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[JoannFran]

Good afternoon

I've posted a few times about this recently, so i'm sorry if I'm repeating myself but I really could do with some advice as I feel like I'm losing it.  I'm 49 and in Peri and on evorel 100 patches and utro for 2 weeks (and Testosterone).  Before HRT I was suffering from palpitations and racing heart/anxiety.  Since being on the HRT (also on Propranolol beta blocker) the racing heart has calmed down however I'm now getting loads and loads of frequent ectopic/missed beats. 

Somedays I only have a few and then days like today I have them one after the other.  Without sounding dramatic I feel like my life is ruined. I can't enjoy anything through fear of these happening.  I've had all the heart tests and been told 'benign'.  However, I just can't live like this anymore  .   I am driving myself completely crazy by searching for the cause (there MUST be a cause).    I thought it was to do with a histamine intolerance but they've come on today when I eaten foods that have been fine on other days.     I think there's also a correlation between when my own estrogen should peak and the frequency of them (more around day 12/13 and days 21/22). 

Meno Dr says increase estrogen to 125 but I'm scared to do this.   I also changed patch today so wondering if that's anything to do with it?  But this doesn't always happen when i change the patch.  maybe it's certain times of the month when I change it? 

I'm really sorry to post about this again, but any advice, any help, anything would be greatly appreciated.  Thanks so much x

[joziel]

Increase estrogen. I had this all the time until I got my estrogen up.

[Gnatty]

I agree. Had this myself when I tried to change oestrogel regime. Only thing that got rid of them was a higher dose. x

[JoannFran]

Thank you both for replying.

Just worried about the high dose. My estrogen levels were around 400 on day 3 (and weirdly 300 on day 21) 2 different labs.  Doesn't really make sense as it should be the same or more on day 21? 

How quickly did they stop once you'd started the higher dose?

Thanks again x

[JoannFran]

Hi merrygoround - thanks so much for your reply, much appreciated.  It’s so hard to accept that they are benign when they feel so awful. And I struggle to stay calm when they happen so anxiety is through the roof, which doesn’t help. It’s so helpful knowing that other people have experienced it and it’s resolved after menopause. I can’t imagine living with this for the rest of my life.  It’s consuming me!

I have a drs appointment next week so going to ask about Bisoprolol.

You said you switched to Bisoprolol. Was you on propranolol first? Any issues switching?

Thanks again for your help x

[bombsh3ll]

Have you been checked for a thyroid condition?

If it is just menopause, the estradiol may well just take a few weeks to see an improvement, I would give it a bit longer as symptoms don't always go away immediately.

Like others have said, a dose increase if things don't settle is also reasonable.

How well are your patches sticking? Unstable levels can be an issue if for example you are getting the full dose on day one, half that on day 2 because the edges have lifted up, and very little by day 3 when it's hanging on by a thread?

[JoannFran]

Hi bombsh3ll - thanks for your reply.  Yes I've had my thyroid checked a number of times and been told it's fine.

Patches stick well as I put a layer of the tegaderm dressing over it.  Otherwise they don't stick great. 

I've upped my patch by half a 25mg so now on 112.5.  Will see how it goes.

Thank you. x

[Gilla999]

I have this too and it's really awful - I wish I could give you some solutions. Mine flares whenever there is a change in either direction to my Estrogen level. I have no idea why this would only start in my 40s (when changes to Estrogen as part of your cycle is totally natural) but there you go. A word of caution about increasing your Estrogen - for me the issues can equally be caused by too high as well as too low Estrogen (definitely the case for me a number of times) so just ensure you make any changes slowly.

I did a bit of research into beta blockers and pressed my doctor to take Atenolol instead of Propranolol, because it has a more favourable side effect profile for insomnia (which is a bit of an issue for me). Atenolol isn't licensed for anxiety and Propranolol is, so I had to push a bit but managed to get it. I take half the lowest dose tablet a day and it does really help take the edge off... it's been a bit of a life saver. If I increase to a full tablet my BP and heart rate drop a bit too low and I feel a bit woozy, so I tend not to unless I'm desperate, which I still get at times when it flares. My mum also suffered terribly from this in her 50s upwards and was prescribed Bisoprolol and this seemed to help her.

[Moog77]

Oh!!!!!!!! Following!!!!!!!!!!

Ectopic beats were a symptom before I started HRT and have been quite problematic the last few months. They are quite unpleasant. I was tested quite extensively pre HRT and got the all clear and they did go away until recently.  I am terrified I am going to have a heart attack when they come in - its mostly at night but they are creeping into the day time. I also feel really flat and like I did pre HRT! So I suspect I need an increase from 1.5mg Sandrena which I have been for a while. I have blood tests on Friday so will see what they say but suspect i need more.

Quite reassuring to read that others have had relief from an increased dose.

[Wrensong]

I had these throughout peri & for a few years postmeno before starting HRT, in long episodes at any time of day 24/7, but worse in evening & overnight.  They resolved shortly after starting HRT 3 yrs postmeno, with a change of thyroid meds around the same time.   

Agree they are v scary & can be overwhelming, but they are also fairly common in menopause, though I didn't know that until I saw a v good MS 3 yrs postmeno.  They started nearly 20 yrs ago & back then there was much less awareness about the effects of menopause so the various medics I'd seen prior to this MS were not sure of the cause, which compounded the worry, especially as I also have a thyroid condition.  Like some of you, I had all the cardiac tests & only benign ectopics were found.

Now 12 yrs postmeno I still get them occasionally, usually in response to a change of HRT or thyroid meds (dose up or down)  but they tend only to last for a couple of weeks & are minimal compared to peri.  I found Utrogestan brought them back with a vengeance though & couldn't take it due to this & other horrible side effects.

Controlled breathing, regular meditation & anything that promotes relaxation can help bring about a calmer default state & reduce the emotional havoc they can wreak.  There are many, many threads on here discussing ectopics if it might help to search & see that you are not alone & find out how others have managed.
Wx

[Moog77]

@wrensong I also have a thyroid condition and recent tests show my TSH has went up to 2.76 (it normally sits around 1) FT4 at 16 and my FT3 sitting right at the bottom at 3.4. This is on 100 of levo. I did start a trial dose of t3 (10 in the morning) on the back of these results (April) but its made no difference whatsoever and the last few weeks have been really particularly bad of feeling generally rotten so getting thyroid and hormone tests on Friday. I think I need an increase of something somewhere!

[Wrensong]

Hi Moog77, I'm sorry you are having probs with your thyroid stability.  Quite a few of us on here have a thyroid condition alongside menopause symptoms & it can be a v tricky combination  .  We have a thread called thyroid issues & support I'll bump for you in case you haven't seen it.
Wx

[joziel]

Moog, what are the ranges for those labs?

TSH of 2.76 isn't awful.

I'm on thyroid meds now but think I need to come off them. I'm on 50mcg T4 and 45mcg T3. I went on them due to debilitating night time symptoms and insomnia which was life-altering. My T3 was on the low side like yours but in range - and I had high rT3. T4 was decent and TSH always alround 1, although once it was 3.5

Anyway, the thyroid meds haven't changed the night time symptoms. Increasing estrogen has helped those although they are not perfect yet but live-able with now.

I think intermittent fasting and erratic eating was causing my low thyroid function. I have fixed all this by eating consistently, 3 meals a day, loads of protein, loads of veg - and doing a reverse diet up to 2200 calories. (I had got stuck where I couldn't eat more than 1200 or less calories a day because my body had adapted to this low level of calories.) Anyway, I've fixed all that by gradually increasing my calories 100 every 2 weeks and tracking absolutely everything I eat on My Fitness Pal.

So next I have to try coming off thyroid meds, which I'm not looking forwards to...

[Moog77]

Joziel ranges are as follows:

TSH 2.72 mIU/L (.27 - 4.2) 62.3%
Free T4 (fT4) 15.9 pmol/L (12 - 22) 39.0%
Free T3 (fT3) 3.4 pmol/L (3.1 - 6.8 ) 8.1%

On 100 of Levo they arent great and certainly enough to feel off. I tend to feel better at at TSH around 1 and with FT4 higher.

Funnily enough i tend to be quite erratic with eating too but its not deliberate Im just not very organised. I need to make sure I am eating 3 meals a day.It definitely makes me feel better.

[joziel]

So looking at those labs, your T3 is the most important active thyroid hormone. Your body should convert T4 into T3 (although some people convert better than others).

Your T4 (which comes from your levo you are taking) is only 15.9, which really isn't high in that range. You should be able to ask for an increase in your levo. That will give you higher T4 - which hopefully your body will convert to more T3. Your doctor should be very happy to increase your levo if you ask and point out that you still have symptoms and that your T4 is not that high in the range. (NICE guidelines say that if you still have symptoms you should be increased.)

If you try increasing the levo and your T4 goes higher but your T3 doesn't really change, you might need some T3 directly. That will be very hard to get on the NHS. But an increase in levo should be easy.