What are palpitations, and what do they feel like?

Palpitations mean noticing your heartbeat more strongly than usual. The NHS describes several ways they can feel (NHS, Heart palpitations):

  • Your heart is beating very fast, as if racing
  • Irregular, as if a beat was skipped or an extra beat came in
  • Pounding, as if beating hard
  • A fluttering in your chest

You may feel this not only in your chest but also in your neck or throat. It can last a few seconds, a few minutes or longer (NHS, Heart palpitations).

Palpitations can be frightening. But most of the time they have a harmless cause. What matters is knowing when they can be expected and when you need help right away.

Can menopause cause palpitations?

The NHS lists heart palpitations among the symptoms of menopause and perimenopause. It also says hot flashes can lead to palpitations (NHS, Symptoms). The NHS palpitations page separately notes that menopause can sometimes trigger them (NHS, Heart palpitations).

According to The Menopause Society, sweating, chills, anxiety and a fast heartbeat can come with a hot flash (The Menopause Society, Hot Flashes). So some people have palpitations together with a wave of heat, and others have them on their own. We cover hot flashes in detail here: Hot flashes.

In Türkiye, the Ministry of Health’s Public Health Directorate (HSGM, Halk Sağlığı Genel Müdürlüğü) and the Turkish Society of Obstetrics and Gynecology (TJOD, Türk Jinekoloji ve Obstetrik Derneği) also list palpitations among menopause symptoms (HSGM; TJOD). The Ministry of Health also advises against using medicines for menopause complaints without consulting a doctor (HSGM). That advice applies to palpitations too.

How common are palpitations in menopause, and how long do they last?

One of the studies that gives detailed information on this is the SWAN study in the US. SWAN is a large observational study that followed women of different ethnic backgrounds for years through the menopause transition. The analysis on palpitations looked at the palpitations reported over time by 3,276 women. The researchers found three different patterns (Carpenter et al., 2023):

  • In 15.9 percent of women, the likelihood of palpitations was high from perimenopause into early postmenopause.
  • In 34.3 percent, this likelihood was moderate.
  • In 49.8 percent, the likelihood of palpitations stayed low throughout.

In the high and moderate groups, the likelihood of palpitations fell in the later postmenopause years. In other words, a large share of women had palpitations mainly in perimenopause and just after menopause (Carpenter et al., 2023).

In the high-likelihood group, hot flashes, more sleep problems, higher stress, symptoms of depression and higher blood pressure were more common. In this study, palpitation patterns were not linked to measurements showing artery hardening (Carpenter et al., 2023). This result is reassuring. But the average result of a study does not tell you the cause of your own palpitations; an assessment is still needed.

What else can cause palpitations besides menopause?

Palpitations have many causes other than menopause. The NHS lists these (NHS, Heart palpitations):

  • Intense exercise
  • Poor sleep
  • Stress and anxiety
  • Some medicines
  • Alcohol, caffeine, nicotine and recreational drugs
  • Pregnancy
  • Iron deficiency anemia
  • An overactive thyroid gland
  • A heart rhythm problem (arrhythmia)
  • Heart valve disease

Part of this list overlaps with things that are also common in the menopause years. For example, when your sleep is broken or your anxiety rises, palpitations may increase too. That is why palpitations should not be brushed off as “just menopause.” Accompanying symptoms and your personal or family history of heart disease matter especially.

Anxiety, sleep and palpitations

During the menopause transition, symptoms often do not come alone; they feed each other. The NHS lists both stress and anxiety and poor sleep among the common triggers of palpitations (NHS, Heart palpitations). For the same stage of life, the NHS also includes sleep problems and mood changes in its list of menopause symptoms (NHS, Symptoms).

The SWAN finding fits this picture: women with a high likelihood of palpitations more often had sleep problems, perceived stress and symptoms of depression (Carpenter et al., 2023). This does not prove that one causes the other. But it shows why tracking your sleep, stress level and palpitations together is useful.

It is very natural to feel anxious when palpitations start. And anxiety can make your heartbeat feel more noticeable. Spotting this cycle makes it easier to tell when you need to worry. Still, if you have chest pain, shortness of breath or feel faint, do not put it down to anxiety; get help right away.

When are palpitations an emergency?

The NHS criteria are clear. If the palpitations do not stop, or they come with chest pain, shortness of breath, feeling faint or fainting, you need emergency help. In that situation, call your local emergency number (112 in Türkiye and the EU, 911 in the US) or go to the emergency department (NHS, Heart palpitations).

If you had those symptoms but they have passed, you still need to see a doctor the same day. The NHS advises that in this case you do not drive yourself, that you ask someone to take you, and that you bring any medicines you use (NHS, Heart palpitations).

When should you see your GP about palpitations?

The NHS advises seeing your GP if you have palpitations during menopause (NHS, Symptoms). Its palpitations page also lists these situations (NHS, Heart palpitations):

  • The palpitations keep coming back or are getting more frequent
  • They last longer than a few minutes
  • You have a known heart condition
  • You have a family history of heart problems

What can you observe yourself?

Palpitations often do not happen during the examination. That makes your own observations very valuable. Note down:

  • When did it start, and how long did it last?
  • How did it feel: fast, irregular, pounding?
  • Did it come together with a hot flash?
  • Did you have caffeine, alcohol or a cigarette that day?
  • How did you sleep the night before? Was the day stressful?
  • Did you have chest pain, shortness of breath or dizziness?
  • Have you started a new medicine?

The NHS notes that if there is no health problem behind your palpitations, avoiding triggers such as stress, smoking, caffeine and alcohol may help. It also suggests checking the leaflet of any medicine you use, because some medicines can cause palpitations (NHS, Heart palpitations). This page does not recommend any medicine or supplement; you should discuss options with your doctor.

What should you ask your doctor?

Bring your notes and a list of all the medicines you use to the appointment. If there is a history of heart disease in your family, be sure to mention it. You can ask:

  • Do my palpitations fit with the menopause transition, or should a heart cause be ruled out?
  • Should I be checked for anemia or a thyroid problem?
  • Could one of the medicines I use be causing palpitations?
  • Which symptoms mean I should go to the emergency department?

If you want to see the other menopause symptoms together: Menopause symptoms.