What you’ll learn:
- Hormonal changes during menopause can trigger heart palpitations due to fluctuating estrogen levels.
- Lifestyle changes like stress management, regular exercise, and dietary adjustments can help reduce the occurrence of palpitations.
- Treatment options range from hormone replacement therapy (HRT/MHT) to medications and holistic approaches for effective management.
Menopause brings many changes—some expected, some surprising. Heart palpitations are often in the category of “symptoms that catch people off guard.” If you’ve experienced sudden fluttering or a racing heartbeat, as scary as it can be, you could be experiencing something common. According to one study, about 42% of people going through menopause report heart palpitations.
Why does this happen? One potential reason is that hormonal shifts, which can start in your late 30s, can temporarily disrupt your heart’s rhythm.
These hormonal changes start during perimenopause (the years leading to menopause), often alongside hot flashes, mood swings, and irregular periods. Palpitations can begin during this phase and continue through menopause, 12 months without a period, and into postmenopause.
Palpitations feel alarming, but they’re usually harmless. Understanding the causes, recognizing when to seek help, and using practical strategies can ease your concerns and help you manage these sensations confidently.
Understanding heart palpitations during menopause
Heart palpitations can come on suddenly. Your heart feels like it’s racing, fluttering, or skipping beats. Maybe these sensations even wake you up at night.
So, what’s actually happening in your body? Estrogen doesn’t just regulate your cycle; it also has a protective effect on the heart. During perimenopause, estrogen levels can fluctuate unpredictably. When this happens, your heart might temporarily react, causing palpitations and mild arrhythmias.
Other menopausal symptoms like stress, anxiety, hot flashes, and disrupted sleep can also trigger or worsen palpitations. While these episodes are usually harmless, they can be unsettling and sometimes interfere with daily life. Understanding what’s causing them can help ease your worries and guide you toward effective ways to manage them.
Causes and risk factors for heart palpitations during menopause
Heart palpitations during menopause can be triggered by a few different things—some related to hormonal changes, others tied to everyday habits or health conditions.
- Hormonal shifts: Estrogen plays a role in keeping the heart rhythm steady, so when levels fall, your heart may react. As estrogen levels drop during perimenopause and postmenopause, your heart can also become more sensitive to changes. That’s why it might suddenly feel like it’s racing, fluttering, or skipping a beat.
- Genetic predisposition: Your background matters, too. Research shows that women of certain ethnicities—like Hispanic and Black women—are more likely to experience palpitations during menopause. While we don’t fully understand why, genetics may play a role in how symptoms show up.
- Underlying health conditions: Sometimes palpitations aren’t just about menopause. Conditions like thyroid issues, anemia, or heart problems can also be involved. These may not be caused by menopause, but hormonal shifts can make them more noticeable.
- Lifestyle factors: What you eat, drink, and do each day matters. Things like caffeine, alcohol, smoking, and certain medications (like asthma inhalers or stimulants) can all set off palpitations. Being less active can also make them more frequent, while regular movement tends to help.
- Natural aging: Menopause usually happens around the same time your body starts going through other age-related changes. As arteries stiffen and heart function gradually shifts, you may feel more sensitive to palpitations—even if nothing serious is going on.
Knowing what’s behind your palpitations can help you make sense of what you’re feeling—and figure out what steps to take next.
How heart palpitations affect daily life
Palpitations can significantly impact your daily routines and emotional well-being.
Frequent palpitations may lead you to avoid exercise or social outings, fearing that symptoms could worsen unexpectedly. Anxiety about heart health or underlying issues can affect your mental health, increasing stress further.
Interrupted sleep from nighttime palpitations reduces overall restfulness and energy levels, creating a challenging cycle. Additionally, heightened anxiety around symptoms can magnify menopausal emotional swings, creating frustration or mood fluctuations.
Everyone’s experience is unique—some people rarely notice palpitations, while others deal with frequent episodes. Whether mild or severe, your concerns and symptoms are valid and can be managed.
How to prevent or reduce your risk of heart palpitations during menopause
Heart palpitations during menopause are often harmless, but they can be uncomfortable or even alarming. Some simple lifestyle changes can help reduce the frequency and intensity of these episodes. In some cases, medication may also be recommended.
Here’s what can help:
- Stay active. Regular movement—like walking, swimming, or yoga—supports your heart and reduces stress. Aim for about 30 minutes most days. But more isn’t always better. Pushing too hard or exercising without proper guidance—especially if you have an underlying heart condition—can sometimes trigger palpitations. Always get any new exercise plan cleared with your doctor if you have underlying health issues and are experiencing palpitations.
- Manage stress. Ongoing stress can trigger or worsen palpitations. In a study, people shared that improving self-awareness and emotional control helped them respond better to stress and supported better heart health overall. Try techniques like deep breathing, meditation, or spending time outdoors.
- Cut back on stimulants. Too much caffeine, alcohol, or nicotine can overstimulate your heart. If you notice symptoms after consuming these, it may help to limit or avoid them.
- Prioritize sleep. Poor sleep can make palpitations worse. Maintain a regular bedtime, establish a calming routine, and limit screen time before bed.
- Support your heart with a balanced diet and adequate hydration. Eat a balanced diet rich in heart-healthy nutrients, like magnesium and potassium, which can help support heart health. Drink enough water throughout the day to stay hydrated.
- Talk to your doctor. If lifestyle changes aren’t enough, your provider may check for underlying issues or recommend treatment. This might include beta blockers (to reduce heart rate), low-dose anti-anxiety medications (if stress is a main factor), or hormone therapy in some cases.
Small changes can make a big difference—and with the right support, most people find their palpitations become easier to manage over time.
Do heart palpitations continue after menopause?
It’s totally normal to still feel heart palpitations even after you’ve made it through menopause. In fact, studies show that about 54% of postmenopausal people still experience them. While these fluttery sensations often start during perimenopause, thanks to fluctuating hormones, they don’t always disappear when your periods do.
For many people, palpitations tend to ease up over time as your body settles into its new hormone rhythm. But if they’re sticking around, getting worse, or just making you feel uneasy, it’s worth checking in with your healthcare provider. They can help rule out other causes and figure out the best way to manage what you’re feeling.
How are heart palpitations during menopause diagnosed?
If you only notice the occasional flutter and it passes quickly, it’s probably nothing serious—but it’s still a good idea to mention it at your next checkup. That said, if palpitations start happening more often, feel intense, or get in the way of your daily life, don’t brush them off. Talking to your doctor can help rule out anything serious and get you on the path to feeling better.
Here’s how providers typically evaluate heart palpitations during menopause:
- Medical history and symptom review. Your doctor will ask about when the palpitations started, how often they occur, how they feel, and what seems to trigger or relieve them. They’ll also review your personal and family medical history, including any history of heart disease, anxiety, or hormone-related issues.
- Physical exam. A basic exam checks your blood pressure, heart rate, and general heart and lung function. This helps rule out visible signs of cardiovascular stress.
- Electrocardiogram (ECG or EKG). This test records your heart’s electrical activity. It helps detect irregular heartbeats or patterns that may indicate an arrhythmia.
- Holter monitor. If palpitations are unpredictable, your doctor may ask you to wear a portable heart monitor for 24 to 48 hours (or longer) to track changes over time.
- Event monitor. For less frequent symptoms, a wearable event monitor can be used for several days or weeks. You press a button when symptoms occur, capturing heart activity in that moment.
- Echocardiogram. An ultrasound of the heart may be used to detect structural issues or valve problems.
- Blood tests. These help identify other causes like anemia, electrolyte imbalances, or thyroid disorders—all of which can contribute to palpitations.
Contact your healthcare provider if you experience:
- Frequent or worsening palpitations
- A fluttering sensation that lasts more than a few minutes
- Palpitations that wake you from sleep
- Severe anxiety or distress related to your symptoms
Early diagnosis helps reassure you and initiates effective management faster.
When to seek immediate medical attention
Go to the nearest emergency room if your symptoms come on suddenly, feel severe, or are accompanied by:
- Intense chest pain or pressure
- Trouble breathing
- Fainting or loss of consciousness
These may be signs of a more serious condition, including a possible heart attack.
If you suspect you’re having a heart attack, don’t wait. Call 911 immediately. Every minute counts. Prompt emergency care can save your life.
Medical treatments for menopausal heart palpitations
Menopausal heart palpitations can feel unsettling, especially when they occur without warning or disrupt your daily routine. You don’t have to live with them. While lifestyle changes and stress management can help, some people need additional support to find lasting relief.
Several treatments can effectively manage menopausal palpitations:
How hormone replacement therapy can help with heart palpitations
When it comes to heart palpitations in menopause, the research is still catching up—but there’s some encouraging news. A review of 84 studies suggests that hormone replacement therapy (HRT) may help, especially if you’re also dealing with other low-estrogen symptoms like hot flashes or restless nights. The takeaway? Treatment works best when it’s tailored to your unique symptoms and needs.
If your palpitations are tied to fluctuating or low estrogen, HRT (also called menopausal hormone therapy, or MHT) might help smooth things out. It can help calm hot flashes, improve sleep, and may even reduce the frequency and intensity of palpitations. In some cases, it might even support your heart health by improving things like blood vessel function or cholesterol levels.
Which type of HRT is best for heart palpitations?
If you’re thinking about HRT to help with heart palpitations, it’s helpful to know that there are a few types. Some may be better than others, too, especially if you have any heart health concerns. Here’s a quick breakdown of the options:
- Estrogen patches, gels, or sprays (transdermal estrogen) – These are often a top choice for people with heart risk factors because they don’t go through your digestive system. That means they may have fewer side effects and provide more steady hormone levels.
- Estrogen pills (oral estrogen) – These can be effective too, but they might slightly raise the risk of blood clots, especially in older women or those with other health conditions. It’s something to talk through with your doctor.
- Estrogen + progestogen (for those with a uterus) – If you still have your uterus, you’ll likely need both estrogen and a form of progesterone. The combination helps protect the lining of your uterus and keeps things balanced.
Your provider can help you figure out which option makes the most sense based on your symptoms and overall health.
Is HRT the first choice for treating palpitations?
Not on its own. HRT is recommended first for managing moderate to severe vasomotor symptoms like hot flashes and night sweats. If palpitations are happening alongside those symptoms—or if they’re clearly tied to sleep or hormone shifts—HRT may help as part of a broader treatment plan. But if palpitations occur in isolation or are severe, irregular, or causing concern, it’s important to rule out other causes like arrhythmias, thyroid issues, or anxiety.
Other medications that can help
Hormone therapy isn’t the only option for easing heart palpitations. If HRT isn’t a good match for you—or if you’re looking for other ways to manage symptoms—there are a couple of medications your doctor might consider:
- Beta-blockers – Medications like propranolol or metoprolol can help steady the heartbeat and reduce palpitations triggered by stress, anxiety, or excess adrenaline. For palpitations linked to hormonal changes during menopause, beta-blockers are often less helpful. Doctors may still recommend them if your symptoms are frequent, disruptive, or related to minor rhythm issues, but they’re not ideal for people with very low heart rates or blood pressure.
- Anti-anxiety or antidepressant medications – If your palpitations tend to show up during stressful moments or alongside anxiety, low doses of these meds might help. They don’t just support your mood—they can also calm the physical symptoms that come with stress, including those fluttery heart feelings.
As always, it’s best to talk to your doctor about which treatment feels right for you and your health goals.
Do natural remedies work for heart palpitations during menopause?
Some natural remedies may help reduce stress or support heart health, but their effectiveness for menopause-related palpitations is still uncertain. Unlike prescription medications, herbal remedies and supplements are not regulated as strictly. This means quality, strength, and safety can vary, so caution is important.
Here’s a breakdown of some commonly used remedies—and what to keep in mind:
- Herbal teas (chamomile, lemon balm, lavender): These soothing teas may help you relax or sleep better, which can make palpitations feel less intense. They don’t directly affect heart rhythm, though. Be sure to check for any possible allergies or medication interactions.
- Motherwort: An herb traditionally used for easing anxiety and supporting heart health. Some people say it helps with palpitations, but there’s not much research. It can, however, lower blood pressure and may interfere with heart or thyroid meds.
- Hawthorn: Often used for general heart support and sometimes recommended for mild heart issues. There’s no strong evidence it helps with menopause symptoms, and it can interact with heart or blood pressure medications, so don’t use it without talking to your doctor.
- Vitamins and minerals: Magnesium and potassium play a key role in keeping your heartbeat steady. If your levels are low, that could trigger palpitations. Getting these nutrients from whole foods like leafy greens, bananas, nuts, or avocados is a good place to start. Vitamin D and B vitamins also support heart and nervous system health, though they’re not proven to directly stop palpitations.
How to cope with heart palpitations during menopause
If you’re experiencing heart palpitations during menopause—especially if they’re frequent, intense, or worrisome—start by talking to your healthcare provider. They can help determine whether your symptoms are related to hormonal changes, an underlying condition, or something else entirely. Receiving the correct diagnosis is crucial for finding the most effective treatment.
Once serious causes are ruled out, here’s how you can manage palpitations day to day:
- Focus on consistent, supportive habits. Light physical activity, like walking or yoga, balanced nutrition, and quality sleep can help regulate your heart rhythm and reduce symptoms.
- Limit known triggers. Caffeine, alcohol, nicotine, and highly processed foods can overstimulate the heart. Reducing or avoiding these may ease symptoms.
- Manage stress. Breathing exercises, meditation, and calming routines help reduce anxiety, which can trigger palpitations.
- Stay hydrated. Drinking enough water supports overall heart function and helps maintain electrolyte balance.
- Track your symptoms. Keeping a log of what you feel, when it happens, and any potential triggers can help your provider find the best approach.
- If lifestyle changes aren’t enough, your provider may recommend options like beta-blockers or hormone therapy, depending on your health history and symptoms.
Managing palpitations can be a trial-and-error process, but most people find relief with the right combination of strategies and support.
Finding relief from menopausal heart palpitations
Menopausal heart palpitations are common and are often linked to hormonal fluctuations, especially estrogen. They can also be triggered or worsened by stress, stimulants, disrupted sleep, or certain health conditions, making it important to talk to your doctor to investigate the causes behind them. Keep in mind that while these sensations can feel alarming, they’re usually harmless and often lessen over time as hormone levels stabilize.
If palpitations become persistent, disruptive, or occur alongside other symptoms, it’s a good idea to talk to your healthcare provider. Tools like ECGs, blood tests, or heart monitors can help rule out more serious causes. Treatment may involve lifestyle adjustments, beta-blockers, or hormone therapy, depending on your health history and current symptoms. Tracking your experiences and identifying patterns can also help guide your care and improve how you feel day to day.
