POTS & Yasmin birth control

[Clorato]

I started taking yasmin COCP last March, and seemingly developed POTS 2/3 months later - at the time I couldn’t pin point what was causing it but now after seeing a neurologist (and being wrongly diagnosed with vasovagal syncope as “it’s common in women your age”) I have done further research. I asked him about the birth control and he brushed it off. Have since been to cardiologist who confirmed. The progesterone in said pill is known to exacerbate POTS. I have tried upping water & salt to no avail, as well as no alcohol and it’s truly debilitating. I have been taking benzodiazepines to control HR.

The question is whether changing birth control perhaps to a non hormonal option will resolve this or am I stuck with it forever. I had never fainted prior to that first incident in May, nor had such terrible heart rate issues/BP issues. My resting heart rate sitting is 66 and it will rush to 140+ on standing. My blood pressure also drops. I don’t want to be stuck with this forever it’s ruining my life. 

Are there any studies of people who have recovered from POTS induced by medicine?

[Pistol]

11 hours ago, Clorato said:

My resting heart rate sitting is 66 and it will rush to 140+ on standing. My blood pressure also drops.

Hello @Clorato - welcome to this forum! Yes, I have heard of people becoming more symptomatic on birth control. But I am wondering about the above statement - POTS is usually diagnosed by an increase in HR WITHOUT a drop in BP. I have NCS ( same as vaso-vagal syncope ) as well as HPOTS. With NCS the HR briefly jumps up and then both HR and BP drop rapidly, causing syncope. Does your HR stay elevated when standing, or does it drop after a few minutes? 

You mention taking benzos to control HR - has your doctor ever prescribed a beta blocker of florinef? These are often prescribed in certain types of POTS, as well as NCS. 

[Sarah Tee]

@Clorato, if you want to search for studies, PubMed is a good place to start.

Keep in mind that if a medication caused POTS-like symptoms, that would be described as side effects, not as “causing POTS”, beacuse POTS means your autonomic nervous system is not functioning properly and all other causes have been excluded.

So a study might say that medication x caused postural tachycardia, or low blood pressure. But it wouldn’t say it caused POTS because there wouldn’t be autonomic dysfunction.

So unless the medicine damaged your autonomic nervous system (a medication injury) and thereby caused POTS, any symptoms that went away when the medication was stopped would be considered side effects.

I haven’t read of medications causing POTS, but having said that, research into the causes of POTS has a long way to go.

It sounds like consulting with your doctor to change your birth control and then getting re-evaluated for autonomic symptoms would be a sensible option.

P.S. Just to add to the complications, not everyone with POTS or OH feels better with increased salt and fluid intake. For some people, it makes no difference. Doctors don’t know why, but it could be because some people with orthostatic intolerance have low blood volume, and those are the people who feel better with extra salt and fluids.