It may feel like your heart is fluttering, racing, even skipping a beat—and it’s not because someone sexy walked by. Heart palpitations and irregular heartbeats called arrhythmia can be symptoms of perimenopause or menopause, but they aren’t talked about much so when they strike it can be terrifying.

According to research in the Journal of Women’s Health, nearly 50 percent of women, ages 42 to 62, who were in the study, reported heart palpitations during a two-week period. Some women experience them along with a hot flash, but many get them separately when they’re sleeping, when they’re sitting on the couch or in their car, or when they’re up and moving.

What causes heart palpitations in menopause?

As with most things menopausal, estrogen is believed to play a role in heart palpitations. Before menopause, estrogen may have heart-protective qualities including keeping arteries flexible. When levels decline that protection declines, too, and reduced blood flow can cause arrhythmia (abnormal heart rhythm). Lower levels of estrogen can also lead to an overstimulation of the heart. More commonly the palpitations are a normal rhythm, just fast, and are associated with mild anxiety, a hot flash, or just all by themselves.

Unfortunately, little is known about menopause-related heart irregularities, but research like the Menopause Strategies–Finding Lasting Answers for Symptoms and Health (MsFLASH) multi-center study is beginning to offer some clues.

How to slow the palpitations

Early research shows that stress, insomnia, and depression may be contributing factors. So, making changes to reduce stress, sleep better, and treat depression may help. Here are some more steps to take at home.

Get a baseline. Find out what your normal pulse rate during exercise and at rest. This will help you calculate how much faster your heart is beating during palpitations. Menopause heart palpitations may increase heart rate by eight to 16 beats per minute; a larger increase may indicate a more serious issue.

The easiest way to check your heart rate is with a fitness tracker like a FitBit or Apple watch or a chest strap monitor like Polar. Sometimes an episode can feel worse than it really is and seeing that your heart rate isn’t as elevated as it feels can be reassuring. It is also helpful information to share with your doctor.

Limit caffeine. It’s stimulant that may contribute to heart palpitations. Remember, coffee isn’t the only source of caffeine. Non-herbal teas, including green tea, contain the stimulant. Even decaf teas have a little caffeine. Chocolate, energy drinks, and soda are other sources.

Read drug labels. Over-the-counter medications, such as antihistamines, decongestants, allergy remedies, and diet pills, often contain ingredients that are stimulants, which may affect your heart. If you’re taking any of these or any prescription meds and experiencing irregular heartbeats, check with your doctor to find out if they may be related.

Pay attention. When your heart starts to race or skip, take note (write it down so you don’t forget) if you feel lightheaded, out of breath, or have pain. What were you doing when it happened—exercising, on medications, working, or sleeping? This is valuable information to help your doctor narrow down possible causes. It will also help you to recognize any warning signs that need immediate attention (see below).

Stop smoking. There are dozens of reasons to quit and here’s another one. Smoking increases your risk of experiencing heart arrythmias. If you're having trouble quitting, a health coach might help.

Reset your heartbeat. Most episodes last a few seconds or minutes, but it often feels longer. When your heart is a flutter, here are three strategies to get it back in rhythm more quickly.

  • Breathe slowly in through your nose and out through your mouth. Count the seconds to focus your mind.
  • Splash icy cold water on your face. This can stimulate the vagus nerve, which connects your brain to your heart and regulates heart rhythms.
  • Cough forcefully stimulate the vagus nerve.

There are other techniques like the valsalva maneuver, but you should talk to your doctor first to find out if they are appropriate for you and how to properly perform them.

When to get help for heart palpitations

Heart palpitations can have many causes beyond menopause, such as thyroid imbalances, anemia, diabetes, some infections, low blood pressure, and heart problems. While these flutters are usually not serious, when it comes to heart issues, you don’t want to mess around. Heart disease is the leading cause of death in women, and your risk increases after menopause.  So, it’s wise to talk to your doctor about this symptom when you start to notice it.

You should also familiarize yourself with symptoms of a heart attack. Heart palpitations aren’t one of the common symptoms, but heart attacks often present themselves differently in women than men. Many women don’t always experience the classic symptoms and delay treatment so it’s important to be proactive when it comes to one of your biggest health risks.

How we can help reduce the palpitations

 

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy. 

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