heart hand on shallow focus lens

Palpitations and menopause

Are palpitations and menopause linked? What are heart palpitations? What causes them? How can your lifestyle choices affect them? When should you get medical help? How are palpitations diagnosed? How are they treated and what can prevent them? At Rowena Health Menopause Clinic we can help you. Lets answer these questions.

Palpitations are a symptom of the hormonal changes in perimenopause, menopause or in pregnancy. I often see women at Rowena Health menopause consultations who are suffering from this symptom. A heart palpitation is when you suddenly become aware of heart beating more quickly than usual, or pounding. Palpitations are usually harmless, but, if you are getting them regularly please get them checked out.

What are palpitations?

Palpitations feel like your heart is pounding, racing, fluttering or like you have missed heartbeats. They can last seconds, minutes or longer and can be felt in your chest, your neck, or your throat.

Palpitations can happen at anytime, even if you are sitting down resting or doing your normal daily activities. They can be unpleasant, even frightening. Palpitations are actually common and, in most cases, they are harmless.

We know that palpitations are a symptom found commonly in menopause and perimenopause, what else can cause them?

Some causes palpitations are:
  • Alcohol
  • Caffeine
  • Stress and anxiety
  • Certain medications, prescribed and those bought over the counter
  • Ectopic beats ( these are early or extra heart beats)
  • Hormonal changes like perimenopause, menopause or pregnancy
  • Intense exercise
  • Smoking
  • Certain foods like spicy food or rich food
  • Recreational drugs
  • Overactive thyroid
  • Anaemia
Some heart diseases which can cause palpitations are:

This is an abnormal heart rhythm. Your heart is controlled by a conduction system which sends out electrical impulses. This causes a heartbeat. An arrythmia is a problem with this conduction system and it can cause the heart to beat too fast, too slowly or irregularly. An example is Atrial Fibrillation, this is the most common irregular, often fast heart rhythm. There are others like Supraventricular Tachycardia, Atrial flutter and heart block. The symptoms of an arrythmia include palpitations, dizziness, breathlessness, feeling as if you may black out, discomfort in the chest and feeling tired.


This is a disease of the heart muscle which affects its size, shape or thickness. Some common cardiomyopathies include hypertrophic cardiomyopathy and dilated cardiomyopathy.

Heart attack

A heart attack is a medical emergency. It happens when there’s a sudden loss of blood flow to a part of the heart muscle. Without enough blood and oxygen your heart can be seriously damaged.

Heart Failure

This is a condition where your heart can’t pump blood around your body as well as it should. It doesn’t mean your heart has failed to work, but you may need support to help it work better like medication, a pacemaker or ICD or heart surgery. 

How to treat palpitations?

As palpitations are often harmless, they usually don’t need treatment, but lifestyle changes can help. However, you will need treatment if tests show your palpitations are caused by an underlying heart condition like those described above. The type of treatment you’ll have depends on your condition. For example, if you’re diagnosed with an arrhythmia, your doctor might prescribe beta blockers to regulate your heart rate and rhythm.

If you don’t need treatment then the easiest way to manage your palpitations is to try and avoid the triggers. However, it can be difficult to do that, if your trigger involves the fluctuating hormone levels found at the time of perimenopause, as these are out of your control. Palpitations and menopause are linked by these fluctuating levels of hormones and are a common symptom.

The most effective treatment to help manage symptoms of perimenopause and menopause is by taking HRT, Hormone Replacement Therapy. Taking this treatment is shown to reduce the many symptoms, like palpitations, by 70-80%. HRT has proven health benefits, other than symptom relief so please do read about these and make an informed decision about how to manage your symptoms and how to protect your future health. Your Dr can discuss this with you and see if it is right for you.

Other things you can do to help improve your palpitations are:

  • Avoiding or drinking less caffeinated drinks
  • Avoiding or drinking less alcohol (no more than the recommended limit of 14 units a week)
  • Avoiding foods and activities that trigger palpitations in you (try keeping a symptom diary so you can recognise and avoid triggers); managing your stress levels
  • Not smoking
  • Making healthy lifestyle changes can really improve perimenopause and menopause symptoms and protect your future health.
When to get medical help?

Please see a GP if you are concerned about your palpitations, they are lasting a long time, or getting worse, or if you have a history of heart problems. Your GP may arrange for you to have a trace of heart (electrocardiogram/ECG) to check whether the heart rate is regular and at a normal rate. If your ECG shows something abnormal, or your symptoms continue to bother you, you may need to have further tests or heart monitoring over a longer period to see if the cause can be found.

You should call 999 if you have palpitations and experience any of these problems:
  • Severe shortness of breath
  • Chest pain or tightness
  • Dizziness or lightheadedness
  • Fainting or blackouts

We are delighted to see you at Rowena Health Menopause Clinic to discuss your symptoms of perimenopause and menopause and help provide all the information you need to decide on the right treatment for you.

Last updated Septmeber 2023 Dr Carys Sonnenberg

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