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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Long QTc on Oestrogel?  (Read 2058 times)

KittyKats

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Long QTc on Oestrogel?
« on: April 21, 2025, 09:30:08 AM »

Has anyone developed long QTc on HRT? I now have ventricular ectopics, frequent short bursts of SVT and a prolonged QT. A relative who is a retired cardiologist said HRT can do this. Oestrogel can prolong QT and Utrogestan can ramp up SVT. Anyone else had this?
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CLKD

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Re: Long QTc on Oestrogel?
« Reply #1 on: April 21, 2025, 09:52:13 AM »

Were U diagnosed prior to starting HRT? 
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KittyKats

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Re: Long QTc on Oestrogel?
« Reply #2 on: April 21, 2025, 10:57:40 AM »

Hi - I didn't have the long QTc on previous Holters or ventricular ectopics. I used to have short runs of SVE before menopause but they are now very frequent i.e every hour I will get a two second run up to 180bpm. I am meant to take oral Utrogestan but relative has said it may increase the SV runs.
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CLKD

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Re: Long QTc on Oestrogel?
« Reply #3 on: April 21, 2025, 11:05:48 AM »

U need to see a Specialist with menopause treatment knowledge.  'may increase ' can cover several issues without medical knowledge, perhaps this relative could take time to do some Research into the possibility?  Does he/she have clinical experience of this associated with HRT?  Interesting to find out.
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KittyKats

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Re: Long QTc on Oestrogel?
« Reply #4 on: April 21, 2025, 12:44:00 PM »

I'll go back to my old cardiologist if my GP will refer me. GP has just ignored the report. My uncle is a retired cardiologist but still does international training. But he's not an electrophysiologist. He's a bit concerned and says I must be monitored. It's well known that oestrogens can increase QT but not in all people. And it was mentioned by my old cardiologist that progesterone can increase SVT hence why so many women get arrhythmias in the luteal phase. Just wondered how common the QT thing is.
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CLKD

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Re: Long QTc on Oestrogel?
« Reply #5 on: April 21, 2025, 01:22:08 PM »

Let us know how you get on. Is there anything on the MM site in the pink with white writing on at the top?
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KittyKats

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Re: Long QTc on Oestrogel?
« Reply #6 on: April 21, 2025, 01:36:50 PM »

I'll have a look. Thanks for replying!  :)
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Cassie

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Re: Long QTc on Oestrogel?
« Reply #7 on: April 21, 2025, 03:06:01 PM »

I would imagine if you already have long QT that Estrogen can make it worse but not sure it can cause it. Apparantly Progestrone prevents the long QT so perhaps using both at the same time would help?
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KittyKats

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Re: Long QTc on Oestrogel?
« Reply #8 on: April 21, 2025, 03:17:02 PM »

Yes I saw that. So probably best to have the progesterone. Uncle said it's all mainly caused by menopause!
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Cassie

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Re: Long QTc on Oestrogel?
« Reply #9 on: April 21, 2025, 05:20:10 PM »

May I ask how many pumps you are using, do you combine it with Utrogestan or only use the gel?
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KittyKats

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Re: Long QTc on Oestrogel?
« Reply #10 on: April 22, 2025, 07:08:12 AM »

I was on 2.75 pumps a day but have dropped down to 2 now plus daily vaginal Utrogestan. Hoping to reduce further as have had lots of bleeding plus lining thicker than ideal.
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Cassie

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Re: Long QTc on Oestrogel?
« Reply #11 on: April 22, 2025, 09:30:20 AM »

Thank you am thinking I must also then go onto daily Utrogestan to avoid problems. Do let us know how you get on and what the Cardiologist says as google seems to have conflicting advice but seems that the take home message is, if used in combination with a Progesterone, the Oestrogel should not cause issues, so its odd that they saying it has if you are on daily Utrogestan or did you only start the daily Utro once you had the Long QT diagnosis. I did read that Long QT needs to be worked out accurately by a specialist so hopefully its just a blip and nothing to worry about.....
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bombsh3ll

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Re: Long QTc on Oestrogel?
« Reply #12 on: April 22, 2025, 09:51:48 AM »

I wonder how the cardiologist thinks your heart can tell the difference between 17 beta estradiol or progesterone molecules that have entered the bloodstream from your ovaries, or from exogenous gel or capsules.

I think a lot of cardiologists, particularly the older ones, still perceive HRT as dangerous and disapprove of it generally, believe they are doing the right thing by discouraging its use and will point to any symptom you have to do so  - "palpitations? must be the HRT, better stop that". Similar conversations take place throughout the medical system "Sore ear? must be the HRT, better stop that".  "Itchy feet? must be the HRT, better stop that".

If ovarian hormones caused arrhythmias, then surely younger women in their teens and twenties would be most affected.

Also if that were the case then the treatment for such conditions in a premenopausal woman would involve either oophorectomy or zoladex.

I suspect hormonal fluctuations are probably implicated more than the presence of ovarian hormones per se.

This may be able to be minimised by maintaining more consistent levels - have you tried patches or pills? I also agree that stable consistent lower doses of progesterone may be better in this instance than intermittent use at a higher dose.
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Cassie

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Re: Long QTc on Oestrogel?
« Reply #13 on: April 22, 2025, 02:24:46 PM »

Bombshll 3 I think the difference would be naturally ocurring hormones fluctuate on a daily basis esp through the monthly cycle but with HRT one is applying a set amount daily and there has been some reports on the use of Estrogen without Progesterone can lengthen the QT interval which is what one would not really want to happen. I really dont know how or why, and my thinking is much the same as yours but if you google, there certainly seems to be some concern, but hopefully the lady asking will be able to get clarity and update us as its all just a minefield out there and as you say when it comes to HRT it often gets bad press unnecessarily.
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Minicat

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Re: Long QTc on Oestrogel?
« Reply #14 on: April 22, 2025, 02:30:56 PM »

Some studies do suggest that certain forms of HRT, like Oestrogel, can increase the QT interval, and progesterone (like Utrogestan) might influence arrhythmias. It might be a good idea to have a chat with your doctor
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