From the FDA Drug Label
Other side effects in children and adolescents include: ... heavy menstrual periods Abnormal Bleeding SSRIs and SNRIs, including sertraline, may increase the risk of bleeding events ... to life-threatening hemorrhage.
Sertraline and Menorrhagia: Sertraline may cause heavy menstrual periods, which is a form of menorrhagia. Additionally, as an SSRI, sertraline may increase the risk of bleeding events, including abnormal bleeding. Therefore, it is possible that sertraline could contribute to menorrhagia in some patients. 1 1
From the Research
Sertraline can potentially cause menorrhagia or heavy menstrual bleeding in some women, although this side effect is not among the most common reactions to sertraline. This is based on the understanding that sertraline affects serotonin levels, which play a role in platelet aggregation and vascular function, potentially interfering with normal blood clotting mechanisms and leading to increased menstrual flow in some women 2. Additionally, serotonin influences uterine contractions, and alterations in serotonin levels might affect the normal menstrual process. Some studies suggest that sertraline may have effects on the hypothalamic pituitary adrenal (HPA) axis and inflammation, which could potentially impact menstrual bleeding 3. However, it's essential to note that the current evidence does not provide a clear and direct link between sertraline and menorrhagia, and more research is needed to fully understand this potential side effect. If you experience unusually heavy menstrual bleeding while taking sertraline, it's crucial to discuss this with your healthcare provider, as they may recommend monitoring your bleeding patterns, checking for anemia, or considering alternative medications if the bleeding is significant. Do not stop taking sertraline abruptly without medical guidance, as this can lead to discontinuation symptoms. Your doctor might adjust your dosage or switch you to a different antidepressant if menorrhagia becomes problematic. Key points to consider include:
- Sertraline's potential impact on blood clotting and uterine contractions
- The need for monitoring and medical guidance if heavy menstrual bleeding occurs
- The importance of not stopping sertraline abruptly without medical advice
- The possibility of adjusting dosage or switching to a different antidepressant if necessary.