Estrogen

[lavender]

One thing I've noticed over the years that really makes all my symptoms worse is estrogen. Birth control, or a couple different supplements I've tried, for various reasons, that act like estrogen (phytoestrogens) make me crash almost instantly.

Do others of you experience this with POTS? Any ideas why estrogen might have this effect?

[ramakentesh]

yes. Im pretty sure estrogen is a potent vasodilator.

[mkoven]

What I've never understood, though, is why so many of us women then are worse during our periods, when estrogen is lowest.

[Guest tearose]

I was always worse during a period too.

Now, in "surgical menopause", I use an estrogen patch, very small dose, twice a week to keep me feeling in balance and help protect bones. The only symptom I think is weird is if I am late for a dose, I get heart pain. Not serious, but I feel it.

The small dose I take, does not effect me in a negative way, I get no symptoms or signs of vasodialation.

tearose

[mkoven]

Tearose,

When you say heart pain, do you mean from your prinzmetal? If so, do you feel that the estrogen helps manage that? I know you've posted about prinzmetal before. (I appear to also be in the vasospasm club). Am I remembering right? If so, do your docs connect the chest pain and hormones? This is very interesting to me, for obvious reasons. The ans stuff is miserable, but the prinzmetal scares the %$# out of me, as it can do damage.

Pretty much any health issue I have is made worse when I have my period and right before.

[juliegee]

I'm with Miss Tea. I use a tiny dose of estrogen and progesterone via a patch twice a week. It does NOT affect me negatively. It helps greatly with hot flashes, etc. I actually use half of a regular dose.

Julie

[Guest tearose]

Hmm, I never noticed if the prinzmetal attacks were on the day I was to change my estrogen patch. That is a good question. I'll have to mark that down if I have that again. I am being very careful not to allow my body to get too cold or too tired. These are contributing precipitant factors in my opinion.

Back to the heart pains from lack of estrogen... I am referring to cramping sharp pains that are bad but not nearly as painful or shocking as the prinzmetal. I think managable chest/heart pains are about a 4-5 on the pain scale and with prinzmetal I was on my knees in prayer at a 10 on the pain scale. Fortunately for me my attacks were very short and I have not had any recently.

best regards,

tearose

[masumeh]

hmm, is it possible that it depends on your individual balance? like maybe it helps during menopause but not during child bearing years??

I think menses causes flare-ups because it's takes energy out of our bodies, and drains fluids. Personally, I recently realized that my menses disturbs my sleep cycle, which in turn exaserbates symptoms like tachy, palpitations, and fatigue. But if I limit activities, drink enough Gatorade, and find a way to sleep well during menses, it doesn't bother POTS symptoms much.

[ramakentesh]

During your menstrual cycle angiotensin II levels in the body peak. This may suggest you have the newly described type of POTS called Low Flow POTS - where elevated angiotensin II levels are too high causing excessive nitric oxide availability. This means that your body is totally over constricted and you have pooling from reduced blood flow.

Id look into this. It mainly seems to effect females.

[firewatcher]

In women, estrogen has an only recently explored role with neurotransmission and generally the way our bodies work. It makes us different from men in so many ways that they haven't studied yet! When the levels fall, it triggers all kinds of hormone and neuronal effects and things just don't work as well. If there is any messing with the hormones, it will throw off our entire body. I was reading a medical article on the use of BCPs to stop or decrease the number of periods that a woman has is actual more natural than a woman having a lifetime of periods, because most women (before BCPs) became repeatedly pregnant and nursed, so had MANY fewer periods during a lifetime and the unknown health effects of what that many periods were doing to a woman's body. So who knows?!?

I did not make enough estrogen or the other hormones, so my OB/GYN put me on Estratest and it has been fantastic! But I am definitely NOT typical. I have fewer periods now and have not noticed any difference in my POTS symptoms. However, when I was cycling regularly (making enough hormones on my own) I would get untreatable, excruciating menstrual migraines every month (which some neurologists are classifying as mild dysautonomia.)

[potsgirl]

How many women here are in perimenopause or taking birth control pills? I thought I'd try going off my pills to see if that affected how I felt, but I'm 47 and also going through all the wonderful delights of night sweats, hot flashes, and insomnia. What are other's experiences?

Thanks,

jana

[mkoven]

I'm 42 and undergoing some kind of hormonal weirdness. My GYN thinks it's not necessarily that my hormones are off, but that I tolerate the fluctuation a lot less well than I did when I was younger. I never had any real issues till I hit 35--of any kind. And then, kaplooey.

I get some waves of heat on the first day of my period, but that's it. Still somewhat regular. But all my ans stuff, migraines, etc. are hormonally triggered--and I never had any of this when I was younger.

[EarthMother]

How many women here are in perimenopause or taking birth control pills? I thought I'd try going off my pills to see if that affected how I felt, but I'm 47 and also going through all the wonderful delights of night sweats, hot flashes, and insomnia. What are other's experiences?

Thanks,

jana

I am 46 and perimenopausal. I had been on hormones of one kind or another (birth control pills or the Mirena IUD which is the same as a low dose BP) since I was 16 except for when I had my three children! After the Mirena I decided to try one of those year round low dose pills and then back to the old bp I used prior to the mirena. I was having horrendous hot flashes with the huge jolts of adrenaline all last summer even on the pills. So when my cardiologist suggested (insisted) I go off all hormones because of my age this past October, I was really concerned that the peri symptoms would get worse.

But to my surprise the earthquake flashes seemed to subside once I was OFF the estrogen. No idea why. Perhaps it was a case of estrogen dominance. No clue. My periods are VERY HEAVY now, but really not much cramping and pain, like I thought there would be with a history of endometriosis. I still get an ocasional hot flash but nothing like last summer when I was taking the birth control pills. So for now, I'm flying solo and it seems to be ok. My PCP and I agreed to check my hormone levels once a year to see if we want to tweak anything as I continue to pass through menapause. But at this time my body seems to be doing what it was designed to do and it feels much better than last year, so I'm in a holding pattern until something changes.

Good luck finding something that works for you ... for now.

~EM

[mae]

I haven't taken any birth control my whole life ( I have 5 kids ) but I will say I've heard not to take anything with estrogen if you have a rare disorder like Lupus, certain heart probs and such because it can aggravated the symptoms. I've heard progesterone only is the least likely to cause side-effects .

With all that said I feel every fluctuation of every hormone in my body throughout the whole month not just during cycle I may have a week or less feeling half way normal. It really seems like my body is not handling not being pregnant even though its been over a year( kinda like a whole body shock) I actually went to the Endo doc to check all hormonal levels and they were normal. But I know I'm not just another piece of the puzzle . Maybe we have all the hormones we need they just aren't working right . I even thought of having a hysterectomy but thought it wouldn't really help because then I'd be dependent on artificial replacement which has its own slue of issues.

Mae

[pat57]

I am post menopause. During perimenopause I had a narrow pulse pressure and low BP. Now both are normal.

I also had more bouts of dizziness/ weakness during perimenopause.

Prior to perimenopause I had normal BP and pulse pressure also. My PCP does think blood loss may have been the issue and reported that one of

his patients had a blood transfusion due to the heavy flow of perimenopause.

[LJENN85663]

Hello-

I actually asked this same question to Beverly (Dr.Grubb's NP) the last time I was there, and she said the reason that POTS patients have increased symptoms at the time of our periods is due to testosterone not estrogen. During our cycle our body gets rid of testosterone, which is a vasoconstrictor, so our bodies react to the Estrogen levels, vasodilator, more as Testosterone is stronger than Estrogen. The fact that Testosterone is stronger than Estrogen is why during the rest of the month we do not feel the effects of our Estrogen levels as much.

[fighting4health]

My docs wanted me on estrogen. I tried several ( 7 or 8) birth controls, but all made me sick. They suggested the Nuvaring since it is a local estrogen and doesn't go through your system. Been on it for 3 years and it hasn't made me sick once!

[Broken_Shell]

My docs wanted me on estrogen. I tried several ( 7 or 8) birth controls, but all made me sick. They suggested the Nuvaring since it is a local estrogen and doesn't go through your system. Been on it for 3 years and it hasn't made me sick once!

I am currently hunting for a hormone therapy to "shut down" my hormone fluctuations and periods... no success yet. I have had a lot of heavy bleeding and been very disappointed. I am glad to hear that the Nuvaring is working for you though, especially after trying many other options. The Nuvaring is on my list of possibilities. Just a note though that the Nuvaring is systemic hormone therapy.

~ Broken_Shell

[Kathy_Ireland]

yes. Im pretty sure estrogen is a potent vasodilator.

That is very interesting.

I seem to the complete exception to the rule here. I feel much better in the week leading up to my period and during the first 5 days of it. I have less symptoms, more stable heart rate and blood pressure, considerably more stamina and energy and I don't end up with as severe a backlash to excertion as I do during the rest of the month. If I have anywhere I need to go or anything I need to do I always pray it will fall during these days as often I can do things on these days that I can't do at all during the rest of the month.

My Dr never has any answers as to why this is despite me always asking if there's any pill I could take that could sustain the effect for longer.

Does anyone else notice this or am I the only one?