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[KaraShannon]

Hi all

another ectopic heartbeat question. 

I was told 4 years ago my ectopics are benign and possibly hormonally triggered (which I think they are usually).  I was also told that ectopics at rest are more likely to be benign than ones on exertion but this doesn't mean the latter are a problem necessarily. 

So today I was rushing and crossed a road quickly before a car turned and my heart did somersaults by the time I'd crossed and for about 4 steps after that. 

Please anyone else who gets ectopics that have been told most likely hormones and benign, tell me you get them on exertion like this.  Kinda brings on the anxiety about them again.  I will tell the doctor but I've told them so many things and get told not to worry.

[Wrensong]

Hi, yes this happened to me for a number of years.  I had really worrying ectopics throughout peri & beyond well into postmenopause until I began HRT.  Though they used to occur at rest, one of the triggers was also definitely exertion.  It felt as though when required to speed up, my heart couldn't easily adapt the pace appropriately.  Cycling was one activity that frequently caused this, about a mile into a regular route when an uphill section started, my heart rhythm would start going haywire.  I also used to find the ectopics sometimes kicked off after exertion.  Again a bike related example - when I used to get off after a ride the ectopics would start at a point when heart rate should be smoothly slowing down.  I also remember the exact same scenario you describe - crossing the road after waiting some time for a gap in traffic, then having to cross quickly, sparking off the unnervingly irregular beat.   

It was eventually thoroughly investigated by Cardiology & diagnosed as benign ectopics, but continued to be a worry as I'm a thyroid patient & had other symptoms suggestive that my thyroid dose was wrong, but that equally could have been due to menopause.  In short, a nightmare that no medic was really sure about, compounding the worry.

You've sensibly said you will mention it to your GP & though I know so well the feeling of not wanting to be a nuisance, I would do so.  It was impressed upon me by hospital staff that it's always right to seek help with heart symptoms if we're worried & that that's what they're there for.

One other thought - if you're on HRT, at the wrong dose this can be a causative factor.

I hope you soon get through this horrible phase as I know how anxious a time it can be. 

[KaraShannon]

Thanks Wrensong, that is what I needed to hear.............I know I can't be diagnosed on the internet but just knowing that other women get this makes me feel less like I'm the only one and that it's seriously dangerous.  Although I agree heart symptoms must be checked out....and anyone reading this, get symptoms like that checked out, don't listen to me.

My cardiologist said as long as I feel ok I don't need to do anything, but that was after thorough checks, an echo, holters, etc.  But I should be rechecked soon.

I am in fact getting all the things you describe, especially since march and since being on continuous hrt at 100 estradiol (no progesterone in that time but I'm going to take it 14 days after my last period again).  I also have thryoid issues (hashimotos).  Blood test in 2 weeks.

[Wrensong]

No problem KS.  I usually try to post if I see someone's worried about ectopics as it was the most frightening symptom for me & I felt very alone with the worry.  No access to MM at that time, no remaining female relatives to ask & no-one I knew hypothyroid or going through menopause.

Like you I had holter monitor, echo, ECGs, treadmill test & more.

I also found my ectopics & other meno symptoms were at their worst in the 10-14 days before a period, however long the cycle.  I used to dread that time, with night sweats & insomnia off the scale & it was as much as I could manage not to go insane.

If you're also hypothyroid I think this can complicate menopause for us, so it's good that you've got a TFT coming up & you can then adjust your thyroid meds if that's indicated, which should help stabilise your heart rhythm. 

That's quite a high dose of oestradiol, not that I'm suggesting it's wrong for you, but have you had bloods to check how well you're absorbing to rule out too high/low oestrogen as a causative factor?  Just a thought. 

Not sure what progestogen you're on & we're all different in terms of what suits us, but I can't use Utrogestan as amongst other truly horrendous side effects it brings back my ectopics with a vengeance, which are otherwise well controlled postmeno, though changes of HRT dose & thyroid meds, up or down, tend to set them off for a couple of weeks, while my body adjusts.

Let us know how you get on?
Wx

[joziel]

KaraShannon, those type of ectopics in a scary situation sound very normal for anyone, even for men and pre-menopausal women 

I mean, that's where the phrase 'my heart skipped a beat' comes from. When something scary happens, it's what our bodies do. I wouldn't think about it being due to the exertion there so much as the fear response... 

[KaraShannon]

wrensong and joziel, thanks for your replies.  I will reply properly soon, I'm exhausted at the moment but will come back to this.  Both replies were really helpful 

[Wrensong]

KS, please don't worry, just do what you can to feel better.

joziel, yes absolutely, a skipped beat or two can be a familiar part of an appropriate fight or flight response to a threatening situation & in this case the heart irregularity is usually fleeting & no cause for concern.  But at menopause some women also find they start getting very noticeable bouts of irregular rhythm without any apparently appropriate trigger & that's when it becomes unnerving. 

In my case this occurred in episodes of around an hour at a time, 24/7, for about a decade, starting during peri & continuing 3 years into postmenopause shortly after I began HRT & a few weeks after a change in thyroid medication (tweaks to both of which still set them off for a week or so though I'm now long postmenopause). 

Cardiology confirmed as due to benign ectopics, these often came on at rest when I was perfectly relaxed & frequently woke me at night.  As in my earlier post, other situations that seemed to initiate them were those where a change of pace is required, during exertion & when stopping exercising.  Prior to peri my body adapted to this smoothly, the heart rate speeding up or slowing down as the situation demanded, while still maintaining a regular rhythm.  During the menopause transition though, for some of us the body's pacemaking capacity seems to malfunction. 

Women with thyroid conditions are already predisposed to palpitations, so I think it's a symptom we as a subset are perhaps more likely to find can become especially troublesome as a result of the sex hormone chaos we experience at menopause.  Our bodies' ability to maintain homeostasis being doubly compromised if you like  .

[joziel]

Wrensong and KaraShannon, can you tell me more about your ectopics?

I guess it was only when my GP listened to my palpitations last week and said I have lots of ectopic beats, that I realised that my palpitations were ectopics (probably). I am currently waiting for a cardiology referral to the disrhymia clinic to come through so they can check it out properly. If it is going to be ages, I will have to go private.

I have terrified myself reading about all kinds of heart problems  so it's reassuring to hear from you both who've been told they are benign and you can ignore them. I just don't want to end up on medication for the rest of my life for some heart issue    I have no history of this before starting HRT in March.

I have now stopped the estrogen (10 days ago) due to this but fortunately my own ovaries appear to have woken up after I came off desogestrel and are now contributing their own estrogen. I am still taking the utrogestan 200mg continuously to suppress endo. I have stopped the testosterone until I've resolved this issue but plan on restarting it.

With your ectopics - how long did each episode go on for? My heart gets stuck in this for hours. Before I stopped the estrogen it had become 24/7, but now it's not happening much during the day - so I guess that is a sign of improvement. But it is happening at night still. And it is worse when going to sleep, often coming on just as I'm falling asleep - and then continuing for hours through the night. It is hard to sleep properly. I am getting maybe 4-5 hours sleep a night, not deep sleep.

I can exercise fine and have no problems then - in fact, I've used exercise a couple of times to stop an episode of palps. But that's not very practical at midnight when I want to sleep 

Were your ectopic episodes for hours at a time? And were you given any meds to stop an episode, just so you could function normally and sleep? (Even if this is benign). Like beta blockers? Lastly, what tests did you have run and what should I make sure are run? I am hoping they do a 48hr ECG and an echo-cardiogram at least. (I've had a normal ECG in hospital A&E - which was a normal result because I wasn't having an episode then.) Thanks!

[Songbird]

Ectopics are disconcerting, I have to say. I also had “benign ectopics” diagnosed years ago but it was never explained to me what the possible cause could be.  I just felt I had to accept it.  It was, for the most part, at rest that they were occurring or if I, for example, got into an argument with someone  …….They happened a lot and it has only been since starting evorel 50 and utrogestan that they have completely disappeared. I can hardly believe that, for me, it has completely been down to diminished hormones 

[joziel]

For me, it only started when I increased the hormones 

This also happened when I was 21yo and went on the combined pill. I was a uni student and I remember trying to write a paper in the library with my hands pulsing and heart beating hard - it didn't feel like palps then, but some of these other symptoms were the same. And lying in bed in my student dorm, feeling throbby and weird. I just stopped the pill and switched to a POP and all was fine shortly after. I don't remember it going on like this after stopping the estrogen. But then I was on the HRT longer than the pill and at a higher dose.

Songbird, how long did your episodes of benign ectopics last? Was it just one or two? Minutes? Hours? Did they feel like a fluttering in the top part of your chest? I also feel it as a sort of tension across the top of my back... a sense of unease.

[Songbird]

Hi Joziel
I'll tell you exactly what happened with me..
Ectopics started in my early 40s, I had a microwave ablation at 44 due to heavy periods. I gave the anaesthetist a "fright" due to  a heart flutter (blimey, he gave me a fright when he told me!) Heart investigations uncovered benign ectopics so I can tell you I have been living with it for 13 years. I just thought I was an anxious worry wart and this was what was causing this disturbing symptom. I never dreamt that it was due to being in perimenopause and, for me, it was hormone decline!
I experienced them , pretty much, every day (sometimes several times a day) and for a minute or so each time. It was in the top part of my chest, it did feel "fluttery" and a creeping feeling of heat accompanied it. Horrible!
I finished up in A and E a couple of times because my anxiety at the time told me that this was a heart attack so I promptly experienced chest pain!!
Fast forward 13 years, 6 months into taking systemic and local HRT and I'm ectopics free (took bloody long enough though).
As a slight aside, to any lady reading this, I took early retirement due to inability to cope at work - again I thought my anxiety and physical symptoms were my fault. Had I taken HRT back in my mid to late 40s, I would have kept working, I have no doubt about that.
It's worked OK for me really as hubby is retired and we're all good but I would hate to think of any lady doing as I did (disregarding HRT because of my misinformed state) 

[joziel]

Thanks, that's very useful!

I'm a bit concerned that this goes on for literally hours for me. I mean, just before I stopped HRT it was pretty permanent as a 24/7 state of being - which is why I stopped the estrogen. Even now it appears to happen all night from about 11pm through to 7am. It doesn't help that I am now anticipating it and dreading it starting, I think the anxiety really doesn't help keep the palps away.

Before any HRT, I did have a different kind of palpitation - it was a single skipped beat which was very noticeable and always surprised me. (No way I could have not been aware that was happening.) Since I started estrogen, that kind stopped immediately - so that was a low estrogen symptom. But then I got the fluttery kind...

I'm also really worried about what happens when I really do go through peri or have estrogen drop so that I really do need it. The thought of having to choose between all the awful low estrogen symptoms I had and this estrogen-related heart stuff... I just don't know what I'm going to do.

So - the tests I need are a 48hr ECG holter and an echocardiogram? I have ordered a 6-lead Kardia ECG thing for my iPhone in an attempt to try to capture some of this.

Oh another question: Is there any way this could be caused by the utrogestan which I'm still taking? I think not, as it has improved a lot since I stopped the estrogen and due to my history of estrogen causing this in the past for me. But I just wondered if other people had palps caused by the utrogestan.

[Marchlove]

The only way you know joziel is by stopping it for a night or two! X

[joziel]

True, but I have a big psychological barrier about that  because it's suppressing the endo. It's actually doing that really well at the moment. I do have a bit of light bleeding for a few days (as when on a POP) but no pain. I feel like, psychologically, progesterone/progestin is something I cling to as warding off the endo.

But I have put a lot of things in place recently, totally overhauled my diet and added in all the supplements Lara Briden recommends. I did hope to, when everything is stable, try to go sequential with the utrogestan.

There was one night that I forgot to take the utrogestan - but remembered at 3am. I remembered because I was awake due to palps so perhaps it's not the utrogestan 

I've just got the referral through for the clinic. It's for a MONTH'S TIME.  I'm going to call on Monday and explain how severe everything is and see if I can get in earlier.

[Marchlove]

That sounds like it rules the Utrogestan out.

I’m sorry to hear your appointment is for a months time, it’s ridiculous!
Cardiologist’s seem to be overrun at present so perhaps you should seriously consider going private. 

X