26 Sep 2023

What you need to know about menopause and heart palpitations

Menopause marks the end of personal care products, premenstrual syndrome (PMS) and often painful side effects. It should call for a celebration — but you're not entirely free from these troubles as they transform into different versions during menopause. 

Instead of PMS, you may experience mood swings, increased stress and heart palpitations. 

Let’s find out how this last symptom can affect you during midlife.

Heart palpitations during menopause

Menopause carries a wave of various symptoms, ranging from hot flushes to night sweats and sleep problems. 

One that's not widely talked about is heart palpitations. It catches people off guard and may be immediately associated with heart disease, causing a higher degree of anxiety.

It's normal and common to experience heart palpitations during menopause because of various biological factors, such as fluctuating hormonal levels. However, only some people go through it.

In a study, around 54% of postmenopausal and 42% of perimenopausal women reported increasing heart rates. (1) 

Up to 87% believed their palpitations required treatment. However, a review found no solid evidence about needing serious treatment, implying this specific symptom isn't well studied.

RELATED: Heart health & menopause: hot flushes are more than an inconvenience says leading Yale professor

What do menopause heart palpitations feel like?

Palpitations occur at any time of the day, whether you're at rest or doing something. They're marked by sudden irregular heartbeats or arrhythmias.

When palpitations manifest, you sense your heart flutters, pounds or races more noticeably.

These heartbeat abnormalities can last from seconds to minutes. It can feel like your heart is beating too fast, it's skipped a beat, or it's flip-flopping.

The sensations can reach your chest, throat and neck. They're worrisome but rarely associated with a medical condition unless co-occurring with chest pain, breathing problems and fainting.

menopause and heart palpitations

What contributes to heart palpitations?

Heart palpitations can happen to many women due to hormonal imbalances, mood changes and stress. Since the body is a network of different systems working together as one, deviations from normal functions can affect the others.

Fluctuating oestrogen

The endocrine system consists of various glands producing and secreting hormones in the bloodstream. It works collaboratively with the cardiovascular system to maintain and coordinate multiple bodily processes.

Changes in hormone levels during pregnancy, menstrual period and menopause can induce cardiac function abnormalities, including arrhythmia.

Mood swings and stress

Hormones affect stress levels and mood swings. Many of us can often feel especially emotional when pregnant and more agitated during menstruation. 

Similarly, declining oestrogen levels can bring about mood swings and higher stress that intersect with heart palpitations. They may combine with irritability, brain fog and loss of self-esteem.

Sugar, carb and salt cravings

Consuming foods high in sugar, salt, and carbs can catalyse irregular heartbeats, which can be serious for individuals with obesity, high blood pressure and high sugar levels. If you're healthy, the common cause of arrhythmia is the ingredients or the process of chewing, swallowing and digestion.

Medications

Several prescriptions and over-the-counter medications produce palpitations as side effects. Some examples are antibiotics, cough and cold medicine, and high blood pressure medications. If you take maintenance medications during menopause, the risk of getting rapid heartbeats is more likely.

Magnesium deficiency

Magnesium is a body mineral with a significant role in regulating heart rate. It helps stabilise blood sugar levels, make protein, strengthen bones and keep the nerves and muscles healthy.

Menopausal women should get at least 320 milligrams (2) of magnesium from their diet or supplements. A blood or urine test will determine if you are deficient. Changing your diet is the preferred treatment for the lack of magnesium, but talk to your doctor about supplementation as an alternative method.

Too much caffeine

Overconsumption of caffeinated drinks can inflict jitters, anxiety and palpitations. A study on postmenopausal women with overactive bladder found that ingesting 400 milligrams of caffeine (3) or up to five cups of coffee daily worsened headaches and nausea. In contrast, those who consumed only 200 milligrams per day or about two 8-ounce cups of brewed coffee reduced their anxiety levels.

Researchers concluded moderate caffeine consumption may have positive effects on postmenopausal women, but overindulgence may exacerbate symptoms.

Exercise

If you lead an intensely active lifestyle before menopause, arrhythmia can happen if you stop working out. Exercise naturally raises the heart rate. When you're out of condition or haven't trained in a while, your heart may go off its normal beat count.

Nicotine

Tobacco products contain thousands of chemicals that spike heart rate and blood pressure levels. Smoking in your 40s or 50s may cause early menopause and worsen hot flushes and night sweats.

Researchers don't understand why this happens. A couple of theories cite that smoking kills a woman's eggs, and the harmful chemicals affect how female hormones are made or removed from the body.

RELATED: Nutrition for heart health through menopause and beyond

menopause and heart palpitations

Managing heart palpitations during menopause

You can manage heart palpitations naturally and with the help of your doctor. As symptoms vary for each woman, you need to consult with your healthcare provider to create a suitable treatment plan.

1. Hormone Replacement Therapy

Since menopause and heart palpitations mainly stem from changing hormone levels, hormone replacement theory (HRT) may be able to downgrade the severity of the symptoms. However, there are some controversies surrounding this method (4), and HRT carries some risks.

For instance, taking HRT tablets can elevate the incidence of blood clots (5) and stroke, which are preventable by switching to patch or gel types. Consult your doctor or an HRT specialist for this treatment. They will know what HRT forms are the best for you. 

2. Lifestyle changes

Medical treatments are best paired with a healthy lifestyle to be more effective. According to the NHS, exercise, a healthy diet, and quality sleep may help minimise menopausal symptoms (6) and protect you against the long-term health effects of low oestrogen levels. 

  • Exercise: The NHS recommends at least 75 minutes of vigorous or 150 minutes of moderate-intensity training for menopausal women. Exercise can help preserve bone density and heart health and lower stress hormones.
  • Nutrition: Calcium, vitamin D, and magnesium are essential nutrients during midlife. The NHS suggests consuming low-fat dairy products, salmon, breakfast cereals, fortified bread and canned sardines and eating at least five portions of vegetables and fruits daily.
  • Sleep: Sleep problems are a prevalent menopause symptom, with up to 47% experiencing it (7) during perimenopause and 60% after menopause. 

A study on over 50,000 postmenopausal women discovered that those with higher glycemic index diets — high-sugar and high-carb diets — are at substantial risk of insomnia compared to those eating fruits and vegetables. 

Filling up on wholesome foods can curb sleep problems during midlife. Other ways include habit changes, such as establishing a pre-bedtime routine (8) and avoiding caffeine and alcohol.

  • Avoiding smoking, caffeine and alcohol: If your heart goes out of beat due to harmful habits, cutting down on smoking, excessive caffeine, and alcohol can help tone down the problem. Even if you exercise, eat healthy and get adequate sleep — but continue to smoke tobacco or drink alcohol — your symptoms won't get better. Doing the don'ts is as essential to good well-being as the dos.

3. Therapy

Cognitive behaviour therapy (CBT) is equally helpful to people with or without mental health concerns. Stress causes many physical and mental health issues. If you need guidance on how to regulate it and make it less impactful to health, therapy can teach you how to cope effectively with life's problems, including symptoms of menopause. 

  • Mindfulness: You can also practise yoga, tai chi or breathing techniques to manage your mental well-being. A study on 1,744 women ages 40 to 65 found that those with higher mindfulness scores (9) experience fewer menopausal symptoms and have lower incidences of irritability, depression and anxiety. 
  • Engage in mood-lifting activities: Another way to divert stress is by participating in activities that make you feel calm. It can be doing art, reading a good book and listening to music. Expressive art is a form of psychotherapy that supports various self-expression mediums in a supportive environment. It can help people work through complex emotions that contribute to stress and cope with mental health issues like depression and anxiety.
menopause and heart palpitations

When to be concerned about heart palpitations

Palpitations are often harmless, but an existing condition can increase your risk for medical attention. These can include a family history of cardiovascular ailments and accompanying symptoms like chest pain and shortness of breath.

When to call for emergency care

If you or a loved one has heart palpitations and experiences the following symptoms, call emergency services:

  • Difficulty breathing
  • Very rapid heartbeat
  • Jaw or chest pain
  • Losing consciousness
  • Dizziness

Know when heart palpitations are serious

Irregular heartbeat or arrhythmia during menopause have several potential causes. They can be due to the loss of oestrogen, higher stress levels, medications and unhealthy lifestyle choices. As it affects nearly half of women, you must know when they signal a serious condition that calls for immediate medical attention. When your heart beats rapidly, and you find it hard to breathe, ask a family member to call emergency services. 

If it’s entirely related to menopause, multiple strategies can help you tackle it. Your doctor may recommend various medical treatments to help. Eating healthy, good quality sleep, exercise, and learning stress regulation skills can also ease heart palpitations and other menopause symptoms.

RELATED: Top tips for a healthy heart


Mia Barnes is a freelance writer and researcher who specializes in women’s health and wellness. Mia is also the Editor-in-Chief of 
Body+Mind magazine and a staff writer for sites like the SMSNA and the MedShadow Foundation.

References

(1) NIH (2022). Correlates of palpitations during menopause: A scoping review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289918/

(2) Cleveland Clinic (2022). Why Magnesium May Help Your Heart Palpitations. https://health.clevelandclinic.org/magnesium-for-heart-palpitations/ 

(3) Journal of Women's Health (2022). The Impact of Caffeine Intake on Mental Health Symptoms in Postmenopausal Females with Overactive Bladder Symptoms: A Randomized, Double-Blind, Placebo-Controlled Trial. https://www.liebertpub.com/doi/10.1089/jwh.2021.0467 

(4) Cardiology in Review (2021). Controversies Regarding Postmenopausal Hormone Replacement Therapy for Primary Cardiovascular Disease Prevention in Women. https://journals.lww.com/cardiologyinreview/abstract/2021/11000/controversies_regarding_postmenopausal_hormone.6.aspx 

(5) Heart Matters (2022). Menopause and your heart. https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/menopause-and-your-heart 

(6) NHS (2021). Menopause: A healthy lifestyle guide. https://www.cuh.nhs.uk/patient-information/menopause-a-healthy-lifestyle-guide/ 

(7) Harvard Health Publishing (2020). Menopause and insomnia: Could a low-GI diet help? https://journals.lww.com/cardiologyinreview/abstract/2021/11000/controversies_regarding_postmenopausal_hormone.6.aspx 

(8) PAM Health. Heart. Health. Happiness. https://pamhealth.com/company/company-updates/heart-health-happiness 
(9) Mayo Clinic (2019). Mindfulness may ease menopausal symptoms. https://newsnetwork.mayoclinic.org/discussion/mindfulness-may-ease-menopausal-symptoms/

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