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You are here: Home » Family Management Tips » POTS and Periods: Why Symptoms Worsen and How to Manage Them

By Stacy Williams January 16, 2015

POTS and Periods: Why Symptoms Worsen and How to Manage Them



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It is hard enough to live with Postural Orthostatic Tachycardia Syndrome, but for many women, the menstrual cycle brings another level of complexity. Many report that their POTS symptoms tend to spike right before or during their period. Hormonal fluctuations, changes in blood volume, and even stress levels can all contribute to this phenomenon, leaving many searching for answers and relief.

In this post, we’re going to dive into the relationship between POTS and periods, why symptoms worsen at certain stages of the menstrual cycle, and most importantly, how you can work with those flare-ups in practice. If this is the first time you’re experiencing this or looking for ways to cope better, we’re here to give you clarity and support. Let’s dive in.

Why Does POTS Get Worse Before and During Your Period?

Many women with POTS observed a notable increase in symptom exacerbation from several days leading up to, during, and just after menstruation. Such changes are a direct result of hormonal shifts caused by the menstrual cycle.

The Role of Hormonal Changes

Hormonal levels, particularly estrogen and progesterone, change in the menstrual cycle. Both hormone levels plummet days before menstruation. Estrogen helps to keep blood vessels healthy and maintain the volume of blood. If the estrogen falls, then there may be a problem with low blood volume and even greater difficulty managing blood pressure, which may make dizziness, fainting, and heart palpitations worse symptoms of POTS.

Similarly, progesterone has been shown to reduce anxiety within the nervous system, and withdrawal could lead to heightened susceptibility to certain stressors potentially elevating dysregulation within the autonomic nervous system-one of the most central pathophysiologies behind POTS. In combination with these hormonal imbalances, they may be correlated with a significantly poorer prognosis.

The Compounding Effects of PMS Symptoms

In addition to hormonal shifts, premenstrual symptoms like bloating, fatigue, and dehydration can further exacerbate POTS symptoms. Bloating, for instance, can put additional strain on the cardiovascular system, making it harder for the body to maintain stable blood pressure and blood flow when standing. Fatigue, a common premenstrual complaint, can worsen the chronic exhaustion already experienced by many individuals with POTS, leading to a cycle of low energy and increased symptom severity. Dehydration, which can occur due to hormonal influences on fluid retention and loss, is another significant factor.

For individuals with POTS, maintaining proper hydration is crucial for stabilizing blood volume. Even mild dehydration can lead to a sudden worsening of dizziness, brain fog, and rapid heart rate. Understanding the interplay between these factors is essential for developing effective strategies to manage POTS symptoms during this time. By addressing both hormonal changes and PMS-related challenges, it’s possible to reduce the severity of flare-ups and regain a sense of balance.

Common POTS Symptoms During Menstrual Cycles

For individuals with POTS, the menstrual cycle can amplify symptoms that are already challenging to manage. Understanding why POTS symptoms worsen during your period involves looking at hormonal fluctuations, along with the physical and emotional toll of menstruation, which often lead to more pronounced episodes of certain symptoms.

Here’s a closer look at the most common POTS symptoms experienced during periods:

Increased Tachycardia

One of the hallmark symptoms of POTS is an elevated heart rate upon standing, and this can worsen significantly during menstruation. The hormonal drop in estrogen and progesterone, combined with potential dehydration, can make it harder for the body to regulate blood flow. This often results in a noticeable spike in heart rate, which can feel overwhelming and exhausting.

More Frequent Dizziness

Dizziness is another common symptom that tends to intensify during the menstrual cycle. Changes in blood volume and fluid retention, combined with the body’s difficulty in maintaining stable blood pressure, can cause frequent episodes of lightheadedness or even fainting. Standing up or moving too quickly during this time can become especially challenging.

Severe Fatigue

PMS-related fatigue is something many individuals experience, but for those with POTS, it can be debilitating. The body’s increased effort to regulate blood flow, coupled with the physical demands of menstruation, often results in profound exhaustion. Tasks that might feel manageable at other times of the month can become overwhelming during a period.

Nausea and Headaches

Hormonal shifts during the menstrual cycle often lead to nausea and headaches, which are already common in POTS. Some individuals may also experience migraines triggered by the drop in estrogen. The combination of these symptoms can make eating and staying hydrated — both crucial for managing POTS — more difficult.

Brain Fog

Cognitive challenges, often referred to as “brain fog,” are another common symptom that can worsen during menstruation. Difficulty concentrating, forgetfulness, and feeling mentally sluggish are all exacerbated by the additional strain on the body. These symptoms can be frustrating and impact daily productivity and well-being.

Understanding these common symptoms and their triggers during the menstrual cycle can help individuals with POTS anticipate and prepare for flare-ups. Proactive management strategies, including hydration, rest, and dietary adjustments, can make a significant difference in navigating these challenging days.

How to Manage POTS Symptoms During Your Period

Managing POTS symptoms during your menstrual cycle can feel overwhelming, but with the right strategies, it’s possible to minimize discomfort and maintain better control over your health.

Here are some practical tips to help you navigate this challenging time:

Stay Hydrated with Water and Electrolytes

Hydration is critical for individuals with POTS, especially during menstruation when blood volume and fluid balance may be compromised. Drinking plenty of water throughout the day helps, but adding electrolytes to your routine can provide even greater support. Products like Buoy, which offer convenient and effective hydration solutions, are excellent for replenishing electrolytes and combating dehydration. This can significantly reduce symptoms like dizziness, fatigue, and tachycardia.

Eat a Nutrient-Rich Diet

A well-balanced diet can play a key role in managing POTS during your period. Focus on foods rich in iron and magnesium, as menstruation can deplete these essential nutrients. Iron helps maintain healthy blood flow and energy levels, while magnesium supports muscle relaxation and nervous system health, reducing cramps and fatigue. Incorporate leafy greens, nuts, seeds, whole grains, and lean proteins into your meals for optimal benefits.

Track Your Symptoms

Keeping a detailed symptom diary can help you identify patterns and triggers specific to your cycle. Use a journal or a health app to record daily symptoms, changes in heart rate, dizziness episodes, or fatigue levels. Over time, this information can help you anticipate flare-ups and adapt your self-care routine accordingly, making it easier to stay ahead of your symptoms.

Prioritize Rest and Gentle Exercise

Rest is essential during menstruation, particularly when POTS symptoms intensify. Allow yourself to take breaks and focus on restorative activities. However, gentle exercise, like stretching, yoga, or light walking, can also be beneficial. Movement improves circulation and may help reduce symptoms such as bloating and stiffness without overtaxing your body. Listen to your body and avoid strenuous activities that could worsen your symptoms.

By implementing these strategies and finding what works best for you, you can better manage POTS symptoms during your period. Small adjustments, like incorporating electrolyte support from solutions like Buoy, eating nutrient-dense foods, and prioritizing self-care, can make a significant difference in maintaining balance and comfort during this time.

Living With POTS and Menstrual Cycles

Living with POTS can be challenging, and the added fluctuations of the menstrual cycle may sometimes feel overwhelming. However, it’s important to remember that while symptoms may flare up during your period, there are effective ways to manage and reduce their impact. By staying hydrated, nourishing your body with nutrient-rich foods, tracking your symptoms, and allowing yourself time to rest, you can take proactive steps toward feeling more in control.

Managing POTS is a journey, and it’s okay to have days when you need extra care and support. Celebrate the small victories, and don’t hesitate to reach out to healthcare professionals, support groups, or loved ones for guidance. With the right strategies and mindset, you can navigate the ups and downs of POTS and menstrual cycles, empowering yourself to live a balanced and fulfilling life. Remember, you are not alone, and every step you take is a testament to your strength and resilience.

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Bio of Stacy Williams, blogger and authorI’m Stacy and I am on a journey to become a six figure family and I would love if you came along with me! We'll kick off our shoes, sip sweet tea, eat loads of goodies, save some money and maybe even learn a thing or two along the way! Six Dollar Family Bio

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