From the Guidelines
Progesterone can cause palpitations or tachycardia in some individuals, particularly through its non-genomic cardio-depressive effect involving modulation of calcium handling and action potential duration. Progesterone is a steroid hormone that plays important roles in the menstrual cycle, pregnancy, and hormone replacement therapy. When taken as medication or when levels fluctuate naturally in the body, progesterone can affect the cardiovascular system in various ways. It may cause heart palpitations by influencing the autonomic nervous system, which controls heart rate. Some individuals experience these symptoms during pregnancy when progesterone levels are high, during the luteal phase of the menstrual cycle, or when taking progesterone supplements or contraceptives containing progestins.
The mechanism involves progesterone's effect on electrolyte balance, particularly potassium, which can influence cardiac electrical activity, as suggested by a study published in 2021 1. Additionally, progesterone can cause fluid retention, which may increase blood volume and potentially contribute to heart rhythm changes. If you experience persistent or severe palpitations while taking progesterone-containing medications, you should consult with your healthcare provider, as dosage adjustments or alternative treatments may be necessary.
Key points to consider:
- Progesterone's non-genomic cardio-depressive effect may contribute to palpitations or tachycardia
- The hormone can influence electrolyte balance and cardiac electrical activity
- Fluid retention caused by progesterone may also contribute to heart rhythm changes
- Individuals with coexisting medical conditions, such as hypertension or dyslipidaemia, may be at increased risk of cardiovascular disease when taking hormonal contraceptive agents, including those containing progesterone, as reported in a 2020 study 1 and another 2020 study 1.
From the FDA Drug Label
Cardiovascular: circulatory collapse, congenital heart disease (including ventricular septal defect and patent ductus arteriosus), hypertension, hypotension, tachycardia The FDA drug label mentions tachycardia as a possible adverse reaction to progesterone, which is related to palpitations.
- Key points:
- Tachycardia is listed under the cardiovascular system in the postmarketing experience section.
- This suggests that progesterone may cause palpitations in some individuals, as tachycardia is a condition characterized by a fast heart rate.
- However, the frequency and causal relationship of this reaction are uncertain due to the voluntary reporting of adverse reactions from a population of unknown size 2.
From the Research
Progesterone and Palpitations
- The relationship between progesterone and palpitations is not directly addressed in the provided studies 3, 4, 5, 6, 7.
- However, the studies discuss the effects of progesterone and progestins on the cardiovascular system, which may be relevant to palpitations.
- The Women's Health Initiative trial, mentioned in 3 and 4, found that the combination of conjugated estrogen and medroxyprogesterone increased the risk of myocardial infarction and stroke.
- Study 5 found that progestin-only treatment can have side effects such as headaches and vaginal bleeding, but does not mention palpitations specifically.
- Studies 6 and 7 discuss the benefits and risks of hormone therapy, including the use of progesterone and progestins, but do not directly address the relationship between progesterone and palpitations.
Cardiovascular Effects of Progesterone
- The studies suggest that not all progestational agents have the same cardiovascular properties 3, 4.
- Micronized progesterone may have a more acceptable metabolic profile compared to synthetic progestins 7.
- However, the direct effects of progesterone on heart rate and palpitations are not clearly established in the provided studies.