Symptoms

Heart palpitations in menopause

The NHS lists a faster, slower or more noticeable heartbeat among menopause and perimenopause symptoms. Episodes that keep returning are a reason to contact a GP, and the NHS palpitations page sets out when to call 999.

By Ines Kovac. Published 21 October 2026. 7 minute read.

Summarize with:

A white pillow and sheet on a made bed beside a wooden nightstand, with a brass lamp switched on against a wood-panelled wall.

What a racing heart feels like

A racing heart in menopause is the sensation the NHS calls palpitations: heartbeats that suddenly become more noticeable. The beat may feel as if it is racing or going very fast. It can pound, flutter, or feel irregular. You can notice it in the chest, the neck or the throat.

An episode can last for seconds, for minutes, or for longer than that.

Why they show up in perimenopause

That NHS page says the feeling can sometimes be a sign you are going through the menopause. The symptom list for menopause and perimenopause says this heartbeat change can show up around the time periods stop, and in the years after. During perimenopause, palpitations can begin while periods are still coming.

A hot flush can make you sweat heavily. The same symptoms page says a flush can also cause palpitations or anxiety, or make you feel dizzy. NICE Clinical Knowledge Summaries treat hot flushes and night sweats as vasomotor symptoms, and say they can come with profuse sweating, palpitations or anxiety. Caffeine, spicy food and alcohol are triggers those summaries name for the flushes. The guide to hot flushes and night sweats is about the heat and the sweating.

The NHS also names stress, lack of sleep, caffeine, alcohol, medicines, anaemia, an overactive thyroid, an arrhythmia and heart valve problems. Menopause is listed with those causes. Worry or low mood that outlasts a flush has its own guide, HRT, anxiety and low mood in menopause.

Palpitations at night

Night sweats belong with the vasomotor symptoms in the summary above, so a pounding beat can arrive with the sweating after you are in bed. The hot flush and night sweat diary records the time of day, how strong the episode felt, and what you had eaten or drunk. Print the sheet and take it to the GP.

People writing about perimenopause often say the worst episodes come in the evening or in the early hours, and that the pounding can wake them from sleep. Those posts are personal reports.

NHS guidance on anxiety says anxiety can cause a faster, irregular or more noticeable heartbeat.

When you feel well and the episode passes

Heart palpitations are common and not usually serious. Get help if you keep getting them, or if other symptoms come with them.

The US Office on Women's Health says it is normal to feel occasional flutters or a racing heart, and that heartbeat changes are harmless for most people. Older adults are more likely to have arrhythmias, partly because oestrogen levels change.

When to contact your GP

Book a GP appointment if you have had palpitations, you feel well, and they keep coming back or are happening more often. Use the same route if an episode lasts longer than a few minutes, if you already have a heart condition, or if there is a family history of heart problems.

There is a separate non-urgent prompt on that symptom list. Get in touch if you think you have perimenopause or menopause symptoms and you want to know your options, or if you have symptoms like a fast heartbeat.

The NHS arrhythmia page says to see a GP if you think you may have heart rhythm problems, or if palpitations keep happening or are getting worse.

Print the menopause symptom checklist for your GP and tick the heartbeat row, with how often it happens and how much it bothers you. The symptoms topic brings together the other changes that show up around this time. If you are unsure whether this is perimenopause, the stage checker uses your age and the date of your last period.

Call 999, go to A&E, or use 111

Call 999 or go to A&E if you currently have palpitations that do not go away, or if they come with chest pain, shortness of breath, or feeling faint or fainting. Do not drive to A&E. Ask someone to drive you, or call 999 and ask for an ambulance.

If you had palpitations with chest pain, breathlessness or faintness and those symptoms have now stopped, ask your GP surgery for an urgent appointment, call 111, or get help from 111 online.

In the United States, the Office on Women's Health says to call 911 if flutters come with heart attack symptoms such as dizziness or shortness of breath.

This is general information from those public pages. A doctor needs to examine you to work out the cause.

What your GP may do

You may have an electrocardiogram, called an ECG. You may be referred to a cardiologist for tests and treatment.

What might help

When a health condition is not the cause, avoiding stress, smoking, caffeine and alcohol may help.

If palpitations come with hot flushes or night sweats, the British Menopause Society 2020 HRT consensus, updated in September 2025, says vasomotor symptoms may be associated with palpitations. It describes that feeling as a racing or fluttering heartbeat. The same statement says oestrogen replacement remains the most effective treatment for those vasomotor symptoms. The guide to hormone replacement therapy for menopause covers what it is and the forms it comes in. Questions for a first appointment are written up in how to start HRT. Flush timing on a new prescription is the subject of how long HRT takes to work.

A 2022 systematic review in the journal Climacteric looked at menopause treatments and this symptom (the review). The evidence it found was mostly low-level. Its conclusion was that no therapies can be fully recommended for practice. Some hormonal agents, such as estradiol, may be recommended only with caution, because of some positive evidence on how common the symptom is or how severe it feels. In one study included there, one person stopped transdermal estradiol because of palpitations.

NICE NG23 cardiovascular evidence says combined and oestrogen-only HRT should not be offered to reduce coronary heart disease risk, and that HRT should not be started for primary or secondary prevention of cardiovascular disease. The Office on Women's Health says hormone therapy is not recommended to prevent heart disease or stroke. Diet and menopause goes through meals, bone strength and heart health.

My take

I would start with a GP appointment when the episodes are new and they keep returning, even when the timing fits menopause. I would judge that visit by whether anaemia, thyroid disease and a heart rhythm problem were considered, because the NHS lists those causes alongside menopause.