Palpitations belong to menopause for many women. They often come together with hot flushes and last a few seconds to minutes. In around 1 in 3 women they play a part around perimenopause (Santoro, 2016). Usually they are harmless, but they can also fit other causes.
I notice that palpitations often frighten women more than hot flushes. Your heart suddenly beats faster or skips a beat, and that feels unsettling. Below you read why this can happen in menopause and when a check makes sense.
Why do you get palpitations in menopause?
In menopause your oestrogen starts to fluctuate and eventually falls. Oestrogen influences your blood vessels and your autonomic nervous system, which among other things regulates your heart rate. Those fluctuations can make your heart beat faster or more irregularly for a while.
Palpitations often come together with a hot flush. During a hot flush your blood vessels widen and your heart rate briefly speeds up with them. That explains why many women notice the two at the same time.
Other things can make it worse:
- Caffeine, alcohol or a heavy meal
- Stress, tension or a restless night
- Little sleep, which is more common in menopause
- A quick drop in your blood sugar
Palpitations or your thyroid after all?
A fast or irregular heartbeat can also fit an overactive thyroid. The complaints look like those of menopause: palpitations, sweating, restlessness and weight loss. That is why it is sometimes hard to tell the two apart.
A thyroid that works too fast speeds up your metabolism. Your heart then beats faster, even at rest. This is one of the reasons the thyroid is often included when palpitations persist.
Wondering if your complaints belong to your thyroid? Then also read our article on the thyroid and fatigue, where the same overlap plays out.
Or is it stress and exhaustion?
Palpitations can also belong to long-term stress or exhaustion. A high stress level keeps your body in an alert state, with a faster heartbeat as a result. In menopause, menopausal complaints and stress complaints often run together.
That does not always make the difference between menopause and overload easy to see.
Do you also recognise exhaustion, irritability and poor sleep alongside palpitations? Then read our article on menopause or burnout and how to tell the difference.
When do you see your GP?
Most palpitations in menopause are harmless, but some complaints do belong with the GP straight away. Do not wait if your heart feels different from what you are used to, especially combined with other complaints.
Contact your GP with:
- Palpitations with pain or pressure on the chest
- Shortness of breath, dizziness or fainting
- Palpitations that last long or keep returning
- An irregular heartbeat you do not recognise
When in doubt: rather have it checked once too often. This article does not replace an assessment by a doctor.
Which values give insight?
No single blood value explains palpitations on its own, but a few values help to place the cause. With menopausal complaints you mainly look at your thyroid and your oestrogen. The table below lays it out.
| What you notice | Value that gives insight | What it shows |
|---|---|---|
| Palpitations, restlessness, sweating | TSH | Whether your thyroid may be working too fast |
| Hot flushes, irregular cycle | Estradiol (E2) | Whether you are in menopause and how your oestrogen stands |
The Menopause Check brings these values into view in one draw. So you can see whether your complaints fit menopause or whether something else plays a part.
Want the whole picture of menopause first? Then read our pillar on perimenopause, symptoms and solutions. You always discuss a result with your GP.
What can you do yourself?
For harmless palpitations in menopause you can often do something yourself. It comes down to limiting triggers and giving your body rest. What helps differs per person, so calmly try out what works for you.
What helps many women:
- Less caffeine and alcohol, especially in the evening
- Attention to regularity in your sleep
- Breathing or relaxation exercises during an episode
- Regular exercise, at a pace that suits you
If the complaints persist or increase, do not keep living with them. Discuss with your GP what is sensible in your situation.
Frequently asked questions
Are palpitations in menopause dangerous?
Usually not. In many women they belong to the hormonal fluctuations and are harmless. If they come together with chest pain, shortness of breath or fainting, contact your GP straight away.
How long do palpitations in menopause last?
That differs greatly. In some women they play a part mainly around perimenopause and ease off afterwards. In others they stay present longer. There is no fixed timeline.
Can I test myself whether it is my thyroid?
A TSH blood test gives a first impression of whether your thyroid may be working too fast. An abnormal result is not a diagnosis; you discuss it with your GP, who arranges further testing if needed.
References
- Santoro N. Perimenopause: From Research to Practice. J Womens Health (Larchmt). 2016;25(4):332-339.
- Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550-1562. PMID: 28336049.
- NHG-Standaard De overgang (Menopause). Dutch College of General Practitioners.
- Thuisarts.nl. I am going through menopause. Available via thuisarts.nl.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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