2.1. Study Participants and Design
urogenital tract infection, pelvic pathologies, myomas, first-episode MDD, PCOS, infertility, Addison’s disease, malignant diseases, MDD, depression, Depression
SYSTEMIC DISEASE, DISORDERS, MYOMAS, LIVER FAILURE, ENDOMETRIAL POLYPS, ACUTE INFECTIONS, DIABETES MELLITUS, DRUG SIDE EFFECTS, CHRONIC DISEASES, DISEASE, THYROID DYSFUNCTION, CUSHING SYNDROME, KIDNEY FAILURE, POLYCYSTIC OVARIAN SYNDROME, OVARIAN CYSTS, MALIGNANT DISEASE
Women of reproductive age (18–35 years) who applied to the psychiatry clinic and were diagnosed with first-episode MDD using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) diagnostic criteria, and who were prescribed SSRI antidepressants, were referred to the study center of the gynecology clinic before treatment to be included in our study. In addition, healthy volunteer women of reproductive age (18–35 years) who applied to the gynecology outpatient clinic for a routine gynecological examination were referred to the study center to be included in the control group.Exclusion criteria were: a previous history of SSRI use, a diagnosis of infertility, known serious chronic diseases (type 1 or 2 diabetes mellitus, Addison’s disease, Cushing syndrome, kidney failure, liver failure, thyroid dysfunction, etc.), urogenital tract infection, existing malignant diseases, polycystic ovarian syndrome (PCOS), use of anticoagulants, use of drugs that affect or alter the sex hormone profile, and alcohol use. A total of 168 women of reproductive age who were consecutively referred to the study center in the gynecology clinic were evaluated for study eligibility. Among them, three women with a diagnosis of infertility, nine women were diagnosed with pelvic pathologies (cervical or endometrial polyps, myomas, masses, or ovarian cysts), eight women with systemic diseases, seven women with acute infections, eight women who regularly used combination oral contraceptives (COCs), four women who used anticoagulants, 10 women whose treatment was changed due to drug side effects after starting SSRI antidepressant treatment, 12 women without regular menstrual cycles at the six-month follow-up after starting antidepressant therapy, five women who did not attend the follow-up examination after six cycles, and six women who later refused to participate were excluded. Thus, in total, 48 women with regular menstrual cycles (totaling 21–35 days) and who were diagnosed with MDD were assigned to the MDD group, while 48 women who had regular menstrual cycles (totaling 21–35 days) without depression or any known medical disease were assigned to the control group (Patients with regular medicament were included in the study. Sertraline, fluoxetine, and escitalopram were the SSRIs used in the patient group. The SSRI doses were used in accordance with the treatment guide and were also the most commonly used doses (50–100 mg/day for sertraline, 20–40 mg/day for fluoxetine, and 10–20 mg/day for escitalopram). In the MDD group, 40 cases were treated with sertraline, 5 with fluoxetine, and 3 with escitalopram. The Hamilton Depression Rating Scale (HAM-D) [Participants were asked to complete a self-assessment questionnaire that recorded demographic information as well as clinical menstrual characteristics. Body mass index (BMI, in kg/m