The Long-Term Postural Orthostatic Tachycardia Syndrome Outcomes Survey-Gynecologic Findings: A Cross-Sectional...

Objective: Postural orthostatic tachycardia syndrome (POTS) affects up to 3 million people in the United States. Although 78%-83% of POTS patients are female, gynecologic comorbidity has not been well-studied. We created an online questionnaire to assess outcomes in female patients with POTS formerly followed at a single-center pediatric POTS program. Design: Cross-sectional study. Setting: Single-center pediatric POTS program. Population or Sample: All female patients ≤ 18 years at diagnosis. Methods: We developed and distributed The Long-Term POTS Outcomes Survey with questions about diagnosis, therapy, education, employment, social impact, quality of life (QoL), and gynecologic symptoms and management. Main Outcome Measures: Gynecologic symptoms and QoL. Results: Regular menstrual cycles were seen in 81/167 participants (49.1%). POTS symptoms worsened prior to and during menses in 118/167 subjects (72.4%); hormonal contraceptive therapy helped to control symptoms in 52/110 subjects (50%). Menorrhagia, polycystic ovary syndrome, and endometriosis were not reported in higher numbers compared to the general population. Conclusions: Menstrual flow disorders are not more prevalent in younger females with POTS. Symptoms often worsen perimenstrually, and hormone therapy can help to reduce symptom severity. Further research is needed to better define optimal hormone therapy in suppressing perimenstrual symptoms.