Racing heart? It could be a menopausal symptom

What people often describe as a racing heart is known in medical terms as heart palpitations. It can feel like your heart is beating too fast, fluttering rapidly, or even skipping beats. Some people liken it to a “flip-flopping” sensation that can be felt in the chest, neck, or throat. 

Heart palpitations can be triggered by stress, panic attacks, acid reflux, dehydration, strenuous exercise, stimulants (such as caffeine, nicotine, or certain cold medications), thyroid imbalances, and in rare cases, serious heart conditions. But they can also be caused by hormonal changes before and after menopause. They are the most common during peri-menopause.

The symptoms during these two phases may be slightly different.


During the time period leading up to menopause, or the end of your monthly period, the drop in estrogen production is associated with an increased heart rate as well as an increased frequency of palpitations and non-threatening arrhythmias (irregular heartbeats).


As your menstrual cycle stops, there’s a further decline in estrogen. This can correlate to symptoms such as arrhythmias, palpitations, and brief bursts of chest pain.

What’s normal versus not normal

Heart palpitations can be quite unsettling. After all, your heart is suddenly pounding, seemingly out of nowhere. But if they’re infrequent and only last for a few seconds, palpitations are usually harmless and don’t generally require evaluation or treatment. 

If you have a history of heart disease or your palpitations are frequent or seem to be worsening, however, talk to your healthcare provider. Heart-monitoring tests such as an electrocardiogram (ECG/EKG) or Holter monitor may be recommended to rule out underlying heart conditions. 

Note: You should seek emergency medical attention if your heart palpitations are accompanied by chest pain or discomfort, fainting, severe shortness of breath, or severe dizziness. 

A potential treatment option

Hormone replacement therapy (HRT) may decrease palpitations and other menopausal symptoms, such as hot flashes, insomnia, and sweating.  There are some risks and contraindications for HRT, however, so talk to your provider about whether it’s a fit for you.  

Reviewed by the Ovia Health Clinical Team

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