The Testosterone Blueprint
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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, because palpitations can occasionally signal something else. The features that warrant a closer look rather than reassurance include:

  • Palpitations with chest pain, breathlessness or fainting
  • A very fast or irregular beat that lasts a long time
  • Symptoms that point to a thyroid problem, such as weight change or tremor

That is why new palpitations should not simply be dismissed as "just hormones" without a basic check. The good news is that a single round of tests usually settles the question, after which you can treat the hormonal version with confidence.

The adrenaline link is worth understanding, because it explains why palpitations cluster at certain times. Falling oestrogen leaves the nervous system more reactive, so the surges of adrenaline that come with stress, a broken night or a hot flush hit harder than they used to. That is also why caffeine and alcohol, which both amplify that adrenaline response, are among the easiest triggers to cut.

What to do: mention new palpitations to your GP at least once, since 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.

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Based on guidance from the NHS, NICE, Cleveland Clinic and peer-reviewed research.
By M. Videika, author of The Testosterone Blueprint · Reviewed June 2026
General information, not a substitute for personal medical advice — always consult your doctor or a qualified health professional before making health decisions.