Symptoms During Period

[alicios]

Hi guys,

I know most of you get worse during your period, but I'm the total opposite. I usually have a heart rate of 120-140 the first few hours after getting out of bed, but when I’m on my period it’s like 80-90! I feel a little more dizzy the first few days but other than that I feel pretty normal. I still can’t exercise and stuff without my heart rate going way up but I feel better all over. Any theories on this? My bp is a little higher (usually low) during this time, but not much – still low. Do any of you feel better during your period?

Have a good one.

Alice

[ks42]

I'm the same. My symptoms are much, much better during my period (even though they often get worse the week before). Two theories on this: One has to do with water retention. Your body retains water during your period - you produce more water retaining hormones during that time, which is often what makes many people bloat and gain water weight. Because I know I have low blood volume as a consequence of my POTS, and I have difficulty retaining water in general, my theory is that it's the water retention that happens during our periods that makes us feel better by helping increase blood volume to a more normal range... maybe?? Although we're also losing blood during that time, so I'm not sure if the water retention is enough to offset that.

One of my POTS docs had a different theory - she said certain hormones (such as estrogen and sometimes progesterone) have been found to aggravate POTS. Estrogen and progesterone are actually lower on day 1 of your period than most other times of the month, then slowly increase again. Because I generally feel worse during times when estrogen is supposed to be particularly high, that would make sense. So it could be hormonal in nature as well.

Maybe it's a little bit of both?

[alicios]

Thanks! Both theories make sense. I wonder if birth control would help? I was on birth control for many years and had no problems but then I wanted children and got off the pill. Maybe I should give it a shot...Have you tried the pill and if so did it work for you?

[ks42]

I've tried the pill multiple times, and have even tried Nuva Ring and the mini pill. Even before I got POTS, the pill made me unbelievably sick - I basically couldn't keep food down at all, and was so lightheaded I could barely get out of bed. I stuck it out for a long time to see if it would get better, but it only got worse. My OB/GYN said that high estrogen & progestin/progesterone levels just don't agree with me. You might be different since you tolerated it well in the past.

I do know birth control is often used for POTS patients who experience a worsening of symptoms during their periods, but I've never heard of it being used for the opposite situation. Birth control pills are actually made up of estrogen and progestin, so it increases the levels of these hormones in your body. If the hormone theory is correct, and we feel better during periods because estrogen and progesterone are lower during that time, I would tend to think that birth control could actually worsen symptoms on a more permanent basis by increasing your estrogen even more, and by not allowing it to drop as low during your period as it normally would.

However, the hormone idea is just a theory, and hormones are extremely complicated - they can have very different effects at different levels, so I'm guessing it's still possible it could work for your particular situation. I've found that most of my POTS specialists were pretty knowledgeable on the use of birth control for POTS symptom control, so it might be worth it to ask your autonomic neuro / POTS specialist.

[MomtoGiuliana]

I feel worse in the days prior to my period--and I have felt at least slightly worse on the pill the times I have tried it. I was also very sick w POTS in late pregnancy and post partum (when I was diagnosed). Hormones are definitely an issue for me but I am not sure I understand it exactly.

[alicios]

Thanks for the replies:-) Sorry to hear the pill didn't work for you. What have you found the most helpfull in terms of meds? I was thinking that by taking the pill you would have the same pretty low levels of hormones in your body throughout your cycle instead of the fluxuations and relatively high numbers. Maybe it would be easier to deal with for me? I'm not sure, but I'm thinking about trying it. I'm 35 though, so I'm worried about the risk of blood clots. I think I will talk it over with my POTS doc.

[SarahA33]

Hi, Alicios, when considering all the birth control pills out there, my POTS specialist said if I was ever to talk to my gyn about them that I should take Yaz/Yasmin off the table. Its mentioned in article written by Dr. Raj. (Pharmacological Treatment of Pots) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756553/ Here is the portion on b/c:

"Given their demographic, many POTS patients take oral contraceptives. Some agents (e.g., Yaz™ or Yasmin™) include drosperinone as the progestin, which is a spironolactone analogue. Given that inappropriately low aldosterone and low blood volume has been identified as a problem in some POTS patients, we recommend that this be switched to an oral contraceptive that uses a different progestin."

Just an FYI - Sprinolactone is a diuretic BP medication, which is typically not recommended for those with fluid or electrolyte imbalances or some POTS patients.

All of us are so different though, so your right, talking it over with your doctor is best! Sarah

[Nymph]

Interesting. I often have troubles during my period, especially when it's heavy. But consistently my worst times are the week after my period. Go figure.

[mrsfunkway]

my POTS symptoms were horrible during my period this past month! It also happened to be my first month off the pill. I've been having milder POTS symptoms since September but it was my first pill-free period that pushed me to get a diagnosis. Maybe it will be better next month but if not I'm going back on the pill!

[Katybug]

Here is a link that explains and graphs the various hormones involved and what days they spike and drop, etc.. I thought this might help some of you see a pattern with your symptoms and the hormones.

http://www.merckmanuals.com/home/women-s-health-issues/biology-of-the-female-reproductive-system/menstrual-cycle

[alicios]

my POTS symptoms were horrible during my period this past month! It also happened to be my first month off the pill. I've been having milder POTS symptoms since September but it was my first pill-free period that pushed me to get a diagnosis. Maybe it will be better next month but if not I'm going back on the pill!

That is an interesting observation. Maybe the pill is a good option for you. I was also having mild POTS symptoms my whole life, but when I got off the pill I got really ill. The fainting started again which I had not experienced since I was a kid (when I naturally was not on the pill:) Let me know how it goes for you, and if you get back on the pill and experience a change in symptoms.

Hi, Alicios, when considering all the birth control pills out there, my POTS specialist said if I was ever to talk to my gyn about them that I should take Yaz/Yasmin off the table. Its mentioned in article written by Dr. Raj, you can find it under the section Pharmacological Treatment of Pots, second Paragraph http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756553/

All of us are so different though, so your right, talking it over with your doctor is best! Sarah

Thanks, Sarah. I'll make sure to avoid those.