Chest pain and perimenopause - British Heart Fou...

British Heart Foundation

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Chest pain and perimenopause

14566787 profile image
12 Replies

has anyone had symptoms of chest pain,hot flushes and nauseous due to the perimenopause? I've looked back when my symptoms started and it seems to have all started when I came off the combined pill. I'm awaiting a CT scan for my chest pain and on Bisoprolol and aspirin untill I get my scan due to family history.

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Milkfairy profile image
MilkfairyHeart Star

Microvascular angina can be a possible of cause of chest pain in women around the menopause.

Microvascular angina can happen in men too.

Microvascular angina along with vasospastic angina are types of non obstructive coronary artery disease NOCAD.

There are no permanent blockages of the coronary arteries, the person's angina is due to the blood vessels of the heart not working properly.

The BHF has this information about microvascular angina.

bhf.org.uk/informationsuppo...

Captain_Birdseye profile image
Captain_Birdseye

I'm not quite at perimenopause yet (I think) but I've noticed a flaring up of my symptoms (chest pain, temp fluctuations, pins and needles, etc) when I should be ovulating/menstruating.

But then it also happens when I'm stressed.

Women's health is grossly under researched... hormones play a big part in our bodies and we should be doing more research to understand their impact, on both women and men.

14566787 profile image
14566787 in reply toCaptain_Birdseye

100% agree there needs to be more research into women's hormones and how they affect the body. Same for heart attacks the classic pain in the chest is research on men is different for women having a heart attack and they can display many different symptoms to men. Oestregn protects heart health as it keeps the blood vessels supple and flexible and also protects your bones and against dementia.

Poppy451 profile image
Poppy451

I am at perimenopause/menopause and have been thinking I would like to take some form of HRT but am scared to do so due to the risks. It would be awful for my chest pain to get worse due to blockages or get a blood clot in the lung or something. I would be very anxious about that.

14566787 profile image
14566787 in reply toPoppy451

HRT through the skin by patches,gels etc have no increased risk of blood clots and are safe. HRT gets a lot of bad press but they help a lot of women and protect women's heart health as oestregn keeps the blood vessels supple and flexible and things like bone health and protect against dementia. There is loads of info on the balance website about the menopause

Milkfairy profile image
MilkfairyHeart Star in reply to14566787

The evidence is mixed about whether it's safe to take HRT after a heart attack or being diagnosed with angina.

What we need is more research about the safety of using HRT if you have heart disease.

You might be interested in this thread when HRT is discussed.

healthunlocked.com/bhf/post...

Sljp0000 profile image
Sljp0000

I asked my GP for HRT at the advice of my diabetic nurse. I was getting sleepness nights and feeling incredibly weary. Was trying to play golf (as i have done for years) but getting half an hour in and just didn't have any energy. Also had some chest pain on pushing myself hard physically as well as upper abdomen pain everyday.

Anyway, I've had scans and finally a an Angiogram. She wouldn't give me HRT until I had the results. Turns out I've got severe Coronary Artery Disease and need a triple bypass op. 🥺 Maybe you should wait until your tests are clear before you make any decision. I'm sure you'll be fine. Womens bodies are definitely unlike Men's! All our symptoms need to be checked out differently.

Good luck, hope all OK, Susie x

Shellac profile image
Shellac

Hi I'm going through perimenapause nightmare in itself I got an angiogram to check my mircovascular arteries on 16th I've already had s stent as Coronary artery disease I have been getting burning, aching, severe pain in my heart, cardiologist prescribed me ranexa which really works, once I have my angiogram then I will see the doctor about my perimenapause symptoms, my body is falling apart and rattling from all the medication but I've given up drinking and slowly changing my diet so hopefully my symptoms will get easier ❤❤❤❤

Milkfairy profile image
MilkfairyHeart Star in reply toShellac

The microvessels are too small to see during an angiogram.

To diagnose microvascular angina special tests are needed to check whether the small vessels can work properly. Adenosine and a guide wire are used to do this to measure how the blood flows through the small blood vessels.

Acetylcholine is then used to induce vasospasms, if it does then vasospastic angina is diagnosed.

Until recently this type of testing wasn't available so it's good to see that you are going to have the appropriate testing.

You might have microvascular or vasospastic angina. While the symptoms can be similar the treatment options are different.

Eg. Beta blockers can improve microvascular angina however are contraindicated in people with vasospastic angina as beta blockers can make coronary vasospasms worse.

You may find this article interesting about ongoing chest pain following a stent insertion.

acc.org/latest-in-cardiolog...

Good luck for your angiogram.

Shellac profile image
Shellac in reply toMilkfairy

Thank you not looking forward to the test but hopefully I will get some answers hope your ok ❤❤

Just-Wanna-Run profile image
Just-Wanna-Run

I too have microvascular dysfunction which started during peri-menopause. I started getting chest pain and breathlessness when running. I had been running half marathons without issue previously. As Milkfairy said, it's difficult to diagnose and my angiogram showed clear main arteries but the flow of blood was poor. I'm on felodipine and rosuvastatin and use a GTN spray before and during exercise. The consultant told me that around 70% of microvascular diagnoses are with perimenopausal/menopausal women. They believe that oestrogen protects the cell walls of the microvessels and when that drops its like the walls lose elasticity and collapse in causing the pain. I did ask if I'd taken HRT could I have prevented it and he said it is believed HRT protects the heart but these things just aren't researched enough.

Milkfairy profile image
MilkfairyHeart Star in reply toJust-Wanna-Run

There are also patients who are already taking HRT who then develop microvascular dysfunction too.

Definitely more research is required.

Many of us living with vasospastic angina have our symptoms from our 20's.

I was incorrectly diagnosed with microvascular dysfunction at first as it's more common in women.

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