Heart palpitations in menopause: what's going on
Your heart suddenly feels like it is pounding, racing, fluttering or skipping a beat, sometimes in your chest, sometimes up in your throat or neck. These are heart palpitations. They can last a few seconds or longer, and they are unsettling, especially when they arrive at rest or in the middle of the night. They are #19 in our guide, The 42 Symptoms of Menopause.
Palpitations are common during the menopause transition and are usually harmless. Still, they should never simply be assumed to be "just hormones," so we also cover when to get them checked.
Why can this happen around menopause?
During perimenopause, estrogen and progesterone rise and fall unpredictably, and the heart's electrical system is sensitive to those shifts. Hot flashes and night sweats can also bring a pounding or racing heartbeat with them, and so can the poor sleep and stress that often come with this stage. Palpitations are not always caused by hormones, though: lack of sleep, stress, dehydration, caffeine, certain medicines and thyroid problems can all play a part.
Common triggers to notice
Things many people find can set palpitations off. Worth watching for in your own life:
- Caffeine (coffee, tea, energy drinks), alcohol and nicotine
- Lack of sleep or a stretch of poor nights
- Stress, anxiety or a sudden fright
- A hot flash or night sweat
- Strenuous exercise or being dehydrated
- Some medicines (check the leaflet or ask your pharmacist)
Gentle things to try
These are comfort ideas, not a treatment. They are meant for palpitations that you have already mentioned to your doctor or that are brief and familiar, not new or alarming ones.
- Pause and breathe slowly. Sit down, let your shoulders drop, and breathe in through your nose, then out slowly through your mouth. Our breathing exercise can guide you, and a few minutes of Calm can help settle a busy mind.
- Keep a palpitation diary. Note the time, what you were doing, what you recently ate or drank, how you slept and whether you had a hot flash. Doctors often ask for exactly this. You can log it in the GoBloomWell symptom tracker, and a sample doctor-visit report shows how your notes can look at your appointment.
- Ease off the usual suspects. Try cutting back on caffeine and alcohol, especially in the afternoon and evening, and avoid nicotine.
- Protect your sleep. A regular bedtime, a cool dark room and a calming wind-down make a real difference. See our menopause and sleep guide.
- Sip water through the day and avoid big, heavy meals right before bed.
- Move gently and regularly. Walking and other easy movement from the Move section can ease stress and help you sleep. If exercise itself brings on palpitations, tell your doctor.
- Manage hot flashes by dressing in layers and keeping your space cool, since flashes can bring a racing heart with them. See natural remedies for hot flashes.
When to see a doctor
Please get palpitations checked if they keep coming back, are happening more often, last longer than a few minutes, or if you have a heart condition or a family history of heart problems. Ask for an evaluation, which may include a simple heart tracing (ECG) and blood tests such as a thyroid check. Call emergency services or go to the emergency room right away if palpitations don't go away or come with chest or back pain, shortness of breath, or feeling faint or fainting. Palpitations with nausea or vomiting also need prompt care.
You're not alone
A racing heart can be frightening, and it is easy to worry in the moment. Most palpitations in menopause turn out to be harmless, and a check-up gives you peace of mind and a clear plan.
GoBloomWell helps you see how palpitations line up with your sleep, stress, caffeine and cycle, so you can take clear notes to your appointment.
This article is general information, not a diagnosis or medical advice. It does not replace care from your doctor.
Sources: NHS, "Heart palpitations" (nhs.uk/symptoms/heart-palpitations/), reviewed March 2026 · Let's Talk Menopause, "Heart Palpitations," interview with Dr. Chrisandra Shufelt, MD, NCMP (letstalkmenopause.org/our-articles/heart-palpitations) · NHS, "Symptoms of menopause and perimenopause" (nhs.uk/conditions/menopause-and-perimenopause/symptoms/).