Heart Palpitations in Perimenopause?
Heart palpitations, fluttering, or skipped beats can be scary! It turns out, they can be a common symptom that occurs during the whole hormonal transition. According to this review, up to 42% of perimenopausal women and 54% of postmenopausal women report having palpitations. That's a lot!
I’ve experienced them too.
It was probably 2 years ago and BAM out of nowhere I started getting heart palpitations. I would feel irregular heart beats or fluttering in long stretches of time. Sometimes they were so bad I would cough! Being a doctor, I listened to my own heart but also had my all 3 of my doctor besties listen.
While waiting to get into my primary care, I tried multiple types of calming herbs, more magnesium, extra B-vitamins, breathing exercises, cut out caffeine, etc. Nothing really helped and I was having them pretty regularly throughout the day.
Cue to my doctor's appointment and she couldn't figure it out. I wasn't anemic. It wasn't my thyroid. There wasn't anything that stood out to cause them EXCEPT I WAS PERIMENOPAUSAL!
She suggested a beta blocker medication. I looked at her like she was crazy although I understood her suggestion.
At the time (remember, 2 years ago), I wasn't as good at remembering my progesterone pills. So, I starting taking 200-300mg of progesterone as I was still in my luteal phase during all the work-up THEN I got my period and poof my heart palpitations went away.
And they haven't come back.
Please note, any weirdness with your heart beat or heart rate should be evaluated by a medical professional! Common causes of heart weirdness can include cardiovascular disease, heart valve problems, low iron, hypo or hyperthyroidism, electrolyte imbalance, hypoglycemia, certain medications, stimulants, too much caffeine, and anxiety.
Sadly, heart palpitations as part of the perimenpausal journey is NOT well studied. Shocker, I know.
Here's what we do know:
In some studies, it's associated with a sedentary lifestyle
It can be associated with hot flashes (vasomotor symptoms)
It can be associated with poor sleep
It can be associated with poorer menopausal quality of life
While black women have more cardiovascular disease, they do not seem to have more heart palpitations than other women
Study found here
Your heart cells known as myocytes have hormone receptors on them for estradiol and progesterone! This means, the relative ratio of estradiol and progesterone through life play a role in your heart's rate, rhythm and heart rate variability. In particular, it's better studied that when estradiol drops low (as can happen in perimenopause and definitely happens in postmenopause), the heart can temporarily freak out and create symptoms.
Progesterone is not as well studied, but is known to have an effect on the heart.
In my case, I'm guessing it was a combination of my own estradiol dipping down really low that month and adding in progesterone supplementation that helped.
I still take my magnesium EVERY.SINGLE.NIGHT without fail and have added in calming support for sleep (as discussed in this article). I'm also really good about taking my progesterone capsules before bed in my luteal phase.
Knock on wood, no heart palpitations since that event!
If you are reading this and experience heart palpitations/fluttering/irregular beats, please go get worked up. And bring up your hormones as a possible culprit!
<ps - I use the Prosorb+ Magnesium New in Italian Ice - it’s delicious!>