Increase in Menstrual Cycle Length Induced by Extended-Release Methylphenidate in an Adolescent with Attention-Deficit/Hyperactivity Disorder

Methylphenidate-Induced Menorrhagia in Twin Girls

“…Our report is the first report of methylphenidate-induced menorrhagia in twins. Some hematologic and gynecologic side effects such as thrombocytopenia, nasal bleeding, oligomenorrhea, and hypermenorrhea have been reported for methylphenidate before (2)(3)(4)(5). In a previous study, a possible mechanism of methylphenidate induced thrombocytopenia was hypothesized to be related to peripheral thrombocyte destruction; but in our two cases, both twins' thrombocyte counts were normal (4).…”

“…In another case report, methylphenidate-induced oligomenorrhea was reported. Increased dopamine in the brain was considered to be the link between methylphenidate and oligomenorrhea, and this increase could interrupt the secretion of the pulsatile gonadotropin-releasing hormone (GnRH) and the luteinizing hormone (LH) ( 3 ). In normal levels, dopamine functions as a co-agonist of adenosine diphosphate (ADP) associated aggregation and has a prothrombotic effect.…”

“…It is also reported that methylphenidate has rare side effects such as urticaria, visual disturbances, gynecomastia, excessive sweating, muscle cramps, and hematological problems (1). Some side effects like thrombocytopenia, nasal bleeding, and menstrual cycle problems are extremely rare in the literature, only reported in case studies (2)(3)(4)(5). One of the extremely rare side effects of methylphenidate is menorrhagia, which is part of menstrual cycle problems.…”

Methylphenidate-Associated Ecchymosis in a Young Patient With Poststroke Attention Deficit

“…There are several other reports on bleeding disorders linked to methylphenidate, including 4 menorrhagia cases 7–9 . In these cases, platelet count, coagulation profile, liver function test, hormonal levels, and gynecological examination revealed no abnormalities.…”