Heart palpitations are irregular heartbeats, including racing, pounding, or fluttering sensations. Most of the time, there’s nothing to worry about, but you should talk to your doctor to be sure. This guide to perimenopause heart palpitations will help you understand why they happen, when they’re normal, and how you can best support your heart.
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Heart palpitations are irregular heartbeats, including racing, pounding, or fluttering sensations. Most of the time, there’s nothing to worry about, but you should talk to your doctor to be sure. This guide to perimenopause heart palpitations will help you understand why they happen, when they’re normal, and how you can best support your heart.
You're sitting at your desk when suddenly your heart starts racing. Or lying in bed at night when you feel a flutter in your chest. These unexpected sensations, irregular heartbeat in perimenopause, also called heart palpitations, affect up to 42% of women during the menopause transition. While they can feel alarming, they're usually harmless.
Perimenopause heart palpitations are irregular heartbeats that come on out of nowhere, then go away again just as suddenly. While this can feel unsettling and maybe even scary, it’s generally not cause for concern. Checking in with your doctor is always a good idea though, especially if you often have heart palpitations.
Here, we’ll cover everything you need to know about perimenopause heart palpitations, including what they feel like, why they happen, and when they’re normal, plus tips for managing heart palpitations and supporting heart health in perimenopause and beyond.
Quick Facts About Perimenopause Heart Palpitations
- Affect up to 42% of women in perimenopause
- Usually last just a few seconds
- Most common in women with hot flashes or sleep issues
- Generally harmless but always worth discussing with your doctor
What are heart palpitations?
Most of the time, you don't notice your heartbeat. Heart palpitations change that suddenly, your heartbeat becomes noticeably irregular, racing, pounding, or skipping beats.
Heart palpitations, sometimes called arrhythmias, are sudden changes to your heartbeat, and they’re significant enough that you take notice. You may feel like your heart is racing, or pounding, or skipping beats.
Heart palpitations can feel scary and unsettling – these are completely normal emotions! But often, heart palpitations are harmless and you don’t need to worry [1]. Still, it’s always a good idea to talk to your doctor about perimenopause heart health and persistent heart palpitations.
Does perimenopause cause heart palpitations?
Yes, perimenopause can cause heart palpitations.
Heart palpitations and irregular heartbeat in perimenopause are recognized symptoms (although they tend to be less well-known than other perimenopause symptoms, and they haven't been studied as much). They’re a common symptom, too: up to 42% of people experience heart palpitations, feelings of irregular heartbeats, and heart rate changes in perimenopause [2]. That’s nearly half of all women!
In other words, if you get heart palpitations in perimenopause: you’re not imagining the changes in your heart rate, and you’re definitely not alone.
You may be more likely to experience perimenopause heart palpitations if [2]:
- You started perimenopause on the early side (like in your late 30s)
- You’ve had multiple pregnancies
- You have hot flashes and/or night sweats (vasomotor symptoms)
- You have more depressive symptoms
- You have higher stress levels
- You have more sleep problems
Track your symptoms: If you notice patterns between your heart palpitations and other symptoms (like hot flashes or sleep disruptions), tracking your hormones with at-home testing can help you and your doctor understand what's happening in your body.
Research suggests perimenopause heart palpitations aren’t a predictor of your future health, and aren’t an early sign of heart disease [2]. Put differently, having heart palpitations in perimenopause doesn’t automatically mean that something is wrong with your heart, or that you’ll develop heart problems later in life.
What do perimenopause heart palpitations feel like?
Perimenopause heart palpitations come on suddenly. They typically only last a few seconds or around a minute, and then your heartbeat returns to normal [1].
Menopause heart racing is one of the most commonly reported sensations. Many people describe perimenopause heart palpitations as:
- Racing heart (menopause heart racing)
- Pounding or thumping heart
- Fluttering heart
- Heart turning over in your chest
- Heart skipping a beat
- Heart having a few extra beats
- Feeling your heartbeat in your throat or neck
Along with palpitations, some people simultaneously have:
- Dizziness
- Lightheadedness
- Changes in breathing
You may also feel a wave of panic or anxiety wash over you when you experience perimenopause heart palpitations. Try to remain calm and focus on breathing deeply, and remember that your heart rate will typically steady itself again.
What causes heart palpitations in perimenopause?
Heart palpitations are a common perimenopause symptom, but very little research exists on the subject. This means that experts aren’t really sure yet what causes heart palpitations [3].
Like so many perimenopause symptoms, though, hormone changes may well be part of the reason. Estrogen and progesterone, for example, play key roles in supporting heart health, and are thought to be involved in regulating heart rate [4]. When these hormones fluctuate and decline during perimenopause, it could contribute to heart palpitations and irregular heartbeats.
Other perimenopause symptoms also play a role in heart palpitations, including:
- Hot flashes and night sweats (vasomotor symptoms)
- Increased stress
- High anxiety
Take vasomotor symptoms, for example. For many people, these sudden rushes of heat are accompanied by menopause heart racing – that pounding or fluttering sensation in your chest that can feel alarming. Since 80% of women experience hot flashes in perimenopause, it’s no wonder that perimenopause heart palpitations are common, too [5].
Is irregular heartbeat in perimenopause the same as menopause heart racing?
Yes, these terms describe the same experience. Whether you call it irregular heartbeat, heart racing, heart palpitations, or arrhythmia, they all refer to sudden changes in your heart rate that feel noticeable and sometimes alarming. The medical term is "palpitations," but many women describe the sensation as their heart racing, especially during hot flashes or moments of anxiety.
When do perimenopause heart palpitations first start?
People can start experiencing perimenopause heart palpitations at any point during the transition to menopause.
You might have this perimenopause symptom starting as early as your late 30s, or you may not experience heart palpitations until your 40s. Alternately, you may never get perimenopause heart palpitations at all.
How frequently do people have perimenopause heart palpitations?
A recent study found that heart palpitations happened frequently in 16% of people, occasionally in 34%, and rarely in 50% [2]. But what does frequently mean? Since research on perimenopause heart palpitations is still so limited, it’s hard to know.
For some people, frequently could mean daily: in one small study, half of all participants who had perimenopause heart palpitations experienced palpitations at least once a day [6]. For others, though, palpitations could be a rare occurrence.
You might experience palpitations multiple times a day, once every few days, or only once in a blue moon. Consider talking to your doctor about your perimenopause heart palpitations or any concerns about heart health.
When do perimenopause heart palpitations stop?
For many, heart palpitations can last through to late postmenopause. That means that you might continue to get heart palpitations from time to time for a few years beyond official menopause (you’ve reached official menopause once you’ve gone 12 consecutive months without a period) [2].
When are heart palpitations normal in perimenopause?
Perimenopause heart palpitations are generally normal if:
- You occasionally experience irregular heartbeat sensations like racing, pounding, thumping, fluttering, or skipped heartbeats
- Your heart palpitations only last for a few seconds
- Your heartbeat returns to normal afterward
In these cases, you’re likely experiencing heart palpitations as a symptom of perimenopause. While this can feel scary, it generally isn’t cause for concern.
When to talk to your doctor about heart palpitations in perimenopause
Usually, perimenopause heart palpitations are mild, palpitations can be managed without medical intervention, and your heartbeat returns to normal afterward.
However, it’s always a good idea to talk to your doctor about perimenopause heart palpitations (and other perimenopause symptoms), just to be safe. That way, you can check that all is well and find strategies for managing symptoms along your perimenopause journey.
Be sure to talk to your doctor if:
- Your heart palpitations are getting worse or more frequent
- Your heart palpitations last longer than a few seconds to a minute
- You or your family have a history of heart disease
- Your heart palpitations coincide with other new symptoms
- You're concerned or want peace of mind
While most perimenopause heart palpitations are harmless, certain symptoms require immediate medical attention. Seek emergency medical care right away if you have heart palpitations accompanied by these symptoms:
- Chest pain or discomfort
- Shortness of breath
- Severe dizziness
- Feeling faint or fainting
Tips for managing heart palpitations in perimenopause
When you experience heart palpitations, try to:
- Take slow deep breaths in through the nose and out through the mouth, focusing on filling your belly with air
- Sit or lie down, especially if you’re feeling lightheaded
- Drink water
For managing heart palpitations in your day to day, consider:
- Limiting stimulants: Avoid triggers and stimulants that are known to set off heart palpitations, including caffeine, alcohol, and smoking
- Lowering stress and anxiety levels: Therapeutic practices like cognitive behavioral therapy (CBT), talk therapies, and counseling can all help you address stress, anxiety, and other emotional symptoms of perimenopause.
- Talking to your doctor about treating vasomotor symptoms: Hormone replacement therapy (HRT) is one option for treating hot flashes, and it could also help with heart palpitations (a doctor likely won’t prescribe HRT for treating heart palpitations alone) [7].
Tips for supporting heart health in perimenopause
As you get older, it’s important to think more intentionally about heart health.
Lifestyle strategies like these can support heart health and boost physical and emotional health, all while managing perimenopause heart palpitations [2]:
- Taper your caffeine intake, or cut out caffeine entirely and switch to decaf coffee or decaf tea
- Reduce your alcohol intake, or swap out alcoholic drinks altogether for non-alcoholic beverages and mocktails
- Lower stress with stress management techniques like meditation, deep breathing exercises, yoga, or mindfulness practices
- Prioritize sleep and practice good sleep hygiene, aiming for 7 to 9 hours of sleep per night
- Exercise regularly, with both cardio and strength training
- Eat a balanced diet, with lots of fruits, veggies, whole grains, protein, and healthy fats, and less processed and high-salt foods
- Know your numbers: Get regular check-ups to monitor blood pressure, cholesterol, and heart health markers
- Track your cycle and hormones: Understanding your hormone patterns can help you identify triggers and work with your doctor on treatment options
- Build a support system: Connect with other women going through perimenopause to share experiences and strategies
Heart palpitations during perimenopause: The bottom line
Perimenopause heart palpitations are a common symptom, likely caused by shifting hormones, as well as other perimenopause symptoms like hot flashes, night sweats, increased stress, and high anxiety.
If you're experiencing heart palpitations during perimenopause, know that you're not alone, and in most cases, they're a normal part of the transition. While they can feel unsettling, they're usually harmless and manageable with lifestyle changes. Aim to reduce stress, exercise regularly, prioritize sleep, eat a nutritious diet, and limit caffeine, alcohol, and other stimulants.
The key is staying informed about what's happening in your body. Track your symptoms, talk to your doctor, and remember: understanding your hormones is the first step to feeling like yourself again.
Ready to take control of your perimenopause journey? Learn more about Oova!
Frequently Asked Questions
Can low estrogen cause heart palpitations?
Yes, declining estrogen levels during perimenopause are thought to play a role in heart palpitations, though more research is needed.
Will my heart palpitations go away after menopause?
For most women, heart palpitations improve after menopause, though they can persist into postmenopause for some.
Should I wear a heart monitor for perimenopause heart palpitations?
Your doctor may recommend a heart monitor if your palpitations are frequent or concerning. This can help rule out other heart conditions.
About the author

Sources
- NHS. (2022). Heart palpitations.
- Carpenter JS, et al. (2022). Palpitations Across the Menopause Transition in SWAN: Trajectories, Characteristics, and Associations with Subclinical CVD.
- Carpenter JS, et al. (2022). Correlates of palpitations during menopause: A scoping review.
- Zeitler EP, et al. (2022). Arrhythmias in Female Patients: Incidence, Presentation and Management.
- Avis NE, et al. (2018). Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.
- Carpenter JS, et al. (2025). Palpitations in midlife women: the Menopause Racing Heart Pilot Study.
- Sheng Y, et al. (2021). Effect of Menopausal Symptom Treatment Options on Palpitations: A Systematic Review.
About the Oova Blog:
Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.


