Are heart palpitations normal in perimenopause?
Reviewed by Dr. Ana Lisa Carr, MD, MBA · Last reviewed May 10, 2026
Answer published
Palpitations — the sensation of skipped, fluttering, or pounding heartbeats — affect roughly 40% of perimenopausal women and are usually benign. Estrogen modulates the autonomic nervous system, and as levels swing, the heart becomes more sensitive to adrenaline. Episodes often cluster around hot flashes, before periods, and at night. HRT typically reduces both frequency and intensity. That said, palpitations with chest pain, shortness of breath, fainting, or a known cardiac history are not "menopause" and need cardiology evaluation — an ECG and 24-hour monitor are reasonable first steps.
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