Banging, fluttering, racing, even skipping a beat – when your heart does any of these when you’re neither exercising nor suddenly realizing Benedict Cumberbatch is standing next to you, it can be very frightening.

Declining levels of estrogen can cause heart palpitations and irregular heart beats called arrhythmia. When caused by menopausal hormone changes, the slow, fast, fluttering, and pounding heartbeats aren’t dangerous.*

However, since this sign of perimenopause or menopause isn’t much talked about, many women are unaware that it can happen until it suddenly, terrifyingly, happens to them.

Because it is so scary and so prevalent, we are making heart palpitations our symptom of the month.

(are you taking care of your heart? check out three ways to a healthier heart)

What’s happening with my heart?

Heart palpitations and hot flashes at night? In the middle of the day? No pattern whatsoever? As most things menopausal, “estrogen decline” is a major culprit. According to Medical News Today, lower levels of estrogen can lead to an “overstimulation of the heart.” Additionally, estrogen may have heart-protective qualities including keeping arteries flexible. When that protection declines or disappears, reduced blood flow can cause arrhythmia. However, estrogen dominance heart palpitations are also documented, and it appears too much estrogen can cause arrhythmias as well.

Be still, my beating heart

So, if your fluttering heart is caused by a decline in estrogen, you’re not in any physical danger, and your heart should reset in a few seconds or minutes. Knowing this does not, however, make it any better when a pounding heart wakes you in the middle of the night, or when a racing heart makes a hot flash even more uncomfortable. 

How to stop hormonal heart palpitations is not exactly obvious, so what can you do to calm a racing heart from menopause?

There are healthy lifestyle changes that can reduce your risk of palpitations:

  • Eat regularly to avoid low blood sugar, which can cause palpitations,
  • Hydrate, but not with caffeine or alcohol,
  • Stop smoking,
  • Get the best-quality sleep you can,
  • Exercise, meditate, reduce stress as much as possible,
  • Make sure you’re well-stocked on electrolytes like potassium, magnesium, calcium, and sodium. You can get these from your diet or high-quality supplements.
  • Check your meds, both prescription and over-the-counter. Some can cause heart palpitations, so talk over possible side effects with your doc.

We also suggest everyone get to know their normal pulse during exercise and at rest. This will help you calculate how much faster your heart is beating during palpitations.

Many women find relief from heart palpitations with a daily supplement of magnesium glycinate. 

What to do when palpitations are happening (with doctor approval, please):

  • Breathe slowly in through your nose and out through your mouth. Count the seconds to focus your mind.
  • According to Best Health Magazine, you can try the Valsalva maneuver: pinch your nose and close your mouth, then try to exhale (you won’t be able to – that’s OK). This causes a brief elevation in blood pressure that may be enough to reset your heartbeat. Don’t bear down harder than you would for a normal bowel movement, for example, as you don’t want to damage your eardrums.
  • The vagus nerve connects your brain to your heart; sometimes you need to get its attention with “vagal maneuvers.” Splash cold water on your face or jump into a cold shower. This can stimulate the vagus nerve to get it back to the business of regulating heart beats. Forced coughing can also stimulate the nerve.

What else could be causing the heart palpitations?

Of course, heart palpitations aren’t always the result of estrogen decline. Lifestyle choices can also cause a racing heart: too much caffeine, too much stress, stimulants such as diet pills or decongestants, dehydration, exercise, eating too much at a single sitting, medications like antihistamines and cold and allergy remedies.

More alarming causes include thyroid imbalance (hyper or hypothyroidism), anemia, diabetes, some infections, low blood pressure, or a heart problem.

(do you know the symptoms of a heart attack in women? they can be different, so learn the signs)

When do I need to see a doc?*

Because there may be more serious causes, see your doc if any of the following come along with the palpitations:

Because the palpitations rarely happen on command, your doc probably won’t get to see them in action, so you may need to wear a monitor. When you do get in to see the doc, be ready with some information: know your resting pulse and what your pulse is during palpitations. Note if you feel lightheaded, out of breath, or have pain. What are you doing when they happen – exercising, taking medications, working, etc.? Any information you can provide can help your doc narrow down the possible causes.

*The information in this blog is never intended to replace expert care from a licensed health professional. If your heart is flopping like a fish out of water, and you feel something more than menopause (or Benedict) may be behind it, don’t hesitate to check with a doctor.

Heart disease risk increases after menopause, so it’s important to take heart changes seriously. If you’ve had experience with palpitations, we’d love to know what you did or are doing to manage them. Please share in the comments below, on Gennev’s Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.