Perimenopause Heart Palpitations: A Calming Breath for a Racing Heart
You're sitting on the sofa after dinner, not doing anything at all, and suddenly your heart is thudding. Fast, then a flutter, then a strange skip, as if it missed a step on the stairs. You put your hand on your chest and wait. Your mind races ahead of it: is this my heart? Should I be worried? Why now?
If this has happened to you, you are not imagining it, and you are definitely not alone.
In short: Perimenopause heart palpitations, a racing, pounding or fluttering heartbeat, are something many women notice as hormone levels shift. They are often harmless, but new palpitations should always be checked by a doctor. Get urgent care if they come with chest pain, fainting or breathlessness, or if they don't settle. Slow breathing at about 6 breaths a minute may help you feel calmer while one passes.
Why does my heart race in perimenopause?
Your heart responds to far more than exercise. Hormones, stress, poor sleep, caffeine and alcohol can all change how fast and how hard it beats. During perimenopause, oestrogen rises and falls unpredictably, and many women find their heart feels more reactive: a skip here, a pounding spell there, a racing beat that arrives with a hot flush or in the middle of the night.
The tricky part is what happens next. A racing heart feels like danger, so your body releases more stress hormones, which can make your heart race more. Fear feeds the feeling. That is one reason a palpitation at 2am can feel so much bigger than one in the afternoon. If you'd like to understand this loop better, why everything feels harder right now explains how menopause affects your nervous system.
Perimenopause heart palpitations: when is it urgent?
Please read this part before any breathing.
Get urgent medical care, by calling your local emergency number or going to the nearest emergency department, if your palpitations come with any of these:
- Chest pain, tightness or pressure
- Fainting, or feeling as if you are about to faint
- Breathlessness
- Palpitations that do not settle
Even if your palpitations are mild and pass quickly, tell your doctor about them, especially if they are new. A doctor can check your heart and rule out other causes. It's okay to ask. You are not wasting anyone's time. This checklist for talking to your doctor about perimenopause can help you say it clearly.
Once your doctor has checked you and you know what you are dealing with, the practice below is something you can lean on when your heart starts racing.
Try this now: hand on heart, six breaths a minute
You don't need to slow your heart down by force. You need to give it a slower rhythm to follow. That rhythm is your breath.
- Stop and sit. Sit down, or lean against the kitchen counter or a wall. Let your shoulders drop.
- Place your hands. Rest one hand on your chest and the other on your belly. Feel the warmth of your own hand.
- Breathe in slowly for 5 counts. Breathe in through your nose and let the hand on your belly rise first.
- Breathe out slowly for 5 counts. Let the air leave through your nose or softly parted lips. If it feels good, stretch the exhale to 6 or 7.
- Keep this rhythm for up to 5 minutes. In for 5 and out for 5 is about 6 breaths a minute. Count quietly, or say "in" and "out" in your head.
Slow breathing at about 6 breaths a minute is linked with calmer heart-rate patterns and the body's "rest and digest" response. That doesn't mean it will stop every palpitation. It means you are giving your body a gentle, steady signal at a moment when everything feels unsteady.
What if focusing on my heart makes it worse?
That is very common, and it's okay. For some women, paying attention to the heartbeat makes the anxiety louder, not quieter.
If that's you, move both hands to your belly instead, or rest them on your thighs. Look around the room and name five things you can see. Feel your feet on the floor. Not this: chasing every beat with your attention. This instead: letting your breath stay slow while your eyes rest on something ordinary, like the steam rising from your chai or a photo on the wall.
You can't do this wrong. If your count drifts, start again at one. Your दिल, your heart, has carried you through so much. It is allowed to feel a little restless now, and you are allowed to sit with it kindly.
Keep a little palpitation note
When your heart settles, take one minute to jot down:
- The time and what you were doing
- How long it lasted
- Whether you'd had tea, coffee or alcohol, or slept badly
- Whether it came with a hot flush
Over a few weeks, this gives your doctor real information instead of "it happens sometimes". The daily symptom and mood check-ins in the MySakhi app can hold this for you, so you aren't relying on memory in the appointment.
You are not overreacting
Many women carry palpitations quietly for months, worried about being called anxious or dramatic. What if you treated your heart the way you would treat your best friend's? With curiosity rather than panic, and with a doctor's appointment rather than silence.
Palpitations often travel with anxiety in perimenopause. If that sounds familiar, this guide to perimenopause anxiety might be a helpful next read.
And if your heart races tonight and you want something to do with your hands and your breath, talk to Sakhi. Tell her your heart is racing and she can suggest a short practice for that moment. She is not a doctor and can't check your heart, so if you have any of the warning signs above, call for help first.
5 minutes. No mat. No mantra. Just you.
Questions women ask
Are heart palpitations normal in perimenopause?+
Many women notice palpitations as hormone levels shift, and they are often harmless. But any new palpitations should be checked by a doctor, who can rule out other causes.
When are perimenopause palpitations an emergency?+
Get urgent care if palpitations come with chest pain, fainting or breathlessness, or if they don't settle. Call your local emergency number or go to an emergency department.
Can breathing help heart palpitations?+
Slow breathing at about 6 breaths a minute is linked with calmer heart-rate patterns and the body's rest and digest response. Once a doctor has checked you, it may help you feel steadier while a palpitation passes.
What should I tell my doctor about palpitations?+
Note when they happen, how long they last, what you were doing, and whether caffeine, alcohol, poor sleep or a hot flush came first. A few weeks of notes gives your doctor much clearer information.
Why do palpitations happen at night in perimenopause?+
Many women notice them at night, sometimes with a hot flush or night sweat. In a quiet, dark room you also notice your heartbeat more, and worry can make it feel stronger.
Listen free, wherever you are