--- title: 'What Do Palpitations Mean In Perimenopause?' slug: palpitations-perimenopause-what-is-happening lifeStage: perimenopause category: Symptoms author: 'Samaira Farid' medicalReviewer: 'Dr Shree Datta, Consultant Obstetrician and Gynaecologist ' reviewerId: 'https://blog.bloume.com/perimenopause/medical-board.md#dr-shree-datta' lastUpdated: '2026-08-30' primarySource: 'Management of menopause for women with cardiovascular disease' wordCount: 874 readTimeInSeconds: 219 --- # What Do Palpitations Mean In Perimenopause? A fluttering, pounding, or racing heartbeat can catch you off guard. In perimenopause, this often comes down to your shifting oestrogen levels, and for most people palpitations are harmless and settle over time. Knowing what is driving them, what can help, and which symptoms need urgent attention gives you a clearer picture of what your body is doing and what to do next. **Q: Are palpitations in perimenopause dangerous?** A: Palpitations in perimenopause are usually harmless and tied to your shifting oestrogen levels. Most settle on their own or ease as your hormones steady. If yours come with chest pain, severe shortness of breath, dizziness, or fainting, call 999 or go to A&E straight away. If you feel worried, or palpitations last a long time or get worse, speak to your GP. A sudden flutter in your chest. A heartbeat that pounds or races for no clear reason. A feeling that your heart has skipped a beat. These are the sensations you might notice when palpitations first show up in perimenopause. They can feel alarming ,but palpitations are usually a harmless part of perimenopause and menopause, tied closely to the hormonal changes happening at this stage of life. ## Why palpitations show up in perimenopause A heart that beats faster, harder, or more irregularly than usual, even when you are resting, often traces back to your hormones. During perimenopause, oestrogen rises and falls unpredictably before settling lower. Oestrogen helps regulate how your heart and blood vessels work, so when its levels shift, the part of your nervous system that controls your heart rate can become unsettled. That is when your heartbeat can start to feel off. You may notice palpitations turning up alongside hot flushes and night sweats. Sometimes a flutter and a flush arrive together. Sometimes palpitations come more often when your sleep is broken. These symptoms cluster because they share the same hormonal swings, the kind that drive hot flushes and night sweats (often called vasomotor symptoms). ## When palpitations are hormonal and when to get checked Palpitations that are brief, occasional, and settle on their own are most likely down to the hormonal shifts of perimenopause. They do not usually point to a heart problem. It is still worth speaking to your GP if you feel worried, if palpitations last a long time, if they are coming more often or feeling more intense, or if you have a personal or family history of heart problems. Your GP can check your heart rhythm, rule out other causes like low iron or thyroid changes, and give you a clear picture of what is going on. > **WARNING**: Call 999 or go to A&E straight away if palpitations come with chest pain or tightness, severe shortness of breath, dizziness, or fainting. These need urgent medical attention. ## What helps with perimenopausal palpitations A few everyday changes can ease how often palpitations come and how strong they feel. They work best alongside any medical care, and they do not replace a conversation with your GP if you have concerns. - Easing stress with breathing exercises, gentle movement, or rest. - Cutting back on caffeine and alcohol, which can trigger palpitations. - Keeping your fluids up and eating regular meals to keep your blood sugar steady. - Moving gently and regularly, which supports your heart health over time. ## How HRT can help Hormone Replacement Therapy (HRT) can be an effective treatment for palpitations in perimenopause. By steadying your hormone levels, it can ease palpitations along with other symptoms. Whether HRT suits you depends on your health and medical history. That is a conversation to have with your GP or a specialist, who can weigh up the benefits and considerations with you. ## How this changes after menopause The palpitations here belong to perimenopause, the stretch of time when your hormones swing up and down. After menopause, when oestrogen settles at a steadily lower level, the pattern of heart-related symptoms can change. If you are further along in the transition, or past menopause, the things shaping your heart health will be different and are worth talking through separately with your GP. --- **Q: Are palpitations in perimenopause dangerous?** Palpitations in perimenopause are usually harmless and tied to your shifting oestrogen levels. Most settle on their own or ease as your hormones steady. If yours come with chest pain, severe shortness of breath, dizziness, or fainting, call 999 or go to A&E straight away. If you feel worried, or palpitations last a long time or get worse, speak to your GP. **Q: What does a perimenopausal palpitation feel like?** You may notice your heart pounding, fluttering, or racing, sometimes with a feeling that it has skipped a beat. These episodes are often brief and can happen while you are resting or during a hot flush. They can feel unsettling, and you may find they ease as your hormone levels steady over time. **Q: When should I see my GP about heart palpitations in perimenopause?** Book an appointment with your GP if you feel worried about palpitations, if they last a long time, if they are coming more often or feeling more severe, or if you have a personal or family history of heart problems. Your GP can check your heart rhythm and rule out other causes. Do not wait if you develop urgent symptoms like chest pain, severe breathlessness, dizziness, or fainting; call 999 or go to A&E straight away. **Q: Can lifestyle changes reduce palpitations in perimenopause?** Yes. Cutting back on caffeine and alcohol, keeping your fluids up, eating regular meals, easing stress, and moving gently can all help to bring palpitations down. These steps support your general heart health and may ease symptoms. They do not replace medical advice if you have concerns. **Q: Can HRT help with palpitations during perimenopause?** HRT can help by steadying your fluctuating hormone levels, which may ease palpitations and other perimenopausal symptoms. Whether it suits you depends on your health history. Speak to your GP or a specialist to talk through whether HRT is an appropriate option for you. ### Clinical Sources - [Management of menopause for women with cardiovascular disease](https://thebms.org.uk/wp-content/uploads/2026/06/22-NEW-BMS-TfC-Management-of-menopause-for-women-with-CVD-JUNE2026-A.pdf) - [Symptoms of menopause and perimenopause](https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/) - [Management of menopause for women with cardiovascular disease](https://thebms.org.uk/wp-content/uploads/2026/06/22-NEW-BMS-TfC-Management-of-menopause-for-women-with-CVD-JUNE2026-A.pdf) - [bhf.org.uk](https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/when-to-worry-about-heart-palpitations) - [uhsussex.nhs.uk](https://www.uhsussex.nhs.uk/resources/palpitations-emergency-department-leaflet/) - [Menopause and your heart and circulatory conditions](https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease) - [Management of menopause for women with cardiovascular disease](https://thebms.org.uk/wp-content/uploads/2026/06/22-NEW-BMS-TfC-Management-of-menopause-for-women-with-CVD-JUNE2026-A.pdf) --- Reviewed by Dr Shree Datta, Consultant Obstetrician and Gynaecologist | [Medical Board](https://blog.bloume.com/perimenopause/medical-board.md) | August 2026