Many of us are all too familiar with the hallmark symptoms of menopause and perimenopause, like hot flashes, brain fog, and weight gain. But there’s another lesser-known symptom that can sneak up on you during this midlife transition — heart palpitations.
Around the world, up to 42% of people going through perimenopause and 54% of those in postmenopause experience heart palpitations. While these sensations can be unsettling or even worrisome, they’re usually nothing dangerous. Let’s dive into why they happen, the role of hormones, and how to manage them.
What are heart palpitations?
Heart palpitations are feelings of unusually strong, fast, or irregular heartbeats. They might feel like your heart is skipping beats, racing, or pounding in your chest, throat, or neck. It’s important to note that heart palpitations aren’t the same as a heart attack.
When it comes to heart attacks, females often experience a wider range of symptoms compared to males. While chest pain is still the most common sign, females are more likely to feel other symptoms like nausea, trouble breathing, vomiting, fatigue, and pain in areas such as the jaw, neck, arms, shoulders, and between the shoulder blades.
Sometimes, these symptoms can be triggered by emotional stress rather than physical exertion, which is more common in males. Because females can have a variety of symptoms, it’s important not to brush them off as just stress or anxiety. If you’re feeling any of these symptoms, don’t hesitate to seek medical attention right away.
While heart palpitations may be annoying and worrying — they always stop me in my tracks when I feel them — most of the time they’re benign. Even though they may not cause any harm, it’s still a good idea to tell your doctor that you’ve started having heart palpitations.
For more information on heart health as we age, check out Menopause and Heart Health: What You Need to Know.
What’s the connection between menopause and heart palpitations?
Heart palpitations can happen at any time, but they tend to be more frequent during perimenopause and menopause. This is largely due to fluctuations in estrogen and progesterone levels. These hormone changes can also make you more sensitive to things like stress, caffeine, or alcohol, which can induce heart palpitations.
Other potential causes of heart palpitations include:
- Fever
- Nicotine
- Stimulant drugs and medications (including certain decongestants)
- Strenuous activity
- Hormonal changes experienced during pregnancy and menstruation
How estrogen and progesterone impact the heart
Both estrogen and progesterone play a role in your heart rate. Research has shown that during menstruation, when these hormones are at their lowest, your heart rate tends to be slower. This suggests that hormones play a role in how fast the heart beats. These same hormones may also influence the timing of the electrical signals that control the heartbeat. Estrogen, in particular, is known to protect the heart. So, when estrogen levels fluctuate during perimenopause and menopause, heart issues may be more likely to occur.
Other risk factors for heart palpitations in perimenopause
Several factors can influence the likelihood of experiencing heart palpitations during perimenopause and menopause. Some of these factors are within your control and others are not:
- Ethnicity. People of certain ethnicities, such as Hispanic descent, may be more likely to experience palpitations compared to non-Hispanic White individuals. This isn’t just a one-off finding. Research shows that menopause symptoms can vary in number and severity among different racial and ethnic groups. We don’t fully understand these differences, but they may be caused by issues like financial stress, systemic racism, access to healthcare, and lifestyle factors.
- Physical activity. A sedentary lifestyle may increase your risk of palpitations. Regular physical activity has been associated with fewer palpitations in some studies, though not all studies have found this connection.
- Hot flashes and sleep problems. If you have hot flashes that disrupt your sleep (night sweats), you may be more likely to experience palpitations. Some researchers believe that hot flashes and palpitations share a common physiological mechanism, but more research is needed to confirm this.
- Stress. Studies suggest people in perimenopause and menopause who feel more stressed tend to have more palpitations.
A review showed that age, body weight, and conditions like metabolic syndrome, diabetes, osteopenia/osteoporosis, and atherosclerosis don’t seem to be linked with heart palpitations. More research is still needed on the connection between heart palpitations and an increase in the risk of heart disease.
How to manage heart palpitations during menopause
While treatments for common menopause symptoms like hot flashes have been well-researched, the same can’t be said for heart palpitations. A 2022 review found that few studies have looked specifically at treatments for menopause palpitations. The authors of the study also concluded that many of these studies are of poor quality.
While we wait for more research to be done, here are some lifestyle changes that can help limit heart palpitations:
- Reduce stimulants. Cut back on caffeine, nicotine, and other stimulants.
- Manage stress and anxiety. Try yoga, meditation, relaxation techniques, or breathing exercises.
- Stay active. Regular exercise can help.
- Avoid smoking. If you smoke, consider quitting.
When to seek medical attention
While most heart palpitations are not dangerous, it’s important to consult your healthcare provider if you suddenly start experiencing them. Seek immediate medical attention if your palpitations are followed by:
- Chest, back, left arm, or jaw pain
- Shortness of breath or trouble breathing
- Feeling faint
- Nausea or vomiting
- A pulse of over 100 beats per minute
- Persistent palpitations that don’t go away
Takeaway
Heart palpitations are a common but often overlooked symptom of perimenopause and menopause. They affect over half of those going through this change. The main causes are likely due to fluctuations and changes in hormone levels. Factors like stress, caffeine, and alcohol can also contribute.
While most palpitations are benign, managing them through medications and lifestyle changes can help. If you have any concerns or if your palpitations are severe, don’t hesitate to consult your healthcare provider.
FAQs
Can menopause cause heart palpitations?
The hormonal fluctuations during perimenopause and menopause can increase your likelihood of experiencing heart palpitations. Around the world, up to 42% of people in perimenopause and 54% in postmenopause report heart palpitations.
Do heart palpitations increase cardiovascular disease risk during menopause?
Research suggests there’s no direct connection between heart palpitations and an increased risk of heart disease in those experiencing perimenopause and menopause. Studies haven’t found a link between palpitations and measures of heart health like atherosclerosis, arrhythmias, coronary artery calcium, heart rate, or blood pressure. However, more long-term research is needed to link heart conditions with declining estrogen during the menopausal transition.
Does menopause hormone therapy (MHT) help with heart palpitations?
Some studies suggest that MHT with estrogen and progesterone can help manage heart palpitations during perimenopause and menopause, but we need more research to understand how heart conditions are connected to lower levels of estrogen during menopause.
When do menopause-related heart palpitations commonly occur?
People going through perimenopause (the time of hormonal changes leading up to menopause) are more likely to experience heart palpitations compared to those in postmenopause.
When to worry about heart palpitations?
Heart palpitations are usually benign, but you should seek medical help if they’re accompanied by chest, back, arm, or jaw pain, shortness of breath, feeling faint, a pulse of over 100 beats per minute, or if they persist for a long time.
1 comment
I think I’m experiencing perimenopause.