Menopausal Heart Palpitations Can Cause Distress May Signal Serious Health Issue Everyday Health MenuNewslettersSearch Menopause News Menopausal Heart Palpitations Can Cause Distress May Signal Serious Health IssueRacing heart, fluttering, and skipped heartbeats can be common before and during menopause transition. By Becky UphamDecember 22, 2020Everyday Health ArchiveFact-CheckedWhy don’t experts know more about why women’s hearts race during midlife?Vichuda Sirisarakarn/Getty ImagesEven though menopause is an inevitable fact of life for women, most aren’t aware of all the changes in their bodies, brains, and overall health that the transition will bring. Vasomotor symptoms, such as hot flashes, are widely recognized, but there are dozens of other menopausal symptoms that a woman can experience. RELATED: 10 Ways to Beat Menopausal Belly Fat Not All Menopausal Symptoms Are the Same in Terms of Risk or Discomfort And although no menopause symptom can be considered unimportant, heart palpitations can be particularly concerning as they could possibly signal a more serious underlying health issue. Menopausal palpitations are described as loud, racing, or skipped heart beats, flip-flops, fluttering, or pounding that occurs with or without dizziness or lightheadedness. “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, associate dean of research at Indiana University School of Nursing in Indianapolis and lead author of a study that examines heart palpitations. “It’s not clear why they happen, we don’t know if they’re associated with EKG changes, and we don’t know if they increase women’s risk for cardiovascular disease,” says Dr. Carpenter. An electrocardiogram or EKG is a test that measures the electrical signals in your heart to check for signs of heart disease. RELATED: Perimenopause and Menopause: What’s the Difference? Menopause Hormones and Heart Disease Risk When a woman is still having her menstrual period, estrogen and progesterone levels rise and fall during different times of the month, according to the Cleveland Clinic. When a woman enters perimenopause, the lead up to menopause, there is a significant decrease in estrogen production that is associated with an increase in heart rate and an increased frequency in palpitations and nonthreatening arrhythmias. Perimenopause can begin 8 to 10 years before menopause; during the last one to two years of this transition, the drop in estrogen accelerates and many women can begin to experience menopausal symptoms. Menopause is diagnosed in hindsight, after a woman has gone without a menstrual period for 12 consecutive months. Estrogen declines even further during this phase and irregular heartbeats and palpitations can occur, according to research published in the journal Climacteric. Although menopause doesn’t cause heart disease, the risk for developing heart disease goes up with the onset of menopause, according to the American Heart Association (AHA). One factor that may contribute is the decline in estrogen, which is believed to have benefits for the inner layer of the artery wall, helping to keep blood vessels flexible. RELATED: The Menopause Transition Is a Time of Serious Heart Disease Risk Heart Symptoms Often Minimized in Women It’s not totally clear why heart palpitations in perimenopausal or menopausal women are understudied and underrecognized 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. Women’s symptoms often aren’t believed or listened to in the same way that men’s symptoms are,” she says. At the same time, symptoms of menopause have often been trivialized as “no big deal,” she says. “Heart palpitations are at this 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. RELATED: Clinicians Show Gender, Racial Biases in Treatment Decisions for Heart Failure Patients Are Menopausal Heart Palpitations Just Part of a Hot Flash Another reason that heart palpitations may be underrecognized is that some previous research has grouped heart palpitations as part of a hot flash, rather than 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 palpations 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 lay down at night or in the middle of the day- sort of odd times that aren’t related to the hot flashes,” says Carpenter. This suggests that palpitations is its own symptom, separate from hot flashes, she adds. RELATED: Some Hormone Therapies Are More Effective Than Others In Preventing Heart Disease Millions of Women Could Experience Heart Palpitations Related to Menopause Jennifer Lewey, MD, MPH, assistant professor of medicine at the Hospital of the University of Pennsylvania and director of Penn Women’s Cardiovascular Program, both in Philadelphia, agrees with Carpenter’s assessment, saying, “Although I see many menopausal women who present with heart palpitations, there isn’t a lot of literature explaining what the prevalence is, what sort of risk factors there are for it, or even understanding why it happens.” The existing research on palpitations in menopause indicates that it is a common symptom, and anywhere from 18.6 to 46.8 percent of women will experience them, according to research published in the journal Menopause. RELATED: Having Multiple Severe Menopause Symptoms Linked to Increased Risk for Heart Disease Midlife Women with Insomnia Depression and Higher Stress Are More Likely to Experience Palpitations Carpenter and colleagues published a study in the December 2020 issue of the Journal of Women’s Health that looked at 759 women who were perimenopausal and postmenopausal and had vasomotor symptoms, meaning that they were experiencing hot flashes 14 or more times a week and the hot flashes were bothersome or severe on four or more days or nights per week. Investigators found that on average about 1 in 4 women reported palpitation distress which they could rate from “not at all” to “a lot” of bother. “Although the palpitations were fairly common, they didn’t cause severe distress in a lot of women,” says Dr. Lewey, who was not involved in this research. “Only about 5 percent of women said that they had moderate distress and 1.5 percent said they had severe distress from the palpitations,” she says. That may seem like a small percentage of women, but if you consider the hundreds of thousands of women going through some stage of perimenopause or the menopausal transition every year, this symptom does actually impact a large number of women, according to Lewey. “This study does a nice job of characterizing the problem and how common it is. I think a lot of women don't expect to have heart palpitations as a symptom of perimenopause or menopause, and they can be surprised and sometimes scared when it does happen,” she says. Researchers also found that the likelihood of women reporting palpitation distress was higher in those with worse insomnia, depressive symptoms, perceived stress, and menopausal quality of life issues. Could Midlife Heart Palpitations Be a Sign of a Serious Heart Condition in Women In many cases, palpitations aren’t cause for concern and will go away on their own, according to Penn Medicine. However, there are instances where someone with heart palpitations does have an underlying heart condition or discovers underlying heart disease that was previously undiagnosed, says Lewey. In addition to heart disease, palpitations can also be a sign of an abnormal heart valve, heart attack, heart failure, or cardiomyopathy, according to Penn Medicine. Cardiomyopathy is a collection of different conditions of the heart muscle that can cause the heart muscle to stiffen, thicken, thin out, or fill with substances the body produces that shouldn’t be there, according to the Centers for Disease Control and Prevention (CDC). If you’re concerned about heart palpitations, it’s important to talk with your doctor. If heart palpitations come with signs of a cardiac event — such as loss of consciousness; chest pain; difficulty breathing; pain or discomfort in one or both arms, the back, neck, jaw, or stomach; nausea or vomiting; or lightheadedness — you should call 911 and get to a hospital right away, according to the American Heart Association (AHA). RELATED: Fitness at 40 and Beyond: What to Know About Midlife Exercise Needs How to Talk With Your Doctor About Heart Palpitations Lewey emphasizes the importance of talking with your healthcare provider if you have heart symptoms that you’re not expecting or that are particularly bothersome. “For the women in this study who experienced moderate to severe distress from their palpitations, I’m curious how many of them actually spoke to their healthcare provider about it, because we know that women are less likely to seek care,” says Lewey. Sometimes it may just take a quick phone call or maybe it will require further evaluation, but it’s important to communicate with your doctor about these symptoms, she adds. How to Monitor Menopausal Symptoms Collect Info to Share With Your Doctor Self-monitoring and keeping track of your heart palpitations along with your other menopause symptoms can help you be clear when you talk to your provider about heart palpitations, says Carpenter.Pay attention to the time of month and time of day that they are occurring. Make a note of anything that seems to bring it on, such as exercise, smoking, or drinking.Track your other menopause symptoms as well, Carpenter suggests. “If you’re under a lot of stress or having insomnia, that could influence the palpitations,” she says.If you’re still having your period, track your cycle. Your hormones may be influencing when you experience the palpitations.If you’re concerned about the palpitations, make sure you contact your healthcare provider right away and advocate for yourself. NEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. 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