Heart palpitations during menopause: What this stage of life can mean for your heart health

When you’re going through menopause, you may experience a whole range of changes in your body. While the conversation about menopause often focuses on symptoms like hot flashes or irregular periods, understanding what menopause means for your heart health is just as important.  

From menopause-related heart palpitations to your overall risk for heart disease, menopause is a period of transition for your heart, too. That’s why it’s a good time to check in on your heart and take steps to keep it going strong during this next phase of life.  

What is menopause and how does it affect your heart health?

Menopause occurs when you go 12 consecutive months without a period, typically between 45 and 55 years old. As you reach menopause, the level of your heart-protective hormone—estrogen—starts to decline. And that means the protective benefits for your heart also start to go away.

Estrogen helps protect the heart by controlling cholesterol levels and reducing the risk of plaque building up in arteries. When this hormone declines during perimenopause, the risk of heart disease for women starts to increase. After menopause, the risk of heart disease for women becomes equal to that of men.

Heart palpitations during menopause

Along with symptoms of menopause like hot flashes and night sweats, as many as 54% of women report heart palpitations during menopause. These irregular heartbeats may feel like a fluttering, skipping, pounding or racing heartbeat, and most are harmless. But you should still talk to your doctor to understand the cause.

Causes of heart palpitations during menopause

Fluctuating hormone levels are one of the most common causes of heart palpitations during menopause. For some women, big surges of hormones during pregnancy, close to their period or during menopause make them more likely to experience palpitations. It’s also common for women to feel a sense of palpitations or their heart racing at the same time as a hot flash.

The term heart palpitations is used to describe a range of heartbeats, so you should talk with your doctor if you have this symptom. Most menopause-related palpitations don’t need treatment. But some can be caused by an underlying arrhythmia. If that’s the case, you have several options for arrhythmia treatment.

Reducing the risk of heart disease

Because of the increased risk of heart disease, perimenopause through menopause is a great time to put more focus on your heart health. Once you reach menopause, your risk of a heart attack is the same as a man’s—or sometimes even greater, depending on additional risk factors. Catching heart disease early and being persistent about prevention can make a difference.

Some preventive steps you can take include:

• Regularly check your blood pressure: If you notice that the top number of your blood pressure is going up above 130, talk to your healthcare provider.
• Choose a heart-healthy diet: Try to incorporate heart-healthy choices in your diet. Diets like the DASH diet or Mediterranean diet are recommended.
• Prioritize exercise: Find a form of physical activity that works for you. The American Heart Association recommends 150 minutes of moderate-intensity activity or 75 minutes of high-intensity workouts every week.
• Check your lipid levels: Schedule your annual checkup and check on your HDL and LDL cholesterol levels. Because of estrogen decline, it’s common for LDL to start to creep up after menopause.
• Talk to your doctor about your risk factors: From high cholesterol to obesity to family history, your doctor can guide your next steps, including options like calcium score screening.
• Stop smoking: If you currently smoke, talk to your doctor about support to quit. Smoking during menopause is linked with coronary artery disease.
• Limit alcohol: Limit alcohol to no more than one drink a day.
• Ask your doctor about supplements: There are many supplements out there for perimenopause and menopause, but they aren’t regulated by the FDA. Always check with your physician, as some supplements can increase the risk of heart palpitations or other conditions.
• Know the signs of a heart attack in women: Heart attacks in women don’t always cause that crushing, elephant-sitting-on-your-chest feeling. Pay attention to other signs like shortness of breath, upset stomach, back, arm or shoulder pain, or unusual weakness.

Hormone replacement therapy (HRT) and heart health

For many women experiencing menopause-related symptoms, hormone replacement therapy (HRT) is a good option for relief. However, numerous studies show that HRT is not recommended during menopause for heart protection only. The hormones in HRT don’t have the same protective effect as your natural hormones.

If you aren’t having bothersome menopause symptoms, HRT isn’t needed for heart protection. In fact, it may increase your risk of some conditions like deep vein thrombosis (DVT)—a blood clot deep in the veins—or pulmonary embolism—a blood clot in the lungs.

If you are having symptoms that affect your quality of life, the benefits of HRT often outweigh the risks. But choose the lowest possible dose for the shortest possible time. Your doctor can work with you to find the right balance for your symptoms and risk factors.  

Be proactive to protect your heart

When it comes to menopause and your heart, paying attention to your specific risk factors and talking to your doctor can help you stay in control. A proactive approach to caring for your heart is especially important if you have obesity, high cholesterol, diabetes or a strong family history of heart disease.

No matter your risk factors, if you’re in perimenopause or menopause, now is the time to prioritize yourself. Even the smallest changes to improve your risk factors can have a great impact on your heart health later in life. Start now and protect your heart for years to come.

Questions about your heart health? Schedule an appointment with a cardiologist near you.