Aim. The authors present the first reported case of simultaneous hyperprolactinemia, loss of menstruation, painful breast enlargement and genital tract bleeding in female following use of sertraline and shortly review these side effects. Case report. A 36-year old female with moderate depressive symptoms had poor effect and no side effects while treated with paroxetine. After change to sertraline satisfactory reduction of symptoms was observed, however the treatment was followed by severe hormonal side effects and bleeding. After next drug - citalopram - the ailments ceased and the symptom reduction remained stable. Results. The case report suggests significant differences in efficacy and tolerability between the SSRIs. In the case described treatment with paroxetine and citalopram was well tolerated while only citalopram was effective. Sertraline treatment in this case was followed by serious side effects. Conclusion. We observed serious hormonal and hemorrhagic side effects during setraline treatment. The case report provides support for essential differences in efficacy and safety between SSRIs and also reminds rare risks accompanying using drugs with serotonergic and dopaminergic properties.