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Heart palpitations in perimenopause: when hormones race your heart

Your heart races while you're sitting still. It flutters, thumps, skips. You've googled it a hundred times at 2am. Palpitations are one of the most frightening — and most common — perimenopause symptoms nobody warned you about.

Why hormones affect your heartbeat

Oestrogen influences the electrical signalling of your heart and your autonomic stress response. As levels fluctuate, many women experience flutters, pounding, or racing at rest — often alongside hot flushes or night waking, and often clustering at particular cycle points.

Important: always get new heart symptoms checked

This article explains a common hormonal cause, but new palpitations always deserve a medical check to rule out cardiac causes — especially with chest pain, breathlessness, or fainting, which need urgent care. For many women in their 40s the workup comes back clear, and the hormonal explanation finally makes sense of the pattern.

What helps

Track when palpitations happen — time, triggers (caffeine, alcohol, stress, poor sleep), cycle day. The pattern is powerful both for your own reassurance and for your doctor. Reduce stimulants during flare weeks, and practice slow exhale breathing, which activates the calming branch of your nervous system.

Common questions

Can perimenopause cause heart palpitations?

Yes — fluctuating oestrogen affects heart rhythm signalling and the stress response, making palpitations a recognised symptom.

When are palpitations serious?

Seek urgent care with chest pain, severe breathlessness or fainting; otherwise book a routine check for any new palpitations and bring tracked data.

Do they stop?

For many women hormone-related palpitations ease as levels stabilise after menopause.

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Educational information only — not medical advice. Always consult a healthcare professional about your symptoms.