Heart Palpitations in Perimenopause: Why Is My Heart Racing?
Heart Palpitations in Perimenopause
If your heart suddenly starts fluttering, pounding or racing — out of nowhere — it can feel frightening.
You might notice:
▫️A fluttering in your chest
▫️A racing heartbeat
▫️A forceful thump
▫️A skipped beat sensation
Heart palpitations are common in perimenopause.
But they should always be taken seriously and assessed — especially if new.
What Are Heart Palpitations?
Palpitations are the sensation of:
▫️Irregular heartbeat
▫️Rapid heartbeat
▫️Strong or pounding beats
They may last seconds or minutes. Sometimes they are accompanied by:
▫️Light-headedness
▫️Shortness of breath
▫️Mild dizziness
In many cases, they are benign. But underlying causes must be ruled out.
Why Do Palpitations Happen in Perimenopause?
Several factors contribute.
1. Oestrogen Fluctuation
Oestrogen affects:
▫️Blood vessel tone
▫️Nervous system regulation
▫️Heart rhythm sensitivity
When levels fluctuate, the heart can become more sensitive to stress hormones like adrenaline.
This can increase awareness of your heartbeat.
2. Increased Adrenaline Sensitivity
Perimenopause can increase sympathetic nervous system activity. This means:
▫️Stress hits harder
▫️Cortisol rises faster
▫️Adrenaline spikes more easily
Your heart responds to this.
3. Anxiety and Stress
Chronic stress increases heart rate variability.
Anxiety can amplify the sensation of normal heart rhythm changes.
The more you focus on it, the stronger it can feel.
4. Dehydration
Low fluid levels reduce blood volume.
Your heart beats faster to compensate.
Even mild dehydration can trigger fluttering.
5. Stimulants
▫️Caffeine
▫️Nicotine
▫️Alcohol
▫️High sugar intake
All increase heart rate and nervous system activation.
6. Underlying Medical Causes
Palpitations can also be linked to:
▫️Thyroid dysfunction
▫️Iron deficiency (anaemia)
▫️Arrhythmias
▫️Blood pressure changes
This is why medical review matters.
When to Seek Medical Attention
Always speak to your GP if palpitations are:
▫️New
▫️Frequent
▫️Worsening
▫️Associated with chest pain
▫️Associated with fainting
▫️Accompanied by severe shortness of breath
Urgent assessment is needed if symptoms are severe.
Most perimenopause palpitations are benign — but never assume.
Practical Ways to Reduce Palpitations
Once serious causes are ruled out, lifestyle stabilisation helps.
1. Improve Sleep
Poor sleep increases cortisol and adrenaline.
Protecting sleep reduces episodes.
2. Stabilise Blood Sugar
Large glucose swings trigger stress hormones.
Balanced meals with adequate protein help reduce spikes.
3. Reduce Stimulants
Limit:
▫️Caffeine
▫️Alcohol
▫️High sugar snacks
▫️Nicotine
Track your response.
4. Manage Stress
Lower nervous system reactivity reduces heart sensitivity. Helpful tools:
▫️Walking outdoors
▫️Strength training
▫️Breath work
▫️Reducing overload
5. Stay Hydrated
Aim for consistent water intake across the day.
Quick Calming Techniques During an Episode
If palpitations strike and you’ve already been medically assessed:
1. Deep Belly Breathing
Inhale through the nose for 4 seconds
Hold briefly
Exhale slowly for 6–8 seconds
Repeat 5–10 cycles.
This activates the parasympathetic (calming) nervous system.
2. Gentle Vagal Stimulation
▫️Splash cool water on your face
▫️Gentle cough
▫️Slow controlled breath holding
These stimulate the vagus nerve, which helps regulate heart rhythm.
Avoid forceful straining without medical guidance.
3. Sit or Lie Down
Reduce dizziness by sitting or lying comfortably.
Elevate legs slightly if light-headed.
4. Relax Muscle Tension
Roll shoulders.
Unclench jaw.
Stretch neck gently.
Muscle tension amplifies the sensation.
5. Track Episodes
Log:
▫️Time
▫️Food
▫️Stress levels
▫️Caffeine intake
▫️Sleep
Patterns often emerge.
Can HRT Help Palpitations?
For some women, stabilising oestrogen levels reduces nervous system sensitivity and palpitations.
However:
HRT is not a treatment for arrhythmias.
Medical guidance is essential.
FAQ Section
Are heart palpitations normal in perimenopause?
They are common due to hormonal and nervous system changes, but medical review is important.
Can anxiety cause heart palpitations?
Yes. Anxiety increases adrenaline, which can trigger palpitations.
Does oestrogen affect heart rhythm?
Oestrogen influences blood vessel tone and nervous system sensitivity, which can affect heart rhythm awareness.
When should I worry about palpitations?
If they are new, severe, associated with chest pain, fainting or shortness of breath, seek medical attention urgently.
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