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[saz42]

Hi all, just looking to see if anyone has had similar to me or has any ideas for when I speak to my GP next.

I posted a while back about very heavy bleeding on Evorel Sequi.  Thankfully that problem has been solved, but when I switched to an new HRT (estradiol gel & utrogestan), I got a constant thumping heart and chest pains.  I ended up in A&E with this & was very thoroughly checked out - everything was absolutely fine.  I stopped my new HRT and the thumping completely subsided but the chest pains randomly carried on happening although at a much lower level. 

Because of a struggle with my GP, I was eventually off HRT completely for about 6 weeks - all my symptoms came back - hot flushes, night sweats, disrupted sleep etc etc.  I've now gone back to Evorel - starting on 25 & after two weeks going up to 50.  I'm due to start Utrogestan in a few days & my 'thumpies' and very slight chest pains are back.  I don't understand why a hormone that agreed with me perfectly (apart from the heavy bleeding) for so long is now doing this to me!

The only difference that I can think of is that I'm now taking ferrous fumarate to get my iron levels back up. 

Has anyone else had this?  Or has any ideas of questions I can ask my GP next time I see her?  She's suggested I stay on the HRT this time and I'm getting further blood tests / ECG soon, but apart from that, she seems as bewildered as me.

On top of it all, I haven't really slept properly for about 3 weeks now, which really isn't helping!!

[CLKD]

What kind of chest pains?

Is it a dull ache: intermittent: stabbing ........

If you are taking 50 from 25 that's a HUGE jump.  MayB go back to 25 for a few nights to see whether it will ease the thumping feelings?  Some find that keeping a mood/food/symptom diary of use to chart symptoms.

Your GP should be asking colleagues etc. as well as referring U to a dedicated menopause clinic, there are waiting lists both in the NHS and private areas. 

[saz42]

Thanks!  I was on 25 (half a 50 patch) for two weeks before I started back to the 50 patches (which I was fine with before).  I only had the thumping heart for a day or so when I started back on the patches and it settled down quickly.  I'm hoping that it is just the adjustment to the higher dose & will eventually settle down again as I had nothing like this before on the 50 patches.  I didn't think that it was such a big leap from half a patch to a whole patch as I'd been fine on the 50 patches for more than 2 years before.  So weird!  The only thing that's changed is the iron, I can't think of anything else that might be making me react to something I was fine with for so long.

I was recommended this gradual approach by a Menopause specialist.  Was this wrong?

My lovely partner bought me a diary yesterday so I've just started tracking all my symptoms / food / mood / when I'm taking my iron etc.  Hopefully that will give me some clues!  I also use my Garmin (fenix 5) to track heart rate / exercise / stress etc so I'm hoping to have a fully picture soon.

[CLKD]

I would speak to a Pharmacist about any connections between iron and chest pains.  Your GP should of course be in the know  .

Also if hormone levels change in those months where you weren't taking replacement, that may impact on any reactions to restarting.

[saz42]

Definitely!  I feel the main thing my body needs at the moment is a bit of stability!  Unfortunately the only thing that is stable at the moment is my exhaustion...

I have an appointment with our GP Pharmacist on Monday, so I will ask her then.  Good idea.

Thanks for your help.

[MileyCyprus]

Could the thumping heart be anxiety? Do you notice it all day or just at night when you're relaxing?  I saw a private heart specialist when I was pregnant with DD. I was going through an extremely stressful time and was experiencing huge health anxiety.  The specialist explained it all perfectly and put my mind at rest.  Things eventually settled down. Hope you start to feel better.

[joziel]

saz42, this sounds very similar to me. Unfortunately your own estrogen levels are fluctuating a lot during peri. And I think it's the fluctuations which can cause symptoms.

I also get the thumping heart which is also beating faster than usual and it tends to happen at night. Is yours worse at night? It leads to insomnia and I see you also have problems with sleep.

I also stopped HRT for about 6 months due to these symptoms (along with tingling feet and hands). It did all subside a lot but it didn't completely go and I still had insomnia as a result and I also got all my low E symptoms back (like you did) so I restarted the HRT (like you) and gradually increased.

I think we actually need higher estrogen levels to overcome the fluctuations so on the basis that my levels have never been higher than about 340pmol, we are trying to get me up to 450-650pmol to see if this helps. I'm with Newson. However getting me up there is a task and a half because I don't absorb well transdermally. I'm now on 12 pumps of gel but my levels are no higher than when I was on 6 pumps of gel.

Which is all to say: Like you I spent ages experimenting with stopping E and with very gradually increasing E but the other thing to explore is really getting that E up - because the thumping heart thing can also be low E...

I also began with a ferritin of 30 and got up to 62 orally but couldn't get higher, so I had an infusion. Which took me to 250 and now 1.5 years later it's 143. And all that hasn't helped these symptoms although it did help with air hunger and weakness, so I'm glad I did it. (I had the infusion privately, hoping it would fix these symptoms.)

The lack of sleep is debilitating and I'm so fed up of the effect of all this on my life about 3 years later. I haven't had a normal night of sleep in 3 years.

[saz42]

There is so much truth in the last 2 messages, so thank you!  Makes me feel less alone.

I am definitely suffering with some anxiety and I think that's where the chest pains in particular are coming from as I have experienced them before many years ago during a career crisis.  The thumping heart thing is new though.  I'm taking heart from the fact that the thumping has been intermittent rather than constant this time round thankfully.  It disappeared completely yesterday for a long while, returned this morning for ages and has now gone again.  Last time, it was constant, day & night. 

I definitely think that the problem relates to fluctuation in my estrogen or too little estrogen.  My doctor's plan is to slowly ramp it up gradually to a higher level than I was on previously as my old dose only got rid of some of my symptoms, not all of them.

I'm hoping that the iron tablets and far lighter periods will get the iron up eventually, but I've got a very long way to go on that as my ferratin was 5.3 last time I had it tested.  I don't think I will have ever had decent ferratin levels due to stupid heavy bleeding since I was 12. Nobody seems bothered by the low iron though and I've had to fight harder to get that sorted than I have for the HRT!

Thanks again for all your insights.

[joziel]

saz42, I had an iron infusion to fix my ferritin. It can indeed cause those heart beating hard symptoms. If you are on Facebook look up the group called 'The Iron Protocol' and check out the guides there. It's very helpful.

I began at 30 ferritin and got it up to 62 orally. I couldn't get higher and my symptoms were so bad, I decided to get an infusion privately. I went to the London Iron Clinic. If you google it, you'll find it. There is also one in Cambridge (Cambridge Iron Clinic). That did the trick and got me up to 211. Only a year later it has dropped to 143, so I'm going to need to start a low level supplement to keep it up I think.

[BermudaQueen]

I had similar to you, thumping heart, rushing in my ears, feeling like my heart was in my throat…

In the end I contacted the GP practice nurse and they were wonderful - did blood tests, blood pressure and ECG… all fine other than borderline anaemic (so as recommended by my GP, taking an iron and multivitamin every day)… feel a lot better not only that there nothing serious happening and that they do care.

The recognition and understanding of all the awful symptoms of menopause is getting better thankfully 🙏