Abnormal Uterine Bleed in a Postmenopausal Woman With the Use of Escitalopram

Selective serotonin reuptake inhibitors (SSRIs) are among the most widely used antidepressants worldwide. They are an effective first-line treatment for depression. Common side effects can be quickly remediated by switching to a different drug, making it easy to miss rare side effects and even causing them to go underreported. This case study examines an instance of uterine bleeding in a postmenopausal woman after starting an antidepressant. A detailed history determined that the medication was the only noticeable change in her daily routine before the onset of bleeding, making it the likely cause. Due to the high index of suspicion, the medication was discontinued, and it was apparent that the bleeding ceased. This phenomenon demonstrated the role of serotonin in potentiating the coagulation cascade. Research on this topic is limited, but there have been other reported cases of similar findings in the past.