CHF symptoms worsening with menstrual cycle?

[Christy]

I'm a 41 yr old female diagnosed in Feburary 99 with idiopathic dilated cardiomyopathy complicated with ventricular tachacardia and an LVEF of 20%.  I currently have an ICD implanted and take Lanoxin, Aldactone, Prinivil, Coreg and Aspirin as prescribed.  After having multiple TIA's in Feburary I was placed on Coumadin. Coumadin therapy was replaced with aspirin therapy early September.  I'd noticed that symptoms of heart failure were greatly pronouced while menstrating.  I'd initally blamed this on the coumadin, but no change was observed after stopping the coumadin.  The pronounced sympotoms are primarly profound exhaustion, some additional edema and more shortness or breath.  I will go from walking a half hour on the treadmill at 2.5 mph to finding difficulty in walking from room to room with leaden limbs at the onset of my period.  This profound exhaustion will last for 6-15 days, but eventually (has so far anyway) I'll regain energy to start walking the treadmill again.  Is this a "normal" reaction with CHF and hormones?  Is there anything that I can do to reduce this impact?   I've mentioned this to my primary care physician, and will further take it up with my gynecologist and cardiologist, but meantime any information you can share would be greatly appreciated.

[CCF CARDIO MD JMF]

Dear Christy,

The fluid retention associated with menses may exacerbate CHF.  You should discuss this with your physician and you may want to tailor your medications to adjust durring this time of the month.