Peri Menopause & AF

Hi, any ladies peri menopausal with AF here? I am and I've been told by two GPs now that I can't take HRT. I think more so because I'm on warfarin long term. Both Doctors suggested 'the alternate' route and to look on which I did yesterday. Seems that not only am I at risk of stroke with the AF, but now due to the menopause, oestrogen declines and makes me more at risk! Going to see my consultant in May but tbh when I've said previously about how I feel my symptons heighten when pre menstral - only to be met with a shrug.,, I'm not holding out much hope for a definitive answer on this from him. I'm independently researching as much as I can. But just wondered if there's any ladies in a similar boat to me that could share their story? Tia Andria 😊

11 Replies

  • There is a long thread about this very subject a few days ago if you look back over recent posts. I am sure your answers are all there.

  • Hi Andria,

    I am about a bout a year in to the menopause?? and when I went to see my GP with symptoms she said if I wanted to use HRT then she would need to contact cardio to see what would be safe??,however I have been on fluoxetine for a couple of years anyway and they appear to be taking the edge off all things menopausal I think, well apart from horrendous flushes!!

    I wouldn't say my menopause made my AF any worse ,but we are all different I guess.

    Wendi x

  • My menopause was pre-AF.

    I had had cancer and asked my very old and very wise GP what he thought of HRT. He told me that he didn't recommend it as it would merely delay the menopause. So I coped with the hot flushes and made sure that I ate properly and took a mineral/ vitamin tablet daily.

  • Hi, Bob is correct, we've been talking about this a lot the past few days. Taking estrogen does increase your risk of stroke, so that is why you are not a good candidate for HRT, however there are some non-estrogen containing medications, such as Brisdelle that help with symptom control and will not increase your stroke risk. It is very common for AF symptoms to worsen with estrogen and progesterone fluctuations that occur during perimenopause. You need to find a clinician who is willing to listen and to work with you to help you stay comfortable, as well as safe. Feel free to message me if you have other specific questions, as this my specialty was gynecology and subspecialty was menopause.

  • Hi Srmgrandma 😊 I really appreciate your thoughts on this thankyou. I spoke to my anti coagulant nurse today and she said no to hrt for me, could make me more at risk. I cant see my gp until late April... I'm trying to get this sorted out but I'm either getting conflicting answers or no help at all. Which is why I'm especially grateful to you. Are you in the UK? X

  • No, I am in the U.S. When I was going through menopause, my EP, my gynecologist, and I all agreed that a very small dose of estrogen was an acceptable risk because I was on anticoagulation, and my AF episodes were so rare as long as I was on the HRT. Being off the estrogen ramped up my AF. So I made a strong case for it at the time, and for me, it was the right thing to do, and I had supported my arguments with good science, so we all worked together. It was another instance where it was most helpful to be a medical professional, so they really listened to my opinions.

  • Hey Andria

    I'll leave SRMGrandma to give you the best advice as she sounds well qualified!

    Just wanted to mention the mirena coil though.

    Not sure what your menopausal symptoms are, but I've had this little device for bleeding issues which I imagine may affect you too if you are on any form of anti-coagulation. I was on aspirin at one stage and it caused a lot of problems with bleeding and my heart rhythm menstrually.

    The mirena is progesterone based and this may be a problem for you...not sure....ask SRMGrandma. I am early 50's and although I get flushes all other hormonal issues (including stabilising any mood fluctuations) seem to be helped rather a lot by this device which I've had in place for about 4 years now. Also no periods....yay!

    I find that removing periods - which it does (after 6 months or so) - has made me more able to tolerate other symptoms as it's evened out my monthly mood swings too.

    I understand v.small amounts of oestrogen can be used to "top up" the hormones in the coil as menopause advances or if symptoms become difficult. Maybe you could manage better with small doses of oestrogen rather than HRT.

    I didn't have tachycardia when mine was put in so I didn't meet with any resistance. It will be interesting to see what they say when I want a new one next year! I can't cope without it!


  • Hi misdiagnosis 😊 mine isn't so much the bleeding, it's the awful moods, feeling 'weird' memory is bad at times, itchy skin, especially very sore eye lids. Feeling really low. Haven't had the hot flushes much (yet?) but I just know I've got more to come yet. I'm quite an upbeat person but I've even considered anti depressants lately ( but really don't wanna go down that path of I can help it) thanks for your reply. I hope if the mirena keeps working for you and you're allowed to 'keep it' x

  • Hi, i had an attack of svt in nov 2015 and have been horrendous at times of menstruation and now feel pms-y all the time, a locum suggested antidepressants (not wanting even more tablets, coming off bisoprolol and came off flecainide due to side effects). Also feeling extremely low with awful moods. Locum dr says stop being so tough on yourself and trying so hard. At present i am hiding away from all but have for the last days walked 3 or 4 miles and i think it's helped a bit. Anyway he thinks i might be coming into the menopause. Not much to add other than you're not alone! Ehug to you.

  • Hi stargazer 61 😊and thanks for your reply. That's how I feel, and it's not like me to not be sociable but I get days I don't wanna see anyone and then I go the opposite and crave friend's company. Good that you're getting out walking. I feel better when I do go out. Suppose we're in for a rocky ride, best we put our belts on and we'll get there ok 😊👍

  • The Mirena IUD is an excellent choice to get you through peri-menopause if bleeding is an issue. It keeps that uterine lining nice and thinned out. Progesterone is not thought to increase stroke risk significantly. If you are due for another one next year I doubt they will refuse you. Glad you have something that is working for you.

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