The Link Between Menopause and Heart Palpitations

Even though menopause is an inevitable part of life for women, many aren’t aware of all the changes it will bring to their bodies, brains, and overall health.

Vasomotor symptoms, such as hot flashes, are widely recognized. But women can also experience dozens of other menopause symptoms, including heart palpitations.

“Palpitations are not only quite common, but also underdiagnosed and understudied; when I’ve talked to some of my colleagues about heart palpitations, they’ve been a little bit shocked about what we still don’t know,” says Janet S. Carpenter, PhD, RN, dean and a distinguished professor at Indiana University School of Nursing in Indianapolis.

“Most of the time, heart palpitations during menopause are benign and not concerning,” says Purvi Parwani, MD, a cardiologist and the director of the Echocardiography Laboratory at the Loma Linda University International Heart Institute in California.

Though palpitations are typically harmless, they may sometimes signal an underlying heart condition or heart disease that had been previously undiagnosed, Dr. Parwani says.

“Estrogen plays a role in regulating the autonomic nervous system, which controls the heart rate and can affect the heart rhythm,” says David Slotwiner, MD, chief of cardiology at NewYork-Presbyterian Queens in New York City. “As estrogen levels decline, some women may experience irregular heartbeats or a sensation of their heart racing or fluttering, known as heart palpitations.”

• Anemia
• Abnormal heart valve
• Dehydration
• Diabetes
• Infections
• Overactive thyroid
• Atypical level of potassium in the blood
• Low level of oxygen in the blood

Ultimately, these mixed results highlight the need for more research on menopausal palpitations and what might lead some women to experience them.

It isn’t clear why heart palpitations in perimenopausal or menopausal women are understudied and unrecognized compared with other menopausal symptoms, says Carpenter.

“It could partly be due to the fact that there’s been a historic bias against women in cardiology,” she says.

“There has been a historical and illustriously documented bias against women in cardiology, with poor understanding and trivialization of heart symptoms, including palpitations, that results in missed or delayed diagnosis of serious cardiac events,” says Parwani.

At the same time, symptoms of menopause have often been trivialized as “no big deal,” Carpenter says.

“Heart palpitations are at the intersection of these two things. If people have been attributing the palpitations to menopause, there may be a general feeling that these will probably go away, don’t worry about it,” she says.

Another reason that heart palpitations may not be recognized is that some previous research has grouped heart palpitations as part of a hot flash and not its own symptom, says Carpenter.

“There are some studies that define hot flashes in terms of heat, sweating, and heart racing or pounding, suggesting that palpitations occur at the same time as the hot flashes,” she says. “However, when I talk to women, these palpitations are often separate from the hot flashes. They’re feeling these when they lie down at night or in the middle of the day — sort of odd times that aren’t related to the hot flashes.”

This suggests that palpitations are a symptom separate from hot flashes, she says.

If you’re concerned about heart palpitations, it’s important to talk with a healthcare professional.

“It’s best to talk to a cardiologist and be further evaluated to find out about the cause of heart palpitations,” Parwani says. “Many times, these palpitations are sudden and require a monitor, such as a Holter or loop recorder, to catch them. In certain situations, they can be managed with medications. If they are serious, there are procedures like ablation that can help prevent palpitations.”

Dr. Slotwiner notes that it’s important to tell your doctor about the characteristics of what you’re feeling, including:

• Do the palpitations occur with particular activities, while you’re at rest, or both?
• Do the palpitations feel like single extra or skipped beats, or do the palpitations last for minutes or hours?
• Does your heart feel like it’s beating too fast, too hard, or both?
• Does your heart rate feel irregular?
• Do you have any additional symptoms when you notice the palpitations, such as feeling sweaty, light-headed, or short of breath? Do you have chest pain?
• How frequently do your symptoms occur?

It’s also helpful to track your other menopause symptoms, Carpenter says.

“If you’re under a lot of stress or having insomnia, that could influence the palpitations,” she says.

If you feel your doctor isn’t taking your heart palpitations seriously, Slotwiner recommends asking if the doctor has seen a recording of your heart rhythm when you have felt palpitations, which is the type of data obtained from a heart monitor.

“If the doctor is not able to explain what your heart rhythm is when you feel palpitations, you should ask for a heart monitor so the data can be obtained,” he says. “Lastly, it may be time to seek the opinion of a different physician.”

• Loss of consciousness
• Chest pain
• Difficulty breathing
• Pain or discomfort in one or both arms, your back, your neck, your jaw, or your stomach
• Nausea or vomiting
• Lightheadedness or dizziness
• Unusual sweating

• Menopause symptoms vary from person to person, but many women may experience menopausal heart palpitations. Although often benign, these palpitations can cause concern and may signal underlying health issues or an increased risk of heart conditions.
• Heart palpitations may result from dropping levels of estrogen during perimenopause and postmenopause. This is possibly due to estrogen’s crucial role in supporting the strength of the inner artery wall.
• If you notice heart palpitations, track when and how often you experience them, the speed and strength of your heartbeat, and any other symptoms.