Although it is quite common, an irregular heartbeat during menopause can be a concern, and it is often misunderstood and overlooked. What should all women know about this symptom of menopause? Let’s take a look.

What is an irregular heartbeat?

An irregular heartbeat, which is also referred to as heart palpitations, is when the heart feels like it is racing, fluttering, pounding, doing flip-flops, or skipping beats. This may or may not be accompanied by lightheadedness or dizziness. An irregular heartbeat can occur for a number of reasons, including:

• Perimenopause and menopause
• Use of alcohol, caffeine, and/or nicotine
• Use of some cold and cough medicines as well as asthma inhalers
• Vigorous exercise
• Stress
• Thyroid: presence of an overactive thyroid or use of medication for underactive thyroid
• Fever
• Dehydration
• Low blood pressure or low blood sugar levels
• Irregular heart rhythms such as supraventricular tachycardia or atrial fibrillation

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How is an irregular heartbeat associated with menopause?

The significant decline in estrogen production that accompanies perimenopause and menopause is associated with a rise in heart rate and an increased frequency in heart palpitations and benign arrhythmias. These symptoms can increase once estrogen levels become extremely low in menopause. That’s because estrogen helps keep the inner layer of the artery wall flexible, and a decline may trigger palpitations.

An irregular heartbeat during menopause, which is sometimes also called menopause palpitations, is often overlooked or not discussed with women by their doctors because of the uncertainty that surrounds them. According to Janet S. Carpenter, PhD, RN, and associate dean of research at Indiana university School of Nursing in Indianapolis, “It’s not clear why they happen, we don’t know if they’re associated with EKG changes, and we don’t know if they increase women’s risk for cardiovascular disease.”

One reason for this uncertainty, according to Carpenter, is “the fact that there’s been a historic bias against women in cardiology. Women’s symptoms often aren’t believed or listened to in the same way that men’s symptoms are.”

Another thought about irregular heartbeat during menopause is that it’s part of hot flashes rather than a symptom on its own. However, not all women experience heart palpitations while having a hot flash, so it does appear to be a separate symptom. Research indicates that up to nearly 47 percent of women experience irregular heart beat in menopause.

Here are two other little tidbits about irregular heartbeat and menopause. Researchers have found that many women don’t expect to experience heart palpitations as a menopausal symptom and so may be frightened when they occur. In addition it appears that women who report distress about palpitations have worse insomnia, depression, and perceived stress.

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How do you manage irregular heartbeat naturally?

Some lifestyle modifications can help you prevent palpitations, such as avoiding:

• Caffeine in any form (e.g., coffee, chocolate, energy drinks, medications)
• Cold medications that contain pseudoephedrine
• Spicy foods
• Alcohol and nicotine
• Recreational drugs such as cocaine

It’s also recommended you do the following:

• Practice stress reduction, such as yoga, deep breathing, and/or meditation
• Engage in aerobic exercise at least five days a week, such as walking, swimming, jogging, dancing, tennis
• Focus on fresh fruits and vegetables, whole grains, fish, nuts, and seeds
• Reduce or eliminate sugar, saturated fat, cholesterol, and salt
• Maintain a healthy weight

When to see your doctor

Although irregular heartbeat is not a concern and typically goes away once the menopause transition is over, the palpitations may be an indication of an underlying heart condition in some women. Possible conditions include heart attack, cardiomyopathy, abnormal heart valve, or heart failure. If you have any concerns or questions, consult with your healthcare provider and be sure to tell the doctor everything about your symptoms, including severity, when they occur, what you are doing before they start, and how long they last.

If you are experiencing chest pain, trouble breathing, pain or discomfort in one or both arms, vomiting or nausea, or a loss of consciousness along with the irregular heartbeat, then contact medical help immediately.

bottom line

An irregular heartbeat during menopause is a common occurrence and in the majority of cases, temporary and not a concern. However, because women are at higher risk for heart disease postmenopause, it’s important to check in with your healthcare provider and discuss how to take care of your heart health.