BACKGROUND: A transient but robust increase in prolactin levels during and after electroconvulsive therapy (ECT) has been shown repeatedly. Reports on menstrual disturbances during a course of ECT are scarce. METHODS: The case of a woman treated with ECT for depression that developed menstrual disturbances early in the course of the treatment is presented. We conducted a PubMed literature search, supplemented with an Internet (Google) search using the same strategy, and a hand search of the indexes of textbooks on ECT. RESULTS: Publications on the emergence of menstrual disturbances during ECT are virtually nonexistent, although some textbooks mention amenorrhea as a possible adverse effect of ECT. The mechanism of ECT-related amenorrhea is unknown but is supposed to be related to the transient hyperprolactinemia. CONCLUSION: Electroconvulsive therapy can cause menstrual disturbances. These adverse effects are benign and transient. The exact mechanism remains unknown. More research could help to clarify the possible role of a transient but robust hyperprolactinemia.