Irregular Heartbeat During Menopause: Understanding Causes & Finding Relief

During menopause, the body undergoes significant changes, including fluctuations in hormone levels that can lead to various symptoms, like irregular heartbeats. Research shows that up to 54% of women going through menopause report feeling heart palpitations. A study of over 83,000 women aged 50–79 found that 25% developed atrial fibrillation, a type of irregular heartbeat that can raise the possibility of stroke and heart failure.⁽¹⁾⁽²⁾

Certain factors can make heart irregularities more likely during menopause. For example, the possibility of developing atrial fibrillation increases by 4% with each point on the insomnia scale and by 2% with each additional stressful life event. In contrast, women under 65 without a history of depression are less likely to develop heart-related issues in menopause. While often uncomfortable, irregular heartbeat can be managed effectively. Understanding this issue and taking steps to manage it can help women navigate this phase of life more comfortably.⁽²⁾⁽³⁾

Palpitation vs Arrhythmia

When it comes to irregular heartbeat, it’s important to know that palpitations and arrhythmia are frequently mentioned together, but they describe different issues. 

Arrhythmia refers to irregular heartbeats, which can vary from harmless to serious, including conditions like atrial fibrillation, where the heart beats irregularly and rapidly. It is possible to have an arrhythmia and not notice or feel it. In contrast, palpitations are the sensation of the heart beating rapidly or strongly and can last from just a few beats to more prolonged periods. Palpitations are not always caused by arrhythmia and are often benign. 

During perimenopause and menopause, hormone changes can disrupt the heart's rhythm. This disruption can sometimes lead to either palpitations or arrhythmias — or, at times, both.

Why do irregular heartbeats happen during perimenopause and menopause?

Irregular heartbeats during perimenopause and menopause are mostly linked to fluctuating hormone levels, particularly declining estrogen. Estrogen plays a key role in maintaining cardiovascular health, including the regulation of heart rhythm. As estrogen levels decrease during perimenopause and menopause, the balance in the cycle of the heartbeat can be disrupted, which may lead to feelings of skipped beats or a racing heart.

Research indicates that the decrease in estrogen levels contributes to changes in the electrical system of the heart, which can result in arrhythmias or palpitations. Palpitations are generally harmless but can be distressing and may affect quality of life. Hormonal shifts during menopause also have indirect effects, like increased anxiety or stress, which can further contribute to heart rhythm disturbances and the feeling of an irregular heartbeat.⁽⁴⁾⁽⁵⁾

Symptoms of Irregular Heartbeat During Menopause

Knowing the symptoms of an irregular heartbeat is essential for managing the condition well. Women experiencing perimenopause or menopause may notice the following symptoms:

• Skipped Heartbeats (Missed Beats): A sensation that the heart has skipped a beat, often followed by a stronger-than-usual beat

• Extra Heartbeats (Fluttering): A feeling of fluttering in the chest, often described as a rapid or irregular pulse

• Racing Heart (Tachycardia): A sudden increase in heart rate, which can be accompanied by feelings of anxiety or discomfort

• Pounding in the Chest: A strong, noticeable heartbeat that may be regular or irregular and can be felt in the chest, neck, or throat

• Feeling of the Heart Flip-Flopping: A sensation like a sudden flop or thump, which can be unsettling and disruptive

These symptoms can vary in intensity and frequency. And while palpitations are often harmless, persistent or severe symptoms may sometimes require medical attention.^(6)(7)(8)

When to See a Doctor About Palpitations 

It's good to know that while irregular heartbeats can be common during perimenopause and/or menopause, they are not always a cause for concern. With that in mind, there are certain situations where medical consultation is a wise choice:

• Palpitations are accompanied by chest pain, shortness of breath, dizziness, or lightheadedness: These symptoms may indicate a more serious condition, so it’s advisable to have them evaluated by a healthcare professional.

• Palpitations last for a long time or occur frequently: If irregular heartbeats persist or become more frequent, it’s important to seek medical advice to rule out any new or underlying heart conditions.

• Heart palpitations develop suddenly, especially in women that have a history of heart problems: Those with a history of heart disease or other cardiovascular conditions should consult their doctor if they experience new or worsening symptoms.

By seeking prompt medical attention, women experiencing palpitations can determine the cause of these symptoms and receive guidance on appropriate treatment options.⁽⁸⁾

Calming Strategies for Menopause-Linked Palpitations

Managing irregular heartbeats during menopause typically requires a blend of lifestyle modifications, stress management, and, in some cases, medical treatments. Several strategies are recognized for their potential to alleviate symptoms and enhance heart health:

• Managing Stress: Stress is commonly associated with irregular heartbeats. Incorporating relaxation techniques like yoga, deep breathing exercises, or mindfulness meditation may help reduce stress and promote a more stable heart rhythm.⁽⁹⁾

• Prioritizing a Healthy Lifestyle: A balanced diet, regular exercise, and sufficient sleep are crucial for maintaining overall heart health. Moderate aerobic exercise has been shown to offer considerable cardiovascular benefits during menopause, though it is advisable to avoid overexertion, as intense exercise may sometimes trigger palpitations.⁽¹⁰⁾
  

• Identifying and Avoiding Triggers: Certain foods, caffeine, alcohol, tobacco products, and other substances are known to heighten symptoms. Maintaining a symptom diary to identify potential triggers can be beneficial in adjusting diet or lifestyle to reduce the frequency of irregular heartbeats. ⁽¹¹⁾

• Exploring Natural Remedies: Some individuals report finding relief through natural remedies, like magnesium supplements. However, it’s strongly recommended to consult a healthcare provider before starting any new treatments, as responses can vary from person to person, and some remedies may interact with other medications or supplements.⁽¹²⁾

• Considering Hormone Replacement Therapy (HRT): For some women, HRT can effectively regulate hormone levels and potentially improve irregular heartbeats. Because HRT involves the use of estrogen to supplement declining hormone levels, it may help prevent the estrogen withdrawal that triggers palpitation symptoms. A 2022 study highlighted that menopausal hormone therapy is currently the only available treatment that may be effective in calming heart palpitations.⁽¹²⁾

Living with Irregular Heartbeats During Menopause

Living with irregular heartbeats during menopause can be uncomfortable, but with the right approach, it's possible to manage symptoms and maintain a good quality of life. Understanding the hormonal changes that contribute to these heart rhythm disturbances is the first step. Implementing calming strategies, maintaining a healthy lifestyle, and seeking medical advice when necessary are all important components of managing this condition.

Although more research is needed to fully understand the mechanisms behind heart palpitations during menopause, existing evidence supports various approaches to symptom management. For example, HRT and cognitive behavioral therapy (CBT) have been shown to effectively reduce the frequency and severity of heart palpitations and irregular heartbeat, as well as alleviate other menopausal symptoms like hot flashes and night sweats.^(12)(13)

By staying informed and proactive, women can navigate this phase with greater confidence and ease. If there are concerns about heart health or if symptoms persist, consulting with a healthcare provider is always recommended to ensure that any conditions are identified and looked after.

Experiencing irregular heartbeat during menopause — is HRT right for you?

Navigating the challenges of irregular heartbeats during menopause can be a bit overwhelming. That's why it’s important to know that support is available. Exploring whether HRT is a suitable option could provide much-needed relief. Take the Winona menopause quiz to see if you’re an eligible candidate for HRT and take the first step toward feeling better.