I have Prinzmetal's variant angina and although I am on 325mg of aspirin, norvasc and nitro (as needed) I still have occasional "issues" of chest pain. Was wondering about the "time of month" and it's affect on this whole heart thing. I am 43, clean angio, no blockages/plaque, good cholesterol, a tad over optimum weight (whatever that is!) excercise lightly for 30 minutes a day and have noticed that, as I get closer to my cycle, I get more pain episodes. Now, according to my GP/Ob/Gyn, I'm still not menopausal which means that my hormones are still doing their thing. I was searching and found an article in the Annals of Internal Medicine (4 December 2001, vol. 135, issue 11, page 977-981) where they tested 10 women (yes, women and NOT men for a change!) with variant angina and the results showed that with higher levels of estrogen in the blood, the coronary arteries were "wider" (especially during ovulation) and that as the level of estrogen decreased, the arteries showed a slight narrowing/response. I have a cardio appointment on the 15th and plan to discuss this with him but thought the whole idea was quite interesting.
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estrogen/angina link?
- By jstmre
- Posted June 7, 2009 at 8:13 pm · 10 replies
- In Younger women with heart disease
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Explore topics in this discussion:
Surgery Pregnancy Morphine Plavix Angina Menopause Endometriosis Stent Norvasc Stress Heart disease Aspirin Miscarriage Anemia Artery dissection Pain Heart attack
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- By martzj
- Posted June 7, 2009 at 9:10 pm
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hi jstmre,
"where they tested 10 women (yes, women and NOT men for a change!) with variant angina and the results showed that with higher levels of estrogen in the blood, the coronary arteries were "wider" (especially during ovulation) and that as the level of estrogen decreased, the arteries showed a slight narrowing/response'
Wow. 10 whole female test subjects. : ) (thanks for citing the article so I can hunt it up)
I had a massive heart attack at 41 during OVULATION...and that continues to be the time of monthly cycle (now 54) that chest pain and tightness are most extreme and threatening. Never had a professional explanation from any doctor on this. PMS phase creates different problems...fluid gain and shortness of breath because of that, more spasms rather than the searing streaking pain that precedes ovulation. Estrogen, in other words, continues to make my life hell. It certainly offered no protection to me from heart attack. I'm hopefully entering the tail end of perimenopause but I've read that women who start menstruating early (11) also may have a much tougher time of it in terms of heavy bleeding, cramping and menopause may come as late as 55-60. whew!
Something to watch out for: if you have heavy periods, your docs need to keep an eye on your blood iron levels. Heart attack girls need every bit of iron and minerals they can to survive and replenish body stores. If periods are increasing with added intensity from cardiac blood thinners, Plavix, anticoagulants...especially if endometriosis rears its ugly head....you need to watch out for chronically lowering levels of iron which could push you into anemia. Anemia, especially acute anemia is a risk factor for heart attack in women.....and widely misunderstood by doctors. You'll want to ask for blood test results so you can track this yourself too.
My oncology hemotologist went to bat for me in getting my ob/gyn to perform partial hysterctomy using the year long blood tests tracking decline and body's inability to replenish stocks before next period hit. I requested keeping ovaries in case they might help my heart make it through the transition to menopause. So far, I believe this has allowed hormonal phases to happen normally....but my heart and body have greatly benefitted from not having to waste valuable blood supply to an organ that was uselss to me any longer. I have never dared try HRT.
Uterine ablation works to stop monthly bleeding .....but the sucess rate of this procedure is not particularly high....about 40% I think.
Heart attack recovery and heavy periods do put women at increased risk for recurrent attacks and the medical community needs to be apprised of this. Don't be surprised if your cardio is clueless about this. You can't afford to be.
best wishes,
Jaynie
- By jstmre
- Posted June 7, 2009 at 10:36 pm
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Good to know! I was wondering about the rate of blood loss and it's general affect on my health. I've noticed that since I've started taking the aspirin AND the norvasc (only since Feb), my periods have been AWFUL! Worse than I ever had even in my three post-partum times!!! I've actually gone through double pads and my clothes which really makes it interesting when I'm away from home. Plus, I think I'm beginning the menopause "slide" since I am now beginning to spot for a week before I get to my period--but my hormones are "fine" so I"m attributing it to the aspirin. I've noticed that I have been tired/out of breath when I go up and down the stairs multiple times at home which is something I've not had before. I will mention this to my cardio doc at my next appointment. I hate the randomness of this whole thing. I spent two days in the hospital three weeks ago because a got a bad batch of nitro (totally ineffective--no headrush, nothing) and, since I have low blood pressure normally, when I got to the ER after taking my third nitro, they gave me one more and dropped my pressure too low to give me anymore so they gave me a shot of morphine (didn't work!) and kept me. Went through the stress test stuff all over again but this time "something" was not quite normal so I have to go in and see him again. I teach middle school and know that stress is an issue (especially during the last few weeks of school). I was into my nitro pretty heavy the last week of school, but since we have been out....none. Not sure if I should keep working at this job or find another but don't know what I'd do since I've been teaching for 22 years. Thanks for the heads up with the anemia thing.
- By gracie62
- Posted June 7, 2009 at 11:30 pm
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Not wanting to aruge with Jaynie in any way shape or form, but the success rate for endometrial abalation depends a great deal on the doctor performing it. It is an alternative women with early onset heart disease should consider if their periods become unmanageable due to medication or other reasons. After my 2nd stent and going back on Plavix for the 2nd time, I could not leave my house for 2 weeks out of the month I bled too heavily. I researched my options and found a local gynecologist who was fairly young and early in her practice, but had extensive training in the procedure. I took the chance and 2 years later am still period free. I don't even know I am supposed to be having my period except for some breast tenderness.
It doesn't take care of the hormonal aspects, but preserves the protection of your heart by your ovaries and can greatly reduce or stop your monthly bleeding. The key, I believe, is getting a doctor who knows the procedure well and is experienced.
Again, not trying to correct Jaynie - just hoping anyone considering their options for excessive monthly bleeding will realize experience of the phyisican plays a big part in success rates and outcome of any procedure.
Take care -
Dianna
- By Clematis
- Posted June 16, 2009 at 8:35 am
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I have felt that my angina was related to hormonal levels also. Although nobody can pinpoint this. I am currently going to go on bio-identical HRT. Cardiologist has given the okay for estrogen, since the studies done in the early 2000, used average age group of 60 plus women, so what did the study really tell us in regards to heart attack and estrogen RT?
You know your body, and keep track of these episodes, then find a doctor that is willing to give you something. Hormone levels are tricky as when they take the levels, the next week you may be at another point.
Slowly inf. is coming out, but will take lot's of research on women and heart disease, to make a medical difference in the future. Interesting article on mayoclinic.org on small vessle disease and low estrogen, might want to check this out.
- By Clematis
- Posted June 16, 2009 at 8:43 am
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I currently have a mirena IUD which lasts 5 years to help with the blood bath! Hormones and Heart disease are related in my body, just can't find anyone in the medical community that supports this. Soon as I am more stable, will be starting bio-identical HRT. Have gotten the go ahead by my cardiologists, although he is confused...This should begin to help with the decreased levels of hormones that I have experienced while in perimenopause. Uterine Ablasion will be next. success rate is higher than 40%.
- By mysparetimedesign
- Posted July 14, 2009 at 10:08 am
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EESh and I was starting to think I shouldn't worry about this at all....but that would have been putting on the ultimate blinders....
I only hope I have some understanding and knowledgeable physicians in my court after this operation....
Last summer I bled every day for almost 8 weeks until I had an "emergency" and ended up taken to hospital...of course I got there and it was over but very heavy bleeding and huge clots...
anyway didn't have period for two months, then had one just before had a hysteroscopy and D&C.....didn't have another period until April when it went back to normal, though still lots of clotting and heavier....
I am now terified of what is going to happen once I get on blood thinners....and right now my surgery is set sometime before the end of this month....which may very well be my next period!
I'm coming back in my next life as a man!!!
I'm wondering if there is anything I can do to prepare....
the other thing is my partner's son is getting married in another province at the end of September and we are hoping I can make the trip by car then but it's not so much the chest pain but this that is concerning me...
- By martzj
- Posted July 14, 2009 at 10:32 pm
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I made it through 8 years of this beyond heart attack....I just made sure I had tampons stashed everywhere I lived, went, worked. Because it took 12 super tampons per day plus maxi pads for overflow...and there was always overflow....sometimes within 30 minutes.
Thank goodness for black slacks and skirts (smile)!! I always wore black on the lower half.....light colors for tops so I didn't appear to be in mourning for my life 8 days a month!! Sometimes twice a month after 44: )
take care,
Jaynie
- By CJM3
- Posted July 15, 2009 at 8:08 am
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I got my cardiologist to talk with my gyno and they decided to put me on a low estrogen birth control as the cyclicity of hormones was too much for my body causing spasms that would put me in the hospital for days whenever I got my period. I now do not get my period as I don't take inert pills. I do have endometrial monitoring to avoid build up. The result has been no more spasms! There is most definately a hormonal link as migranes are basically a spasm of the corroted artery to the brain. My history is a heart attack with bypass and spontaneous coronary artery dissection- most likely caused by hormones but we will never know. On Norvasc and other CCB's ! Good luck! Sharon
- By SunnyD38
- Posted July 25, 2009 at 8:56 pm
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Hi everyone, I am new to this community, and thankful for this discussion. I had LAD heart attack, spontaneous coronary artery dissection in 2004, then another MI in 2006.
8 months prior to the first heart attack, I had been pregnant with triplets (it was natural); I was deathly ill with the pregnancy, and ended up having a dreadful miscarriage at 10 weeks. I always thought that the heart attack was due in part to the huge change in hormones during that period, and then the abrupt drop in pregnancy hormones after the miscarriage.
This is my thesis only...my dr.'s continue to ask me if I smoke, had high blood pressure, etc!!! and I try to be gracious as I explain for the 100th time, that my mother had a heart attack at 40; so I had a genetic component, and loss.
At any rate, I always thought that it was something about my body's reaction to the hormones that caused the incredible sickness, and rejected the pregnancy and played a role in the heart attack.
So I'm interested in any studies about this connection.
Secondly, as I am 42 now, I too struggled with anemia this past year (2008); had a very heavy period, and afterwards, thought I had come down with the flu. Didn't realize i was severly anemic, and needed 3 transfusions. Thank god, it worked out, and no heart damage.
I had a uterine ablation this year in hope to prevent heavy periods in the future. This has helped me; I have cycles but with no periods now or only some minute spotting.
I feel like "Live and Learn" regarding the hormones, the heart attack, the anemia, the ablation, etc.. but I feel tired of the whole thing now. Just want to live fully. Hard to get over the fact that I will not have children, though; but getting a little better with time.
sorry for such a long post;
My best to all of you.
SunnyD38
- By Julie5
- Posted July 27, 2009 at 7:37 am
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Hi Everyone,
Interesting discussion. There is absolutely a link with hormones and heart issues. I haven't had a heart attack but I have an enlarged heart with a history of tachycardia and now have a defibrillator. I do know that when I'm getting closer to my period, I have lots more PVCs. My doctor nods his head at this, knowing this is true, but hasn't said anything more. If your doctor doesn't take you seriously about female hormones and heart issues, find another one. It's only been within the last 10 years at best that women and heart disease have finally been studied. Who woulda thunk that women are different from men?! (and these are the people we're entrusting our lives to?!)
Julie
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