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    chest pains and menapause
    curiousminds77377 posted:
    I am 50 and have not had a period since April, the hot flashed come and go. But now the chest pains are coming. The more I read, other women have chest pains as well. When does one know if it is menapause, or a heart attack? EKG's show nothing, emergency rooms are expensive and nothing ever shows up. So reading everyone's postings is reassuring. Feels like what you think a hear attack might feel like. Thanks for your posts.
    Mary Jane Minkin, MD responded:
    Dear Curious,
    One more thought on this post (I should have linked my two responses together.) One point you bring up: yes, emergency rooms are expensive-and it's far better to consult with a cardiologist outside of an emergency room setting. For example, if your chest pain sounds concerning to a cardiologist, they can do things like a stress echocardiogram-if that's negative, then I think you can be very reassured that the chest pains can be due to a low and fluctuating estrogen level. But seeing the health care provider outside of an emergency event is the ideal,
    Mary Jane
    GlendaFranklin replied to Mary Jane Minkin, MD's response:
    I am glad to know that fluctuating estrogen can cause chest pains. I have been having them for two years and have had a multitude of tests including an ECHO. I know my doctors think I am crazy but all my tests have been within normal limits. Sometimes just walking across the room can cause me to be short of breath and I have pressure in my chest. Is there a way to releive these symptoms?
    Mary Jane Minkin, MD replied to GlendaFranklin's response:
    Dear Glenda,
    Obviously having chest pains is very disconcerting.
    If you've already had an echo, I would think you are already plugged in to a cardiologist. I would suggest speaking with her or him about further evaluating this problem, or treatments.
    For example, some women with this type of what we refer to as atypical chest pains do respond to low dose, transdermal estrogens (which lead to blood vessels dilating). Some women will respond well to beta blockers, more in the cardiologists realm.
    And if your cardiologist feels uncomfortable dealing with this problem (some cardiologists do not feel comfortable with specific female type issues) there are cardiologists who do deal specifically with women's health-your gynecologist should be able to direct you to someone in your town who has a special interest there.
    Good luck,
    Mary Jane
    curiousminds77377 replied to Mary Jane Minkin, MD's response:
    Dr. Minkin,
    Thank you so much for your response. I have had all kinds of heart tests done and everything has come out OK. I am trying to releave some stress in my life and hope that is the problem. Thanks again for your time!
    DoveOmeri replied to Mary Jane Minkin, MD's response:
    I am 52 next month and have not had my period for about 3 years now. I think I am doing pretty hot flash's..but I have noticed mood changes and sleep problems. There are some days it's best for me to not talk to anyone. I don't mean to be crabby,and being the oldest woman in my family,no one around me understands what I am going through. Thank God my husband and I found a way to avoid conflicts with each other..He lives in an apt three floors up from mine.(lol) True.But funny.And it works for the most part for us.(So we don't fight) I guess I'm looking for a way to NOT go on HRT..some days I can't even stand being alone with Myself!
    Mary Jane Minkin, MD replied to DoveOmeri's response:
    Dear DoveOmeri,
    Perhaps some of your mood changes might not be strictly related to menopause; you could be dealing with mood changes which might not be related to hormonal changes. One thought to consider: would something like antidepressant therapy be something that might help? That certainly is non hormonal, and many women do very well with it-so it might be something to think about.
    Hope you feel better,
    Good luck,
    Mary Jane
    mitibbs replied to Mary Jane Minkin, MD's response:
    OMGOSH, I'm getting chest pains also...started early this year I've been to ER at least 7 times, cardiologist about 4 times to the regular dr about 6 times for chest pains/heart palps and everything is in the scope of me I'm sadden by this I get horrible nite sweats and I'm just 48 years old...ALL of the drs say the same thing "your healthy and nothing is wrong".....I just need some support to get through this menopause things....HELP!!!
    Mary Jane Minkin, MD replied to mitibbs's response:
    Dear Mitibbs,
    Sounds like your cardiac situation has been well evaluated. Have you spoken to your gynecologist with all of this? Sounds like you might benefit from a trial of estrogen therapy. A small transdermal dose may be all you need. And your gynecologist can safely guarantee to you that a small dose of estrogen for a couple of months will not give you cancer. Presuming you do well on this, then you and your gynecologist can formulate a longer term management plan. And it would be helpful for you to know if indeed it is lack of estrogen which is triggering your problems.
    Good luck,
    Mary Jane

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