Are heart palpitations normal in perimenopause?

Yes — heart palpitations are a common and usually harmless symptom of perimenopause, though they can feel alarming, and any new palpitations should be checked at least once.

The flutters, skipped beats, or pounding — often noticed at night or alongside a hot flush — are linked to fluctuating oestrogen, which affects the nervous system and blood vessels that help regulate heart rate. Surges of adrenaline and cortisol (more common with broken sleep and anxiety) add to it, and hot flushes themselves can briefly raise heart rate. So palpitations usually travel with the other classic symptoms rather than appearing alone.

While most perimenopausal palpitations are benign, the heart is one area where it pays to be careful: palpitations can occasionally signal something else, such as a thyroid problem or an arrhythmia. So they shouldn't simply be dismissed as “just hormones” without a basic check.

What to do: mention new palpitations to your GP at least once — a simple exam, blood tests (including thyroid), and sometimes an ECG can rule out other causes and reassure you. Meanwhile, cut back on caffeine and alcohol, manage stress, and protect your sleep, all of which reduce them. Seek urgent help if palpitations come with chest pain, breathlessness, fainting, or last a long time.