During perimenopause, shifting hormone levels can cause the heart to beat faster or feel irregular, leading to sensations known as perimenopause heart palpitations. These episodes are usually harmless and related to changes in estrogen and progesterone, but they can feel alarming.
Some women notice fluttering, pounding, or skipped beats, especially during hot flashes or stress. While most cases improve with lifestyle support, persistent palpitations, chest pain, or shortness of breath should be evaluated by a doctor to rule out heart disease.
Treatment focuses on managing hormones, improving heart health, and identifying triggers that worsen symptoms.
At SensIQ, neurologists and women’s health experts create science-based plans to help women stay calm and focused through hormonal changes.
This article explains the causes, symptoms, and treatments of perimenopause heart palpitations, offering clear and trustworthy guidance for women in this stage of life. Each insight is supported by Dr. Luke Barr, Chief Medical Officer at SensIQ.
Key Takeaways
- Hormonal changes during perimenopause can cause heart palpitations, which feel like a racing or fluttering heartbeat and are usually harmless but sometimes need medical evaluation.
- Factors such as stress, hot flashes, night sweats, caffeine, and low hormone levels can trigger these sensations, especially at night or before a menstrual period.
- Lifestyle habits like regular exercise, hydration, and relaxation techniques can help support normal heart rate, blood pressure, and overall heart health.
- Magnesium and other nutrients may help support healthy muscle and nerve function, but supplements should only be used under medical supervision and not as replacements for prescribed treatments.
- Ongoing monitoring, healthy habits, and expert guidance, such as from Dr. Luke Barr and the SensIQ medical team, can help women maintain cardiovascular balance and improve overall quality of life during the menopause transition.
Understanding Heart Palpitations in Perimenopause
Heart palpitations in perimenopause are feelings that your heart is racing, fluttering, or skipping beats. These changes occur when levels of estrogen and progesterone fluctuate before menopause, affecting how the heart and nervous system work together. The sensation can last only a few seconds but may feel worrying.
Knowing that these feelings are common during perimenopause can help ease concern and remind you to keep track of your heart rate and heart health.
Other common symptoms include hot flashes and night sweats, mild chest pain, or shortness of breath, especially during stress or activity. While these symptoms can feel scary, they usually happen because of normal hormone shifts. Watching your patterns helps you understand what is typical and when to ask a doctor for advice.
Causes and Triggers of Perimenopausal Palpitations
How Hormones Affect the Heart
Changing hormone levels are a main reason for irregular heartbeats during the menopause transition. When estrogen drops, the body produces more adrenaline, which can raise heart rate and make you feel more alert or tense¹.
Lower estrogen also affects blood pressure and blood vessels, sometimes linking palpitations with a hot flash or sudden warmth. These are part of normal menopausal symptoms, including changes in circulation and nerve signals.
When Palpitations Occur (Night, Period, Eating, Dizziness)
Palpitations can happen at different times. Some women feel them before or during their period when progesterone rises. Others notice them at night, when changes in cortisol and body temperature make sleep harder.
Palpitations after eating can come from changes in blood sugar levels or digestion. Feeling dizzy at the same time may be related to dehydration or low blood pressure. Paying attention to when palpitations occur helps doctors understand what might be causing them.
Hot Flashes and Stress
Hot flashes and night sweats can trigger the body’s stress system, which raises the heartbeat. Stress and worry make this worse, especially with caffeine or alcohol. Research suggests that women under constant stress report more frequent palpitations². Simple breathing, stretching, or yoga may help the body relax.
Risk factors that make palpitations worse include smoking, too much caffeine, thyroid issues, and anxiety. While these moments are usually not dangerous, frequent palpitations should be checked to rule out cardiovascular disease or other problems that may increase your risk later in life.
How to Manage and Treat Heart Palpitations
Natural Relief Techniques
Lifestyle changes are often the best first step for perimenopause and heart palpitations. Light to moderate exercise supports heart health, reduces stress, and helps balance hormones. Activities like walking, yoga, and swimming can improve circulation and help regulate heart rhythm.
Cutting back on caffeine, alcohol, and nicotine can prevent sudden spikes in heart rate or blood pressure. Managing daily stress through relaxation techniques such as deep breathing, mindfulness, or progressive muscle relaxation can also help steady the heartbeat.
Staying hydrated and maintaining steady blood sugar levels throughout the day may reduce heart palpitations linked to fatigue or skipped meals. Eating balanced meals that include protein, complex carbohydrates, and healthy fats keeps energy stable. Learn more about how nutrition supports hormonal balance in our perimenopause diet and nutrition guide.
Other helpful strategies include:
Adequate sleep: Going to bed at the same time each night and limiting screen use before sleep helps regulate hormones and lower nighttime palpitations.
Stress management: Journaling, gentle stretching, or time outdoors can reduce cortisol spikes that trigger heart rhythm changes.
Mind–body activities: Practices such as tai chi or guided breathing can calm both body and mind, improving heart rate variability.
Medical Treatments and Supplements
If lifestyle steps don’t help enough, doctors may suggest medical or supplemental support. Hormone replacement therapy (HRT) can help balance hormones and reduce hot flashes for some women.
It should only be prescribed after reviewing your risk factors³. Doctors may also recommend nonhormonal medicines such as beta-blockers or antidepressants for some cases.
SensIQ reminds users that supplements are not a replacement for prescribed care. They may be part of a wellness plan under a doctor’s supervision. Magnesium plays a role in keeping muscles and nerves healthy*.
Research suggests that it may help support normal heart rhythm and muscle function, though use should always be discussed with your healthcare provider⁴.
Dr. Luke Barr emphasizes that combining lifestyle habits with medical advice is the safest way to manage palpitations. SensIQ’s clinician-guided protocols provide nonhormonal options that support calm, focus, and overall cardiovascular wellness. Results vary depending on each person’s health and habits.
When to Seek Medical Advice
Most palpitations during perimenopause are harmless, but some need medical attention. Talk to your doctor if palpitations come with chest pain, ongoing shortness of breath, fainting, or a family history of cardiovascular disease. Simple tests like an electrocardiogram can help doctors find the cause.
Women with thyroid problems, diabetes, or high blood pressure should tell their doctors about palpitations early, since these conditions can increase their risk of heart issues. As Dr. Luke Barr explains, getting checked helps prevent worry and ensures safe, effective care.
Long-Term Heart Health After Perimenopause
After menopause, estrogen stays lower, which may slightly raise the risk of cardiovascular disease⁵. Keeping your heart health strong means staying active, eating well, and maintaining a healthy weight. Routine checkups for cholesterol and blood pressure are key to early prevention.
Good sleep, less stress, and regular exercise can greatly improve your quality of life. Talk to your doctor about other symptoms of menopause, such as vaginal dryness or mood changes, so that you can feel your best overall.
With guidance from Dr. Luke Barr and SensIQ’s medical team, women can go through perimenopause feeling informed and supported. Results may vary.
References
- Allerhand, R. (2025, February 28). Heart palpitations in perimenopause: When to get help. Flo Health. https://flo.health/menstrual-cycle/menopause/symptoms/heart-palpitations-perimenopause
- Let’s Talk Menopause. (2022, April 11). Heart palpitations. https://www.letstalkmenopause.org/our-articles/heart-palpitations
- Carpenter, J. S., Sheng, Y., Pike, C., Tisdale, J. E., Jaynes, H. A., & Elomba, C. (2022). Correlates of palpitations during menopause: A scoping review. Women’s Health, 18, 17455057221112267. https://doi.org/10.1177/17455057221112267
- Shufelt, Chrisandra L. MD, MS, FACP, NCMP; Brown, Vivien MDCM, CCFP, FCFP, NCMP; Carpenter, Janet S. PhD, RN, FAAN; Chism, Lisa Astalos DNP, APRN, NCMP, FAANP; Faubion, Stephanie S. MD, MBA, FACP, NCMP, IF; Joffe, Hadine MD, MSc; Kling, Juliana M. MD, MPH, NCMP, FACP, IF; Soares, Claudio N. MD, PhD, FRCPC, MBA; Thurston, Rebecca C. PhD, FABMR. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause 30(6): 573-590, June 2023. https://doi.org/10.1097/GME.0000000000002200
- Thurston, R. C., & Joffe, H. (2011). Vasomotor symptoms and menopause: Findings from the Study of Women’s Health Across the Nation (SWAN). Obstetrics and Gynecology Clinics of North America, 38(3), 489–501. https://pmc.ncbi.nlm.nih.gov/articles/PMC3185243/
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.