In addition to other well-known symptoms, lowering estrogen levels can also contribute to heart palpitations during menopause. Described as irregular, pounding, fluttering, or faster heartbeats, heart palpitations are generally harmless, but can sometimes signal an underlying or undiagnosed heart condition. 

This article discusses heart palpitations during perimenopause and menopause, what causes them, how to treat them, and when they indicate something more serious that may require treatment. 

Perimenopause, Menopause, and Postmenopause Explained

Perimenopause is the time it takes for the female body to transition from the reproductive phase of life into menopause. During perimenopause, estrogen production begins to decline as the ovaries start to shut down and most women notice the onset of symptoms due to the lowering estrogen levels. Perimenopause normally begins in the late 40s to early 50s and is known to last 4-8 years. 

Menopause is when women have not had a period for 12 consecutive months. At this point, the reproductive stage of life is considered at an end and women can no longer get pregnant. 

Once women reach menopause, they are considered postmenopausal for the rest of their lives. 

What Are Heart Palpitations?

Heart palpitations occur when the heart beats irregularly, more intensely, or faster than usual. It can feel different for each person with many describing the sensation as a pounding or fluttering heartbeat, while for others it can feel like the heart is racing. 

They tend to come and go and are known to last anywhere from a few seconds to a few minutes. Sometimes caused by exercise, stress, anxiety, or medication, heart palpitations are normally harmless. In rare cases, they can indicate a heart condition such as an abnormal heart valve, arrhythmia, or atrial fibrillation, which normally requires medication and sometimes surgery.

When heart palpitations are accompanied by dizziness, trouble breathing, sudden fatigue, chest pain, or pain in the arm(s), neck, or back it is typically something more serious such as a heart attack or stroke.  

Heart Palpitations During Menopause: Are They Because of Hot Flashes?

In the past, heart palpitations during menopause were considered part of, or because of, a hot flash. However, more recent research has shown that heart palpitations often occur without a hot flash or night sweats. Therefore, heart palpitations are now considered a separate symptom of perimenopause or menopause.   

Menopause and Heart Health: What’s the Link?  

In their late 40s to early 50s, women enter the phase of life known as perimenopause, which is the time that the female body takes to transition into menopause. During this stage, estrogen production begins to drop as the ovaries prepare to shut down and the reproductive phase of life comes to an end. 

From puberty to menopause, it is well-known that estrogen supports breast development, menstrual cycles, ovulation, gestations, and pregnancy. Studies also show that estrogen influences nearly every tissue and organ in the female body, including the heart and blood vessels. Bearing this in mind, research has shown that postmenopausal women are more susceptible to heart disease, and it is linked to declining estrogen.  

In addition to increasing the good cholesterol (HDL) and reducing the unhealthy kind (LDL), estrogen improves blood flow by dilating blood vessels and absorbs free radicals to keep arteries healthy.

When estrogen levels begin to drop during perimenopause, however, levels of LDL cholesterol can increase and levels of HDL cholesterol can decrease. This can cause an accumulation of cholesterol and fat in the arteries, which can lead to heart disease, high blood pressure, and stroke. 

Does Low Estrogen in Menopause Cause Heart Palpitations? 

In addition to contributing to high cholesterol and high blood pressure, recent research suggests that low estrogen levels can result in the heart becoming overstimulated and beating as many as 16 times more during menopause. 

Additional studies have ascertained that heart palpitations during menopause are closely linked to other common symptoms associated with this stage of life. The symptoms that cause women stress or anxiety, and lower their quality of life, in particular. 

For example, vasomotor symptoms like hot flashes and night sweats are believed to contribute to heart palpitations during perimenopause and menopause. Women experiencing symptoms of depression or who have trouble sleeping during this stage of life are also thought to be more prone to heart palpitations. 

Smoking, high alcohol, and caffeine consumption, as well as poor diet, are also known to contribute to heart palpitations during perimenopause and menopause. 

As an aside, recent research suggests that women who experience heart palpitations during menopause could be at a higher risk of heart disease in postmenopausal years.

How to Treat Heart Palpitations During Perimenopause and Menopause

Mild heart palpitations during the menopause transition are usually caused by lowering estrogen levels as well as the impact that other menopause symptoms have on the body. Even though they are harmless and normally subside with other symptoms once menopause is reached, heart palpitations can be uncomfortable enough for some women to seek relief. 

Below are the most common medical and natural remedies for reducing the impact of heart palpitations during perimenopause or menopause. 

Hormone Therapy

Hormone therapy (HT), a medication containing synthetic hormones such as estrogen, progesterone, or both, can lower the impact of menopause symptoms for many women. However, HT is also known to increase cholesterol levels, and the risk of heart disease, strokes, and breast cancer. 

For this reason, the American College of Obstetricians and Gynecologists (ACOG), as well as the Endocrine Society, caution that care should be taken if using HT to treat perimenopause symptoms when heart palpitations are present. 

Phytoestrogens

Because the synthetic estrogen used in HT can have adverse effects on the body for some menopausal women, phytoestrogens are being embraced as a natural alternative. A phytoestrogen is estrogen that is derived from plants. They can be consumed through apples, pears, plums, grapes, cabbage, spinach, soybeans, and more. However, it can be difficult to ensure adequate amounts of phytoestrogens are consumed through food for a noticeable impact on menopause symptoms. 

To ensure you are consuming adequate amounts of phytoestrogens to reduce the menopause symptoms known to cause heart palpitations, Vitex Chasteberry supplements are widely recommended. Proven to reduce hot flashes, night sweats, mood swings, and insomnia when taken regularly, Vitex Chasteberry is reasonably priced, effective, and safe.  

Reduce Anxiety & Stress

Although dropping estrogen levels can contribute to the onset of heart palpitations during perimenopause and menopause, the stress and anxiety caused by hot flashes, night sweats, and insomnia often have more of an impact on the heart. Managing anxiety, stress, and the impact that menopause symptoms can have on your quality of life can also help reduce heart palpitations. 

During perimenopause and menopause, practicing daily relaxation techniques like meditation, yoga, tai chi, and breathing exercises can lower the impact of stress and anxiety on the heart. Experts also advise having any symptoms of depression treated to avoid heart palpitations at this stage of life. 

Reduce Alcohol & Caffeine

Alcohol and caffeine can trigger heart palpitations by disrupting the electrical signals within the cardiovascular system. Alcohol can also increase the occurrence of night sweats and interrupt your sleep, both of which contribute to heart palpitations. Avoiding alcohol, switching to decaf or herbal teas, and drinking water to stay hydrated can help. 

Stop Smoking

Smoking results in the heart receiving less oxygen to pump around the body, causing the heart to beat faster to pump more oxygen. When other symptoms like anxiety, stress, or lower estrogen levels during menopause are also at play, heart palpitations are more common.  

Avoid Sugar Fixes

Although you might be craving sugary drinks or food high in carbohydrates at certain times during perimenopause, it’s best to avoid them if you experience heart palpitations. After consuming sugary foods or drinks the body typically experiences a blood sugar dip, which causes an adrenaline release and faster heart rates. 

When To See a Doctor

As many as 54% of menopausal women are known to experience heart palpitations, but most cases are harmless and go away postmenopause. In some cases, however, heart palpitations during perimenopause or menopause could be a sign of a previously undiagnosed heart condition. 

Schedule an appointment with your doctor if you notice any of the following symptoms occurring with heart palpitations during menopause: 

  • They last for several minutes, 
  • They get worse over time or become more frequent, 
  • They cause dizziness, lightheadedness, or shortness of breath

If heart palpitations during perimenopause or menopause are accompanied by chest pain, or pain in one or both arms, the neck or back, jaw, or face, call emergency services or get yourself to the hospital immediately. The same applies if you experience heart palpitations with nausea or vomiting. 

Conclusion

Heart palpitations during perimenopause or menopause are not uncommon. Known to occur in over 50% of women during the change of life, menopausal heart palpitations are linked to low estrogen levels and anxiety caused by other symptoms such as hot flashes, night sweats, and insomnia. 

Although normally harmless, heart palpitations during menopause that are accompanied by dizziness, shortness of breath, light-headedness, or chest pain should be immediately reported to your doctor.  

References 

National Institute on Aging – What is Menopause? - https://www.nia.nih.gov/health/menopause/what-menopause

Mayo Clinic – Heart Palpitations - https://www.mayoclinic.org/diseases-conditions/heart-palpitations/symptoms-causes/syc-20373196

Mount Sinai - Types of Arrhythmias - https://www.mountsinai.org/care/heart/services/arrhythmia/types

National Center for Biotechnology Information - Protective Effects of Estrogen on Cardiovascular Disease Mediated by Oxidative Stress - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260319/

National Center for Biotechnology Information - The severity of individual menopausal symptoms, cardiovascular disease, and all-cause mortality in the Women's Health Initiative Observational Cohort - https://pubmed.ncbi.nlm.nih.gov/36219813/

National Library of Medicine - Correlates of palpitations during menopause: A scoping review - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289918/

Journal of Women’s Health - Finding Lasting Answers for Symptoms and Health - Investigation of Self-Reported Menopausal Palpitation Distress - https://www.liebertpub.com/doi/10.1089/jwh.2020.8586

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