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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by DebbieLynn on September 16, 2001, at 9:17:04
Somebody please help! I am due to start my period. I have been regular until this month. Last Monday I spotted and thought I was getting ready to start, but it stopped. I had PMS and all the symptoms and NOTHING. I am not pregnant. I mean 2 pregnancy tests say "negative."
I am on Effexor XR and Wellbutrin SR. I have been on Effexor 225 mg for about 6 months--went up to 300mg for about 2 weeks and went back down to 225mg. About 5 weeks ago I started Wellbutrin Sr at 100mg to augment sexual side effects from Effexor. My pdoc wants to try to get me off of Effexor, so she have been gradually tapering the Effexor as she increases the Wellbutrin. I am now at 150mg of Effexor and 250mg of Wellbutrin.
Can this craziness be causing my menstrual cycle to be disrupted?? I have no idea when or if I will be starting this month. If anyone has had something similar to this, please share any info with me.
If any males know, feel free to add comments!
SORRY IF I CONFUSED ANYONE!!
Thank you SO MUCH
Debbie
Posted by Cam W. on September 17, 2001, at 5:47:07
In reply to Menstrual changes w/Wellbutrin-Effexor? HELP, posted by DebbieLynn on September 16, 2001, at 9:17:04
Debbie - There is strong evidence that the body's stress response system (ie. cortisol levels and the HPA axis, which are dysregulated in depression), sexual response systems (ie. decreased libido, anorgasmia is seen in depression), and sex hormone levels (ie. estrogen and progesterone levels are changed in depression) are closely linked to each other.
Menstrual disorders have been noted in a few women (< 1%) taking Effexor (venlafaxine) during postmarketing surveillance (after the drug had been approved and used by a large number of women). Side effects that are rare and uncommon may not be seen during clinical trials. These controlled trials use carefully selected groups of people (mainly men) and do not usually represent "real world" examples of people with depression. Clinical trials use homogeneous populations; those without other comorbid disorders (eg. anxiety/depression; heart disease/depression; OCD/depression; etc.; or those taking birth control, herbs, or other drugs). Also, I don't believe that a definite link between the Effexor and menstrual irregularities has been proven (but there is probably a link at some level or levels).
Although rare (< 1%) and, again, with no causal link being confirmed; during development and postmarketing observation, a few women taking Wellbutrin™ (bupropion) have experienced menopause, ovarian disorder (incl. abnormal egg release) and salpingitis [inflammation of the fallopian tube(s)]. These side effects, if they are caused by the Wellbutrin (not proven), could lead to menstrual irregularities, and would perhaps be associated with lower abdominal pain (ie. your PMS symptoms). Dyspareunia (pain during intercourse) may also be present, possibly due to hormonal changes.
Although menstrual irregularities are not commonly attributed to Wellbutrin nor Effexor, these irregularities are seen in women with depression. The additive effect of Wellbutrin on the Effexor may have been enough to disrupt your menstrual cycles. I would suspect that these side effects would be dose-related; so the doctor is decreasing your Effexor dosage to see if this will correct your menstrual cycle problems, as well as your sexual dysfunction.
I hope that all this speculation is of some help to you. - Cam
Posted by Jane D on September 17, 2001, at 9:36:40
In reply to Menstrual changes w/Wellbutrin-Effexor? HELP, posted by DebbieLynn on September 16, 2001, at 9:17:04
DebbieLynn - Drug changes CAN and do cause one or two month disruptions. So can illness and any number of other things. Probably you will get back to normal fairly soon. If not, that is the time to start worrying.
My own hunch is that this temporary disruption occurs far more frequently than the permanent changes like menopause referred to by Cam with their less than 1% incidence.
-Jane
Posted by Wendy B. on September 17, 2001, at 11:15:29
In reply to Re: Menstrual changes w/Wellbutrin-Effexor? HELP » DebbieLynn, posted by Jane D on September 17, 2001, at 9:36:40
> DebbieLynn - Drug changes CAN and do cause one or two month disruptions. So can illness and any number of other things. Probably you will get back to normal fairly soon. If not, that is the time to start worrying.
>
> My own hunch is that this temporary disruption occurs far more frequently than the permanent changes like menopause referred to by Cam with their less than 1% incidence.
> -Jane
i agree with jane and cam (isn't he thorough? i love him!) -just the stress of being on drugs can change your hormone levels. even when not on drugs, stress can make you miss a period. add the meds, and i'm sure this is a symptom more people have than is reflected in the studies.
when your drug regimen is evened out, you can probably expect an even period. don't sweat it, though, and try to take it easy if you can. get enough rest.
if you're worried about birth control and pregnancy, go on the pill: it will force you to bleed on a regular schedule, and then you won't have the added STRESS of worrying whether you're pregnant or not. discuss it with your pdoc and gynecologist, preferably in a team-approach (i.e., both know your medical history, and are working in concert to get your meds straight).
best,
wendy
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