Gynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome

Objective: To assess differences in gynecologic history and lightheadedness during menstrual cycle phases among patients with POTS and healthy control women. Methods: In a prospective, questionnaire-based study carried out at Paden Autonomic Dysfunction Center, Vanderbilt University, between April 2005 and January 2009, a custom-designed questionnaire was administered to patients with POTS (n = 65) and healthy individuals (n = 95). The results were analyzed via Fisher exact test and Mann-Whitney U test. Results: Patients with POTS reported increased lightheadedness through all phases of the menstrual cycle phases as compared with healthy controls. Both groups experienced the greatest lightheadedness during menses, and a decrease in lightheadedness during the follicular phase. Patients with POTS reported a higher incidence of gynecologic diseases as compared with healthy controls. Conclusion: The severity of lightheadedness was found to vary during the menstrual cycle, which may relate to changes in estrogen levels. Patients with POTS also reported an increase in estrogen-related gynecologic disease.