Perimenopause Palpitations: Symptoms and Solutions

Last updated 01.08.2024 | by Sabrina Johnson | 11 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

When your heart starts racing or missing a beat, and you experience palpitation, it is never a good feeling. It’s scary. I remember how frightening it was when I had my heart race at the topmost speed during the first time I experienced hot flashes.

Since we are discussing on palpitations in perimenopause, let’s present some facts here. Around 42% of women experience palpitations in the perimenopause phase. In the postmenopause phase, the number is higher, at around 52%.

Like I always say, most of the menopausal symptoms are an outcome of low hormone levels. This one isn’t an exception as well. Palpitations aren’t always a sign of a failing heart. There are many reasons behind it as well. The onus lies in identifying the triggers and addressing the problem immediately to avoid hazards.

Have you recently experienced changes in your heart rhythms quite often? Does your heart miss a beat now and then? Are you a female in your mid-40s? Then, by now, you must be able to join the dots and comprehend the probable reason behind the same. Right?

To get all your facts right, give this article a read, which will help you understand the probable causes of palpitations when you are transitioning into menopause. I have included some key aspects, like how palpitation is related to the perimenopause phase. I have also elaborated on the symptoms of heart palpitations and how to manage them. So, let’s get started.

How is Palpitation Related to Perimenopause?

When you have reached the menopausal age, you may often feel that your heart is racing faster than it should. It could even be that your heart missed a beat. Is this the only point of concern, or do you experience other symptoms, too, like hot flashes, vaginal dryness, sleep problems, etc?

If your body is going through a lot of these changes alongside hot flashes, that means you are transitioning into menopause or are in the perimenopause stage. So, heart palpitations could be one of the many symptoms you are going through due to perimenopause.

Like all other symptoms, heart palpitations are also caused by fluctuating and reduced estrogen levels, which overstimulate the heart, leading to palpitations and irregular heartbeats. When the hormones fluctuate, it spikes the heart rate and even increases the frequency of the palpitations.

Studies show that one out of five perimenopausal and postmenopausal women experience palpitations. It was deduced that the prevalence of palpitations was 3.7%-40.2% in premenopausal women, 20.1-40.2% in perimenopausal women, and 15.1-54.1% in postmenopausal women.

Of the five articles included in the studies, three of them showed that perimenopausal women and those experiencing surgical menopause were more susceptible to palpitations.

Palpitations can even occur during hot flashes, where you can experience a racing heart. When in between a hot flash, your heart rate could elevate by 8-16 beats.

There are other reasons for you to experience frequent palpitations other than menopause. These include:

  • Increased stress or panic attacks (when the stress hormone triggers the fight or flight response of the body, resulting in palpitations, breathlessness, and chest pain)
  • Depression (which causes the brain to undergo structural changes, leading to hormonal fluctuations; this even results in a disturbance of the heart rhythm, triggering palpitations)
  • Increased physical exercise (which could bring in a change in the heart’s rhythm and cause palpitations)
  • During fever (as that’s when your body begins to use the energy at an increased pace; palpitations may occur when your body temperature rises above 100.4° F.)
  • Thyroid problems (often results in abnormal rhythms of the heart, causing palpitations)

I first had a scary palpitation during a hot flash episode. I would even feel my heart racing after a heavy meal. All these started happening once I had crossed 40. The doctor told me all these resulted from the fluctuating hormones. So, she advised me to be more cautious about what I ate and my overall lifestyle.

What Are the Symptoms of Heart Palpitations?

What Are the Symptoms of Heart Palpitations

The most prominent symptom of heart palpitations is how your heart beats, which varies in manner, intensity, and frequency. Your heart will:

  • Be racing and beat too fast
  • Miss or skip a beat
  • Have an extra beat
  • Pound increasingly
  • Beat in a flip-flop rhythm
  • Flutter

If the palpitations are because of a heart problem or any underlying condition, there could be other symptoms, too. These include:

  • Pain or discomfort in your chest
  • Losing consciousness
  • Increased dizziness
  • Severe breathlessness

If you encounter any or many of these symptoms, do not delay contacting the health care provider.

Does Menopause Put You At the Risk of Heart Disease?

The BHF (British Heart Foundation) mentions that women are less susceptible to heart diseases than their male counterparts till the time they have entered the menopause phase. However, after menopause, females are more prone to coronary heart diseases and other heart ailments.

The factor responsible for the same is the low estrogen levels, which could raise cholesterol levels and blood pressure, triggering heart disease. It is essential to know that estrogen significantly controls cardiac functions. It prevents inflammation that may lead to plaque buildup in the coronary arteries.

When the estrogen levels fall in the perimenopause and menopause phases, it makes women easily susceptible to heart ailments, especially if they do not maintain a healthy lifestyle.

What are the Solutions to Manage Perimenopause Palpitations?

What are the Solutions to Manage Perimenopause Palpitations

If you have recurrent episodes of palpitations in menopause, you need to take medical advice at the earliest. However, you also should take good care of your health and maintain a proper lifestyle for sound heart health and to lessen the incidences of palpitation. That’s what my doctor advised me as well. Here are a few management tips:

1. Cut Down on Caffeine

An increased caffeine intake at the time when you are transitioning into menopause or have already experienced menopause would do more harm than good. It aggravates most of your symptoms, like hot flashes, night sweats, sleep issues, and mood fluctuations.

Caffeine is also known to be responsible for triggering palpitations, especially in those who are sensitive to caffeine. Moreover, if you are susceptible to palpitations or have a history of heart disease, caffeine could do more damage.

So, lessening your caffeine intake, particularly when you have reached the menopausal age, is essential. I have always mentioned my infinite love for caffeine, which I was bound to lessen to stay healthy, mainly at the time when I sensed that I was transitioning into menopause. Many people often resort to herbal teas. However, they must be careful as many herbal teas like guyausa and yerba mate have caffeine.

2. Limit Spicy Food

Spicy food is another trigger that intensifies and worsens hot flashes. The same happened to me. I have mentioned this before in my writings that I had my first hot flash right after a sumptuous lunch of a jalapeno sandwich.

It also results in heart palpitations by irritating the esophagus and raising the blood pressure and heart rate. So, if you have frequent palpitations and hot flashes, you must eliminate spicy foods from your diet. A doctor once said that if you have had spicy food, add mint, cucumber, and yogurt to counteract the heat. It induces a cooling effect.

3. Remain Stress-Free

When stressed or anxious, your heart could beat faster than usual. Menopause often results in increased anxiety due to estrogen levels and troublesome symptoms like hot flashes and vaginal dryness, which often makes you feel low. However, when you are stressed, your overall health is affected. Stress also triggers palpitations and affects your heart health. That’s why remaining stress-free is of utmost importance.

You can practice meditation, yoga, and other relaxation techniques. Also, do things that pleasure you, like reading a book, going out, etc. You can even talk to women in a similar situation as yours over social platforms and share your feelings. Breathing techniques helped me a great deal. I even joined a Zumba class when I was in my 40s. This was something I had wished for long. It helped me stay fit and associated me with several like-minded women. We danced, we talked, and all these made me feel way too better.

4. Follow a Proper Exercise Regime

Exercise is vital in boosting your overall body functions, including heart health. You could do cardio activities like walking, jogging, biking, swimming, and running. However, when you have palpitations, it is better to avoid exercise until you talk to the doctor.

5. Maintain a Balanced Diet

A healthy diet is another prerequisite for maintaining a good heart and overall health. Include fruits and veggies in your diet. Avoid processed foods and foods containing increased sugar and fat. They could negatively impact your heart health.

When transitioning ino menopause, the sudden changes in my body were a little overwhelming at the onset. To cope with the sleepless nights I regularly had and my high-stress levels, I would often binge-eat. Eventually, I overcame this habit. Most of the credit goes to my doctor and physical trainer, who helped me fix a healthy diet and develop a proper workout schedule. I began feeling fitter and better than before.

6. Quit Smoking

Smoking aggravates symptoms of menopause, like hot flashes and sleep problems. At the same time, it even affects your heart health. The nicotine present in cigarettes raises your heart rate and intensifies your blood pressure levels. This could lead to palpitations. If you already have a rapid heartbeat because of menopause, smoking could worsen things. So, it’s advisable to make a conscious attempt to stop smoking.

7. Limit Your Alcohol Intake

In menopause, a limited alcohol intake is recommended, not more than a drink a day. Increased drinking could exacerbate most of the symptoms, like hot flashes, palpitations, and sleep disturbances.


Q. Can hormone replacement therapy help with perimenopause palpitations?

Healthcare professionals often advise Hormone replacement therapy to cope with the different menopausal symptoms like hot flashes, sleep problems, night sweats, vaginal dryness, etc.
However, if the question is about HRT helping manage palpitations or heart problems, there are speculations. Some women were said to find relief in their palpitations after undergoing hormone replacement therapy.
It is necessary to remember some forms of HRT may elevate the risks of stroke, blood clots, and heart disease. So, if you have a pre-existing heart condition, it is essential to talk to the doctor before going for HRT.

Q. When to contact the doctor regarding palpitations?

If you have palpitations once in a while that lasts for no more than a couple of seconds, then it isn’t that worrisome.
However, if the palpitations occur frequently and for long, to the extent that they disrupt your daily living activities, a doctor’s consultation is needed. You should even seek medical help when, alongside the palpitations, you experience chest pain or discomfort, breathlessness, or dizziness.

Q. How are heart palpitations diagnosed?

When you go to the doctor for heart palpitations, he will enquire about your age, overall health, and the medications you take (if any) for an underlying condition. He will ask questions like when you first had palpitations and also about the triggers. 
The doctor may even enquire of the duration of the palpitations and the associated symptoms (if any). The diagnosis depends on the severity of your symptoms. The doctor will examine your heart using a stethoscope. He might advise for tests like echocardiogram, electrocardiogram, or holter.

Q. Who is more likely to experience palpitations? 

One out of every four perimenopausal and postmenopausal women might have palpitations. They were mild or disturbing to the extent that they affected their daily lives. Women with stress or insomnia were more prone to palpitations. These are the findings of a study.


If it has been identified that your racing heart is one of the menopausal symptoms you are facing, then there isn’t much to be worried about. It’s temporary and will subside when you have experienced menopause and transitioned into the postmenopause stage.

By making simple lifestyle changes and also seeking prompt advice from the doctor, you will be able to manage it conveniently.


  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.