Periwell
Guide··7 min read

Heart Palpitations: When It’s Hormones and When to See a Doctor

Sudden racing or fluttering in your chest can be alarming. Learn how perimenopause affects your heart rhythm and when to seek medical advice.

Evidence-BasedStandard-Aligned

Verified against Clinical Guidelines

This article was developed and verified against current clinical standards from NAMS, BMS, and the STRAW+10 staging framework.

Clinical Methodology
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Heart palpitations—the feeling that your heart is skipping a beat, fluttering, or racing—are a surprisingly common perimenopause symptom. While they are often benign and tied to hormonal shifts, they always warrant a professional evaluation to rule out structural issues.

The Autonomic Connection

Estrogen helps regulate the autonomic nervous system, which controls your heart rate. When estrogen levels drop or swing, your 'fight or flight' system can overreact, leading to sudden, unprovoked racing of the heart.

Red Flags

  • Seek immediate care if palpitations are accompanied by chest pain, fainting, or severe shortness of breath.
  • A standard EKG and thyroid check are often the first steps your doctor will take.

Start Today

  • Cut back on caffeine and alcohol for 48 hours and track the difference.
  • Practice 5 minutes of deep belly breathing when you feel a flutter.
  • Log the duration of your palpitations in Periwell.

Related on Periwell

Next step

Log your heart rate spikes

Use Periwell to track when your palpitations occur—is it after caffeine, during a hot flash, or at rest?

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