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