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
poster:Cam W.
thread:78835
URL: http://www.dr-bob.org/babble/20010917/msgs/78905.html