Gynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome

Abstract

Objective To assess differences in gynecologic history and lightheadedness during menstrual cycle phases among patients with POTS and healthy control women. Methods In a prospective, questionnaire‐based study carried out at Paden Autonomic Dysfunction Center, Vanderbilt University, between April 2005 and January 2009, a custom‐designed questionnaire was administered to patients with POTS (n = 65) and healthy individuals (n = 95). The results were analyzed via Fisher exact test and Mann–Whitney U test. Results Patients with POTS reported increased lightheadedness through all phases of the menstrual cycle phases as compared with healthy controls. Both groups experienced the greatest lightheadedness during menses, and a decrease in lightheadedness during the follicular phase. Patients with POTS reported a higher incidence of gynecologic diseases as compared with healthy controls. Conclusion The severity of lightheadedness was found to vary during the menstrual cycle, which may relate to changes in estrogen levels. Patients with POTS also reported an increase in estrogen‐related gynecologic disease.

Gynecological and menstrual disorders in women with vasovagal syncope

“…This stands in contrast to the Peggs et al [12] study in which female POTS patients reported a higher incidence of gynecological abnormalities like uterine bleeding, endometriosis, uterine fibroids, and ovarian cysts. This difference could be attributed to either different ratios of estrogen-to-progesterone or different levels of estradiol in VVS and POTS patients.…”

“…A recent study by Zesko et al showed that the results of tilt table tests are not affected by the phase of menstruation in premenopausal women[17]. In contrast to these data, a recent study by Peggs et al [12] showed that female POTS patients feel significantly more lightheaded during all phases of menstrual cycle compared to healthy subjects. The reason for POTS patients but not VVS patients feeling more lightheaded than healthy subjects may be due to an exaggerated sympathetic tone or more profound hypovolemia in POTS, which leads to increased tachycardia (a distinguishing feature of POTS).…”

“…This questionnaire was previously used to study the prevalence of gynecological disorders and menstrual cycle lightheadedness in women with postural tachycardia syndrome (POTS) [12]. The questionnaire asks subjects about the following five subject categories: 1) current reproductive status; 2) detailed menstrual cycle history with information about the length and heaviness of the flow, irregularity in bleeding patterns, faintness during various phases of the cycle, and the intensity of premenstrual symptoms; 3) preexisting gynecological disorders; 4) medication history with special emphasis on the use of hormonal contraceptives, hormone replacement therapy (HRT), and changes in fainting while on medication; and 5) detailed obstetrics history encompassing pregnancy abnormalities, complications, and history of fainting during the pregnancy trimesters.…”

Postural Tachycardia Syndrome (POTS)

“…About 80% of female patients report an exacerbation of symptoms around menstruation 5 . Many patients have been co-diagnosed with irritable bowel syndrome, some have hypermobile joints, and some have abnormal sudomotor regulation.…”

Symptoms Predictive of Postural Tachycardia Syndrome (POTS) in the Adolescent Headache Patient

“…2 The POTS patient experiences symptoms caused by alterations in cerebral perfusion and activation of the sympathetic nervous system during upright postural changes. 8,9 The sum of symptoms has a large negative impact on quality of life. 1,[3][4][5][6][7] The clinical features of POTS vary between patients, and symptom severity can fluctuate in individuals on a daily or weekly basis.…”