Heart palpitations are very common during perimenopause and are usually a bit startling the first couple of times they occur. Your heart may feel like it is racing, slowing, irregular, or just “thrashing around in there.” It may accompany or precede a hot flash, and is probably responding to the same hormone fluctuations that make the rest of your vascular system a little unstable during this time. Because cardiac problems sometimes start in midlife, you will want to check with your health care provider if you have palpitations frequently or if they are painful or dramatic.
It's Not Love, It's the Coffee
Remember when a rapidly beating heart meant you were excited to see a new love? Menopausal palpitations can feel like that, but the most likely cause is either anxiety or stimulants. It's hard to say whether women feel anxious because their hearts are beating fast, or their hearts beat fast because they are anxious. If you find yourself feeling anxious or having panic episodes, talk to your health care provider or mental health counselor. There are relaxation exercises, biofeedback techniques, and medications that can help you through anxious moments or events.
And if you are a habitual stimulant user you may notice that heart palpitations may occur when you use alcohol, caffeine, diet pills, or decongestants. Even if you are used to these substances, they may set off an episode of palpitating because you're more sensitive to small changes, just as spicy food can trigger a hot flash.
Other medical conditions may have palpitations as a symptom, which is why it's a good idea to check out any changes in your heartbeat. If you are anemic, dehydrated, or have high blood sugar or an overactive thyroid, you may notice heart palpitations. Any of these conditions should be evaluated to be sure they are not serious health problems.
Is It a Heart Attack?
That, of course, is the fear when your heart starts acting erratically. Although cardiac disease is rarely the cause of heart palpitations in perimenopause, it is possible that you are experiencing cardiac symptoms. Heart attack symptoms are different for women than for men, and it is important not to dismiss ongoing heart irregularities without having them evaluated.
Like other transient symptoms of the perimenopause, palpitations usually go away on their own after a few months. If you find that exercise or certain situations trigger them, learn to stop what you are doing and breathe in a slow, regular way until your heartbeat returns to normal. This, too, shall pass.
Although heart palpitations are common during perimenopause and are almost always benign, they can also signal more serious problems. If you have dizziness, fainting, tightness in the neck or chest, abdominal pain, or nausea with the palpitations, or if your heart rate is over 120 beats a minute, go to the emergency room or urgent care to be checked.