You are sitting quietly when, without warning, your heart seems to take off.
It may pound hard for a few seconds, flutter strangely in your chest or feel as though it has missed a beat. Even when it passes quickly, that sudden awareness of your heart can be enough to make everything else stop.
Heart palpitations are often harmless, but seek immediate medical attention if you experience chest pain, fainting, or breathlessness, as these may indicate a serious condition requiring urgent care.
Why Your Heartbeat May Suddenly Feel Different
A palpitation simply means becoming unusually aware of your heartbeat. It may feel fast, pounding, fluttering, irregular or as though your heart has skipped or added a beat.
You might notice the sensation in your chest, throat or neck, and it can last for seconds, minutes or occasionally longer.
Palpitations are common and often harmless, which can help women feel more at ease and less anxious about their health.
Could perimenopause be involved?
Possibly. The NHS recognises a faster, slower or more noticeable heartbeat as one of the symptoms some women experience during perimenopause and menopause.
Hormonal changes during perimenopause and menopause can contribute to palpitations, especially when linked with hot flushes, night sweats, anxiety, or disrupted sleep. Understanding these connections can help you recognise typical patterns and reduce worry.
But this is where it is important not to jump straight to “hormones”.
Palpitations can also occur with iron-deficiency anaemia, an overactive thyroid or an abnormal heart rhythm known as an arrhythmia. Certain medicines and stimulants can contribute too.
NHS: Menopause and perimenopause symptoms
If several other changes are happening at the same time, you may also find FemPhases’ What Are the First Signs of Menopause? helpful.
What Heart Palpitations Can Look Like in Everyday Life
Palpitations do not always happen while you are rushing around.
Sometimes they arrive when you are completely still.
You might notice:
- your heart thumping while you are watching television
- a fluttering sensation after climbing into bed
- a sudden racing heartbeat during a hot flush
- what feels like a skipped beat during a stressful meeting
- pounding after several coffees and very little sleep
- an unfamiliar heartbeat that makes you stop mid-conversation
Night-time palpitations can feel particularly unnerving because the room is quiet and there is little to distract you from what is happening inside your body. The British Heart Foundation notes that some people simply become more aware of their heartbeat when lying quietly in bed.
British Heart Foundation: Heart palpitations at night
The emotional response matters too. Once you notice your heart racing, fear can make you more alert to every beat. Stress and anxiety can themselves increase heart rate, creating an uncomfortable loop of sensation and worry.
That does not mean the palpitation is “all in your head”. It means the body and nervous system influence one another.
Poor sleep can add another layer. If nights have become broken by hot flushes, worry or repeated waking, explore FemPhases’ Why Am I So Tired? Midlife Fatigue Explained.
What May Help You Understand the Pattern
No single home remedy treats every cause of palpitations, but noticing patterns can help women feel more confident and in control of managing their health.
1. Keep a simple symptom record
For a couple of weeks, note:
- when the palpitations happened
- how long it lasted
- whether it felt fast, irregular, pounding or fluttering
- what you were doing beforehand
- caffeine and alcohol intake
- sleep quality
- stress levels
- hot flushes or other symptoms
- any new medicines or supplements
- whether you felt dizzy, breathless or unwell
You are not trying to diagnose yourself. You are creating a clearer picture.
2. Notice whether caffeine is a trigger
Coffee, strong tea, energy drinks and other stimulants can trigger palpitations in some people.
If you notice a clear connection, reducing caffeine gradually may be worth trying rather than assuming you need to give it up completely.
3. Protect sleep where you can
Poor sleep may make palpitations more noticeable and can also increase stress and anxiety.
If night sweats or other menopause symptoms are repeatedly disrupting sleep, it may be worth discussing those symptoms rather than treating each problem separately.
4. Review medicines and supplements
Some prescription and over-the-counter medicines can affect heart rate. If palpitations began after starting or changing a medicine, speak with a pharmacist or healthcare professional.
Do not stop prescribed medication suddenly without advice.
5. Support your wider heart health
Regular movement, a balanced diet, not smoking, moderate alcohol intake and keeping up with routine blood pressure and other health checks support cardiovascular health generally.
These habits support wellbeing, but they are not a substitute for investigating persistent symptoms.
Other Possible Explanations Worth Considering
One reason palpitations deserve thoughtful assessment is that very different things can produce a similar sensation.
An overactive thyroid can cause a fast heartbeat alongside symptoms such as sweating, tremor or weight loss.
Iron-deficiency anaemia can sometimes cause palpitations, along with tiredness, breathlessness, or dizziness. This may be particularly relevant if periods have become very heavy.
Arrhythmias are abnormalities in the heart’s rhythm. They range from relatively harmless extra beats to conditions that require treatment.
An ECG—an electrocardiogram, which records the electrical activity of your heart—is one test a clinician may use when investigating palpitations. Longer-term heart monitoring may sometimes be recommended when symptoms come and go.
British Heart Foundation: Understanding arrhythmias
If you are wondering how to explain several seemingly unrelated midlife symptoms at an appointment, FemPhases’ Perimenopause Appointment: Questions Worth Asking can help you prepare.
When to Speak to a Healthcare Professional
Occasional palpitations are common, but if you notice new, persistent, or changing symptoms-such as longer episodes, irregular heartbeat, or symptoms affecting daily life-consult a healthcare professional for proper assessment.
Consider arranging an appointment if palpitations:
- keep returning
- are becoming more frequent
- last longer than a few minutes
- are changing from your usual pattern
- regularly wake you from sleep
- are affecting your daily life
- occur if you already have a heart condition
- concern you, even if you cannot explain why
The NHS also advises assessment if you have a family history of heart problems.
It is worth getting support if…
- the episodes are becoming more frequent or longer
- your heartbeat feels persistently irregular
- you feel dizzy or light-headed during episodes
- you have unexplained tiredness or breathlessness
- you have very heavy periods and possible symptoms of anaemia
- symptoms began after a new medicine or supplement
- you are unsure whether menopause is actually the cause
- the fear of another episode is beginning to affect sleep or everyday life
Conclusion
A suddenly racing heart can make an ordinary moment feel anything but ordinary.
Palpitations can happen during perimenopause, and they may turn out to have a straightforward trigger such as poor sleep, stress or caffeine. But “common” and “harmless” are not interchangeable words.
You do not need to assume the worst, and you do not need to dismiss the symptom as “just hormones” either.
Pay attention to the pattern. Notice what else is happening in your body and your life. And when palpitations are new, recurring, worsening or accompanied by other symptoms, allow a healthcare professional to help you work out what is actually going on.
Frequently Asked Questions Women Often Ask
Are heart palpitations common during perimenopause?
They can be. The NHS includes a noticeable heartbeat or palpitations among possible perimenopause and menopause symptoms. However, palpitations have many other causes, so repeated or changing episodes should not automatically be attributed to menopause.
Can anxiety cause heart palpitations?
Yes. Stress and anxiety can increase adrenaline and make the heart beat faster or more forcefully. However, anxiety should not automatically be assumed to be the cause of new or unexplained palpitations.
Is a skipped heartbeat dangerous?
Occasional extra or early beats—sometimes called ectopic beats—are common and often not harmful. But frequent or prolonged palpitations, particularly with dizziness, chest pain, breathlessness or fainting, need medical assessment.
Why do I notice palpitations more at night?
You may simply be more aware of your heartbeat when you are lying quietly with fewer distractions. Stress, caffeine, sleep disruption and other triggers may also contribute. You should still discuss persistent night-time palpitations with a healthcare professional.
Can menopause cause a racing heart even if I am not having a hot flush?
Some women report palpitations independently of obvious hot flushes. But because a racing heart can have several explanations, assess new or persistent symptoms rather than assume they’re hormonal.
Key Takeaways
- Palpitations may feel like racing, pounding, fluttering or skipped beats.
- Some women experience them during perimenopause and menopause.
- Stress, poor sleep, caffeine, medication and other factors may also contribute.
- Anaemia, thyroid problems and heart rhythm conditions are among other possible causes.
- A symptom diary can help reveal useful patterns.
- Persistent, recurring or worsening palpitations deserve medical assessment.
- Palpitations with chest pain, shortness of breath or fainting require urgent medical help.
Medical Disclaimer
This article is for educational purposes only and does not replace personalised medical advice, diagnosis or treatment. If you are worried that your symptoms are getting worse, or if something does not feel right in your body, please speak with your doctor, nurse practitioner, gynaecologist, endocrinologist, or another qualified healthcare professional. Seek urgent medical help for severe, sudden or concerning symptoms.
