Out of all the symptoms of menopause, heart palpitations or an elevated heart rate can feel frightening. Sometimes these symptoms are associated with hot flushes, although they can happen at other times too.

Read on to find out more about causes, treatments and when you should think about seeing a doctor.

Palpitations definition

We are not usually aware of our heart beating. However, in certain circumstances, we may begin to feel it. Menopause heart palpitations can feel like your is heart pounding or beating faster than usual.

Palpitations can happen for a range of reasons and are often harmless. However, you may need to see your doctor to rule out any serious causes.

How likely are menopause palpitations?

• These symptoms are common
• One study found that between 20-40% experience menopause palpitations

Read more about the stages of menopause.

How to keep your heart healthy

1. Stop smoking
2. Reduce alcohol
3. Exercise regularly and get your BMI under 25
4. Healthy diet – low in saturated fat and sugar, high in fibre, fruit and vegetables

Find out more about weight gain and anxiety in our symptoms library

How can you reduce menopause palpitations?

1. Aim for 75 minutes of intensive or 150 minutes of moderate exercise each week. You may want to avoid intensive exercise if this worsens symptoms – always check with your doctor before beginning a new exercise regime

2. Get enough sleep – set regular bed and wake times

3. Avoid stimulants, such as nicotine, caffeine, spicy food and alcohol

4. Manage your stress levels – try mindfulness or yoga

5. It may seem obvious, but avoid illegal drugs (including cocaine, amphetamine, heroin, cannabis and ecstasy)

6. See your doctor if your palpitations do not settle – they may advise further tests including a blood pressure check or blood tests for cholesterol and blood sugar.

Would hormone replacement therapy (HRT) help?

Some find that HRT helps to reduce their palpitations. HRT is also useful in treating menopausal symptoms including hot flushes, mood changes and sleep disturbance, among others.

However, HRT is not suitable for everyone. If you would like to find out more about your personal treatment options, speak to your doctor.

Read more about HRT risks and benefits.

Palpitations and menopause

What do heart palpitations feel like?

• Thumping
• Fluttering
• Pounding sensation in the chest
• ‘Missed’ beats
• Increased heart rate

Potential causes of heart palpitations

The ‘female’ hormone oestrogen has many different effects on the body, some of which can be beneficial for the heart and circulatory system.

These include protecting against coronary artery disease and helping to control cholesterol levels.

During menopause, the ovaries begin to produce less oestrogen. It is thought that this reduced level of oestrogen can lead to palpitations, although the exact mechanism is still unclear.

Palpitations or an increased heart rate can also be caused by a number of reasons or different conditions, such as:

• Vigorous exercise
• Feeling stressed
• Stimulants, such as caffeine or nicotine
• Being dehydrated
• Low blood sugar
• Low blood pressure
• Illness, such as a fever
• Some medicines

It can also be caused by heart disease and thyroid problems.

These become more common at menopause as we lose the protective effect of oestrogen.

When should you see a doctor?

Palpitations are usually harmless, but can be dangerous in some circumstances.

You should seek urgent help if you are having palpitations with:

• A shortness of breath
• Tightness or pain in your chest
• Dizziness
• Fainting
• Feeling lightheaded or passing out
• You have a history of heart problems or are worried.

Palpitations which last for more than a few minutes, which start while you are exercising or which are associated with a fast heart rate (over 100) should also be checked out urgently.

Also see your GP if:

• Your palpitations are recurrent or last a long time
• You have a history of heart problems, thyroid problems, anaemia or any other medical condition which you think may be related
• Your palpitations become disruptive or upsetting
• You are concerned for any other reason

I’ve been really focusing on my exercise and it’s helped keep my weight under control.”

Emily

Learn more – the latest palpitations and menopause research

• British Heart Foundation, Menopause and heart disease
• Bruce D and Rymer J, Symptoms of the menopause, Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 23, Issue 1, 2009, Pages 25-32,
• Carpenter JS, Sheng Y, Elomba CD et al, A Systematic Review of Palpitations Prevalence by Menopausal Status. Curr Obstet Gynecol Rep 10, 7–13 (2021)
• Newson L, Menopause and your heart, British Heart Foundation
• NHS 2018, Cardiovascular disease
• NHS, 2019, Heart palpitations and ectopic beats
• Tidy C, 2017, Palpitations, Patient 
• Watson S, Menopause and Heart Palpitations, Healthline