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Menstrual Disturbances During Electroconvulsive Therapy: the Forgotten Adverse Effect Case Report and Review of the Literature

Background A transient but robust increase in prolactin levels during and after electroconvulsive therapy (ECT) has been shown repeatedly. Reports on menstrual disturbances during a course of ECT are scarce. Methods The case of a woman treated with ECT for depression that developed menstrual disturbances early in the course of the treatment is presented. We conducted a PubMed literature search, supplemented with an Internet (Google) search using the same strategy, and a hand search of the indexes of textbooks on ECT. Results Publications on the emergence of menstrual disturbances during ECT are virtually nonexistent, although some textbooks mention amenorrhea as a possible adverse effect of ECT. The mechanism of ECT-related amenorrhea is unknown but is supposed to be related to the transient hyperprolactinemia. Conclusion Electroconvulsive therapy can cause menstrual disturbances. These adverse effects are benign and transient. The exact mechanism remains unknown. More research could help to clarify the possible role of a transient but robust hyperprolactinemia.