Expert: Dr. Ravindra Bhaskar Ghooi - 7/4/2007

Question
I have been taking Effexor( 75 mg) for nearly a year now.  Recently, I also began taking Ultram once a day for about the last two weeks for a back injury.  I have not had a period in nearly 8 weeks and have taken several(7) pregnancy tests which all come back negative. I am working on my doctorate in clinical psychology, which can be extremely stressful, so I thought perhaps that could be the issue. However,my cycle is like clock work...always there each month. Could the Ultram( Tramadol) be to blame?  What do you think is the problem?  Thank you for any advice you can lend.

Answer
Hi Lauren,
There are reasons to believe that Tramadol affects the menstrual cycle. The drug details on rxlist state that the side effect of trammadol is "menopausal symptoms", which could be interpreted as absence of menstrual bleeding. Secondly there are a number of reports of delayed menses by patients on tramadol (see www.medhelp.org)
The other possibility is that stress is affecting your cycles, but the most probable culprit is tramadol.
Ravi Ghooi