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. 2013 Jun;23(3):117-22.
doi: 10.1007/s10286-013-0190-1. Epub 2013 Mar 7.

Gynecological and menstrual disorders in women with vasovagal syncope

Prasuna Muppa  1 , Robert S Sheldon, Maureen McRae, Nancy R Keller, Deborah Ritchie, Andrew D Krahn, Carlos A Morillo, Teresa Kus, Mario Talajic, Satish R Raj
Affiliations

Gynecological and menstrual disorders in women with vasovagal syncope

Prasuna Muppa et al. Clin Auton Res. 2013 Jun.

Abstract

Purpose: Vasovagal syncope (VVS) is a chronic debilitating condition seen mostly in young women of reproductive age. There are anecdotal reports of increased syncope and presyncope around menstruation. This case-control study assessed the effects of the menstrual cycle on lightheadedness episodes and compared the gynecological and pregnancy history of VVS patients to healthy subjects.

Methods: A custom-designed gynecological and menstrual cycle questionnaire was previously developed for patients with orthostatic intolerance. This questionnaire was administered to female patients with VVS (n = 128) as a part of the multicenter Second Prevention of Syncope Trial, and to gender-matched healthy subjects (n = 92).

Results: VVS patients and healthy subjects reported significant variability in self-reported lightheadedness throughout the menstrual cycle. Both cohorts experienced greatest lightheadedness during menses (53 ± 2 vs. 56 ± 4), which decreased during the follicular phase (44 ± 2 vs. 41 ± 4). VVS patients reported less severity in premenstrual symptoms (Fisher's method P = 2.7E-06) compared to healthy controls. There is no difference in the incidence of gynecological abnormalities (Fisher's exact P = 0.193) and pregnancy complications (P = 1.0) between the two cohorts. VVS patients have similar pregnancy rates compared to healthy subjects (P = 0.674).

Conclusion: The severity of lightheadedness varies during the menstrual cycle and is similar in both VVS patients and healthy controls. VVS patients have no greater risk of gynecological abnormalities and pregnancy complications than healthy subjects.

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Figures

Fig 1
Fig 1. Menstrual Lightheadedness Profile of Vasovagal Syncope Patients and Healthy Subjects
The degree of self-reported lightheadedness (in arbitrary units [a.u.] with 100 being worst) during the four phases of menstrual cycle (menstrual, follicular, early luteal, and late luteal) is shown. Both vasovagal syncope (VVS) and healthy subjects perceive similar changes in lightheadedness during the menstrual cycle
See this image and copyright information in PMC

References

    1. Moya A, Sutton R, Ammirati F, Blanc J-J, Brignole M, Dahm JB, Deharo J-C, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Ruiz Granell R, Sarasin F, Ungar A, Van Dijk JG, Walma EP, Wieling W. Guidelines for the diagnosis and management of syncope (version 2009) Eur. Heart J. 2009;30:2631–2671. - PMC - PubMed
    1. Shaffer C, Jackson L, Jarecki S. Characteristics, perceived stressors, and coping strategies of patients who experience neurally mediated syncope. Heart Lung. 2001;30:244–249. - PubMed
    1. Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz IJ, Schondorf R, Stewart JM, Van Dijk JG. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Auton Neurosci. 2011;161:46–48. - PubMed
    1. Park J, Jang SY, Yim HR, On YK, Huh J, Shin D-H, Kim JH, Kim JS. Gender Difference in Patients with Recurrent Neurally Mediated Syncope. Yonsei Medical Journal. 2010;51:499. - PMC - PubMed
    1. Serletis A, Rose S, Sheldon AG, Sheldon RS. Vasovagal syncope in medical students and their first-degree relatives. Eur. Heart J. 2006;27:1965–1970. - PubMed

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