Low heart rate ... convinced it's the HRT ...

[lyrapie]

Is anyone else familiar with this? I am in month 5 of HRT (age 50, perimenopausal). On Elleste Duet so 2 weeks oestrogen, 2 weeks progesterone. In the progesterone periods, I have episodes where my resting heart rate falls to low 40s (normally 60) with nausea, dizziness and tight chest etc. Dr convinced it is not HRT related and am now having ECGs etc. I am pretty convinced it is tbh. Interested to know if anyone has experienced similar.....

Not me, but I’m older and on full time utrogestan. My resting heart rate has been around 50 for years.

One type of progesterone- Utrogestan- does lower blood pressure in some women (but this is seen as a positive overall.) That's why it's taken at night as it can cause temporary dizziness (but that wears off within an hour or so.)

Never heard of this with Norethisterone which is the progestogen in your hrt. I used that alongside gel for 6 years before changing to Utorgestan, but never noticed that side effect.

Isn't the easiest way to check this to change to another hrt? The guidance is try one sort for 3 months then change if there are side effects.

Have you had your thyroid checked?

Interesting. Thanks.

Agree fully that it would be far easier to try another hrt. I have called Dr every month to say that I love the oestrogen but progesterone is causing issues. Different Dr every time. Most recent Dr referred me instantly to A and E for tests. I explained to him that I simply want another type. He said after the tests. I also explained to Dr at A and E. He said same. Seems bit of a sledgehammer to crack a nut if you ask me. I start progesterone in a few days so am hoping the first 5 months were snagging and this one will be event free.

Am going to research Utorgestan.

Thanks. Will look into Utrogestan.

Yes, have had bloods taken. Waiting for response....

One upside is that I appear to be having a full MOT! :)

@lyrapie good. Make sure you ask for the numbers because many GPs will say that your thyroid is fine but in my experience most women don’t do well with a TSH above 2 despite the top range being 4.

This is the Summary of Product Characteristics for Elleste Duet which is a reference for doctors and pharmacists to check for side effects. The 'undesirable effects' are listed under section 4.8 and there's no mention of bradycardia. So I would be surprised if these were causing your issues.
If you're concerned you could stop for a week or two and check your heart rate while you're off them.

www.medicines.org.uk/emc/product/6304/smpc#gref

Any GP worth their salt would check your heart out (plus everything else) if you have unexplained bradycardia - HRT would not be the most obvious culprit. (And with no wish to scare you, this was the main symptom of DHs blocked cardiac artery. Although obviously his wasn’t coming and going with progesterone!).

How are you measuring your resting heart rate?

@Cazzovuoi That's helpful. Thanks. Will do.

@pharmachameleon Thanks for the link. Useful. The bradycardia is episodic. One episode in month 3 so assumed it was an off day. Mentioned it to nurse at 3m review. She said not to worry unless repeated. Three episodes in month 4. Both half day events feeling very under par (actually took sick days - v rare). So not sure if stopping would reveal much? My current plan is to continue this month and see if happens again. Generally I am fit and well..but the low 40 episodes are pretty rubbish .... it's quite hard to breathe at times (sounds more dramatic than it is)

Sorry to hear about DH. Hope that's ok.

Did his bradycardia come and go?

Measuring in mornings before getting up on samsung phone or blood pressure machine. Normally 58/60. When episodes happen I measure while symptomatic. Dr said 40s is ok (unless severe chest pain) but 39 would need medical attention so I tend to check often to make sure it's not in that territory.

You def need investigations into your heart like an ecg or echocardiogram.

The other thing to think about is if the symptoms are anxiety / panic attacks.

A lot of women feel unwell during the progestogen phase and their meno symptoms increase (it's one of the main reasons women give up hrt.)

Do you feel it's possible anxiety?

@jinglingspringbells

V interesting re the progesterone phase. I didn't know that. Tricky this menopause business...

It's a good question. I am not ruling out the anxiety option. I am v good at repression and have a history of panic attacks. Tbh though I haven't had them for years and really don't feel anxious/stressed though I guess that's what repression is :) I asked the A and E Dr if it could be that and he said it was unlikely but I have started yoga again just in case 😅

Low heart rate Decapaptyl and Tibilone.
Resting HR is 42 has this happened to anyone else.GP has done an ecg and says all is well but when HR sitting low all doesn't feel well, feel breathless, dizzy, anxious.
BP is also high at 150/100 I'm on meds for this which means I usually have a resting heart rate of 59.
I have now stopped the tibilone as a process of elimination but the decapeptyl injection is a 12 weekly one due again 10th Oct!

Did you ever get to the bottom of this or find a solution? I am in the same position.