Adult Cardiology specialists have linked the hormonal changes that occur in women during the menstrual cycle to the occurrence of arrhythmia episodes.
How does premenstrual syndrome arise?
Premenstrual syndrome arises as a result of variations in hormone levels and can cause numerous physical and psychological symptoms. Some women during this period prior to menstruation report the appearance or an increase in palpitations, which can become very uncomfortable. This occurs due to an increase in progesterone, a hormone that increases in the pre-menstrual phase. In addition, during premenstrual syndrome, anxiety may increase and arrhythmias may occur more frequently during periods of excitement and nervousness due to increased adrenergic tone. But this previous phase is not the only one that has been related to arrhythmias, since during menstruation, episodes of paroxysmal supraventricular tachycardias may cluster and extrasystoles may increase.
Ventricular extrasystoles are the arrhythmia most clearly related to hormonal changes, and therefore their appearance and worsening is closely linked to the menstrual cycle. It tends to be more frequent in the premenstrual and perimenopausal phases (also during pregnancy) and, on the contrary, is reduced with the estrogen peak that occurs during ovulation. Experimentally, estrogens have even been used to try to reduce extrasystoles. The phase of the menstrual cycle in which the electrophysiological study is performed could, in some cases, influence the induction of arrhythmias. Thus, they may not be induced during the phase of the menstrual cycle with high estrogen levels around ovulation, and may be induced by repeating the study during the premenstrual phase.
Recommendations for patients with arrhythmia
As a general recommendation, the arrhythmia should be documented with an electrocardiogram while the patient is sleeping. In this way, a specialist will be able to identify the specific type of arrhythmia and can provide guidance on possible treatments.