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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Acknowledgments
This study is supported in part by Canadian Institutes of Health Research grant 70319, National Institutes of Health Grants UL1 RR024975, R01 HL102387 and P01 HL056693.
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The authors declare that they have no conflict of interest.
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Muppa, P., Sheldon, R.S., McRae, M. et al. Gynecological and menstrual disorders in women with vasovagal syncope. Clin Auton Res 23, 117–122 (2013). https://doi.org/10.1007/s10286-013-0190-1
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DOI: https://doi.org/10.1007/s10286-013-0190-1