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menopause and heart palpitations

By | Fact Checked By Andrea Donsky |

Does your heart sometimes feel like it’s all aflutter or pounding out of your chest, and there’s no apparent reason why? You may be experiencing heart palpitations, and they could be related to perimenopause and menopause. What do you need to know?

What are heart palpitations?

First of all, heart palpitations are not the same as an irregular heartbeat. Palpitations are characterized by a pounding, fluttering, or rapidly-beating heart, or it may feel like it’s skipping beats. An irregular heartbeat, on the other hand, is when the heart beats irregularly, too fast, or too slow.

Read about menopause and irregular heartbeat

Heart palpitations may be felt in your chest, throat, or neck and can be caused by various factors. Some of them include low iron levels, abnormally high iodine levels, low or high blood sugar, anxiety, stress, and use of certain medications (e.g., cough and cold medicine, diet pills, high blood pressure drugs, thyroid medication, antibiotics, antipsychotics), low or high thyroid hormone levels, alcohol use, marijuana use, low vitamin B1 levels, or exercise. In rare cases, they can be associated with arrhythmia.

How are heart palpitations associated with menopause?

As estrogen levels begin to decline and hormone levels fluctuate, women may experience heart palpitations. However, experts still don’t know much about them, according to Janet S. Carpenter, Ph.D., RN, associate dean of research at Indiana University School of Nursing and someone who has studied palpitations. “It’s not clear why they happen, we don’t know if they’ve associated with EKG [electrocardiogram] changes, and we don’t know if they increase women’s risk for cardiovascular disease,” she notes. 

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Even if heart palpitations in menopause are not completely understood, they still occur. Research shows that about 18.6 to 46.8 percent of women will experience them. One study found that about 25 percent of women reported the amount of distress from having heart palpitations from none to “a lot.”

Once women reach menopause, estrogen declines even more. Since this hormone helps keep blood vessels flexible, a sharp drop is considered to be a potential factor in the greater risk of heart disease among menopausal women. 

Carpenter points out that the lack of information about heart palpitations in menopausal women may partly be related to “a historical bias against women in cardiology. Women’s symptoms often aren’t believed or listened to in the same way that men’s symptoms are,” she notes.

Another reason why heart palpitations may not receive more research is that some believe they are part of hot flashes. Carpenter, however, does not agree because many women experience them completely separate from hot flashes. 

Read about the link between heart health and menopause

How can you manage heart palpitations naturally?

Lifestyle changes can be effective in managing heart palpitations, and incorporating several into your routine can help with other menopausal symptoms as well, such as sleep disturbances, depression, stress, and hot flashes.

  • Practice relaxation techniques. Stress can be a factor in heart palpitations. Daily stress-reducing practices such as meditation, progressive relaxation, tai chi, yoga, deep breathing, journaling, guided visualization, and massage can help lower stress.
  • Exercise regularly. Routine physical activity not only reduces stress and anxiety levels but also strengthens cardiovascular health. Some examples include spinning, brisk walking, jogging, swimming, rowing, and running. Because exercise can trigger heart palpitations in some women, you should discuss your exercise plans with your healthcare provider first.
  • Reduce or eliminate stimulants. These include alcohol, nicotine, caffeinated beverages and foods, illegal drugs, some cold and cough medications, appetite suppressants, and mental health drugs. Speak with your doctor about any prescriptions you may be taking that could contribute to heart palpitations.
  • Balance your electrolytes. The electrolytes sodium, calcium, potassium, and magnesium play many roles, including regulating the heart beat. Include foods that provide these nutrients, such as avocado, banana, potato, and dark green leafy veggies such as spinach, as well as nuts, fish, and seeds.
  • Stay well hydrated. If you are dehydrated, your heart has to work harder, which can lead to palpitations
  • Stimulate the vagus nerve. This nerve runs from the brain to the heart, and when it is stimulated, it can relieve palpitations. You can stimulate your vagus nerve by doing the following:
    • Taking a cold shower
    • Holding your breath and then pushing down as if having a bowel movement
    • Massaging your neck
    • Placing a cold towel or cold water on your face for a few seconds

When you should see a doctor

If your palpitations last only a few seconds and/or occur only infrequently, you usually don’t need to see your doctor. However, if you have a history of heart disease and your palpitations occur more often or they get worse, contact your healthcare provider. Palpitations can be a sign of heart attack, heart failure, or an abnormal heart valve. You also should seek immediate medical care if along with the palpitations you experience chest discomfort or pain, severe breathing problems, fainting, nausea, or severe dizziness.

Bottom line

Heart palpitations in perimenopause and menopause are common, but you can manage them effectively by adding a few routines to your life. Although heart palpitations are usually harmless, see your doctor if they become worse or worrisome.

  • Carpenter JS et al. A menopause strategies–finding lasting answers for symptoms and health (MsFLASH) investigation of self-reported menopausal palpitation distress. Journal of Women’s Health 2021 Apr 19; 30(4)

  • Fletcher J, Veazey K. Ways to stop heart palpitations. Medical News Today 2022 Jun 28

  • Heart palpitations. Mayo Clinic

  • Sievert LL, Obermeyer CM. Symptom clusters at midlife: a four-country comparison of checklist and qualitative responses. Menopause 2012 Feb; 19(2):133-44.

  • Upham B. Menopausal heart palpitations can cause distress, may signal serious health issue. Everyday Health 2020 Dec 22

  • What causes heart palpitations? WebMD 2021 Sep 12

Andrea is a Registered Holistic Nutritionist (RHN) & Menopause Expert. Andrea is in menopause & has been researching for the last 5 years science-based ingredients and methods to help women manage their symptoms. She’s the Founder of NaturallySavvy.com—a multiple award-winning website. Andrea co-authored the book “Unjunk Your Junk Food” published by Simon and Schuster, as well as “Label Lessons: Your Guide to a Healthy Shopping Cart,” and “Label Lessons: Unjunk Your Kid’s Lunch Box.” Andrea co-hosts the Morphus for Menopause podcast and appears as a Healthy Living Expert on TV across North America. Andrea has more than 20 years of experience in the health & wellness space and is a multiple award-winning Influencer.