Menstrual disorders caused by medication
The hormone balance of the body is very susceptible to external influences and can therefore be subject to strong fluctuations. Besides stress, smoking and alcohol consumption, the hormone balance is also significantly influenced by medication. Moreover, every person reacts differently to different medications, so that an influence on the menstrual cycle would in principle be conceivable for almost every medication.
Drugs that particularly frequently cause menstrual disorders include psychotropic drugs, drugs that lower blood pressure, hormone preparations and cancer drugs. Hormonal drugs have a direct influence on the hormone balance of the body. These include hormonal contraceptives (such as the contraceptive pill, the hormone coil, the three-month injection) and hormone preparations for treating menopausal symptoms.
Hormonal contraceptives suppress ovulation in the ovaries. The preparations usually contain certain combinations of estrogens and progestins that replace the female hormone cycle. As this does not correspond to the natural hormone balance of the body, irregular bleeding and inter-bleeding can occur, especially in the initial period of use.
Some women suffer from menstrual disorders or complete absence of menstruation (amenorrhea) even after discontinuing hormonal contraceptives.The same applies to hormone therapies in the menopause (postmenopause), which can also lead to bleeding between periods. The male sex hormones are called androgens. They are also available as drugs and are also used therapeutically in women.
This can also lead to menstrual disorders, especially if the hormone balance contains more male than female sex hormones. In this case, menstruation often stops completely. Similar to the androgens are the so-called anabolic steroids.
These are particularly known for their misuse in sports. They mainly promote muscle building and can lead to masculinization in women. This becomes noticeable by a deeper voice, increased body hair and disturbances/lack of menstruation.
Among the psychotropic drugs, neuroleptics (especially risperidone) and tricyclic antidepressants, which are used for example to treat depression, cause menstrual disorders. Tricyclic antidepressants act on dopamine receptors in the brain and promote the release of the hormone prolactin. Prolactin promotes milk production in the mammary gland, normally for breastfeeding.
It also suppresses ovulation. Therapy with the above-mentioned psychotropic drugs can therefore lead to milk secretion from the breast and disturbances in the menstrual cycle (secondary amenorrhea). Especially in the treatment of breast cancer, chemotherapy based on an anti-hormonal mode of action is frequently used.
Many breast tumors show strong growth under the influence of female sex hormones, which is why it is hoped to eliminate the promoting influence of the hormones on the cancer. To achieve this, drugs such as tamoxifen, aromatase inhibitors and GnRH analogues are used. The production and function of the female sex hormones is thus suppressed for the duration of chemotherapy, resulting in the absence of menstruation.
Initially, this can manifest itself as menstrual irregularities, until the bleeding finally stops altogether. After the end of therapy, the hormone balance can return to normal, but sometimes menstruation does not resume. Cytostatic drugs and radiation therapy in the context of cancer diseases serve to kill the degenerated tumor cells.
Unfortunately, healthy cells are also damaged. Especially the germ cells are susceptible to these therapeutic measures and often perish due to the aggressive cancer therapy. This can result in permanent infertility with absence of menstruation. Menstrual disorders can also occur during therapy with cortisone preparations. For example, there may be intermittent bleeding, especially if the therapy is continued over a longer period of time.
