Is Your Heart Skipping a Beat? Understanding Irregular Heartbeats in Menopause

Menopause comes with an entire suite of symptoms, many of them annoying. We are warned about hot flashes and night sweats, but another common symptom is less often mentioned: Irregular heartbeat.

What is an Irregular Heartbeat?

An irregular heartbeat is also known as arrhythmia or heart palpitations. Your heart normally beats steadily, although its speed can increase or decrease depending on what you are doing. When your heartbeat becomes irregular it most often feels as if your heart is "skipping a beat" or hiccuping, although it can also mean an extra beat or your heart accelerating for no good reason. This typically lasts only a few seconds or, at worst, a few minutes.

Irregular heartbeats can be caused by a variety of things, ranging from too much caffeine to emotional distress to sleep apnea. They can also be caused by hormonal changes (which also means they are not uncommon during pregnancy). In many cases, arrhythmia is not dangerous and doesn't require medical attention, although it can be frightening. It can also be easily managed.

Why Does Menopause Impact Heart Rhythms?

During perimenopause and menopause your estrogen levels naturally drop. Your body produces less estrogen and more estradiol as your ovaries shut down. As estrogen levels fall, your heart can become overstimulated. Estrogen also influences your coronary arteries and blood flow, which can impact the heart.

Estrogen levels can also fluctuate a lot during the perimenopausal period, causing changes in blood pressure and heart rhythm. This can cause temporary, harmless arrhythmia as your body adjusts to the hormonal changes.

It's worth stressing that these changes in heart rhythm are normal and not typically dangerous...especially as becoming anxious about an irregular heartbeat can make it worse.

What Do Irregular Heartbeats Feel Like?

The sensations associated with an irregular heartbeat can vary. The most common feelings are skipped beats, your heart racing, a fluttering sensation, or a feeling of your heartbeat being just "off."

Again, this can last from a few seconds to a few minutes and is annoying but usually harmless. Episodes will generally become less frequent as you pass through menopause into post menopause.

However, if your irregular heartbeats are associated with other symptoms, you should talk to your doctor. These symptoms include chest pain, shortness of breath, dizziness, fainting, or swelling in one of your legs. If you feel as if you are going to pass out, call your doctor. This could be a sign of something more serious, including a heart attack.

How To Calm Your Heart and Soothe Your Nervous System

While arrhythmia during menopause is common and not dangerous, it can also be really annoying. There are some things you can do that can help manage these symptoms. These include:

1. Deep breathing exercises. Slow, deliberate breaths will calm your heart and nervous system, and can bring your heart's rhythm back to normal. Paced breathing can also help and has the advantage of also reducing anxiety for many people.
2. Meditation. A simple mindfulness practice can lower your stress levels. Lowered stress will reduce the frequency of arrhythmia. Meditation also has a number of other health benefits.
3. Setting boundaries. Reduce your stress by learning to say "no." Menopausal women often have a lot of demands from work and family, especially if you have both children and elderly parents.
4. Exercise. If you already have an exercise habit, keep it up. If not, gentle and consistent movement is best, such as brisk walking or yoga.
5. Moderate alcohol and caffeine. Both can cause arrhythmia if consumed in excess and this can aggravate your symptoms. Avoid illegal drugs.
6. Stay hydrated. Dehydration can cause palpitations. Drink plenty of water, especially when exercising.
7. Sleep. Set a consistent sleep schedule and make sure you get 7-9 hours every day.

All of this can make a huge difference to your symptoms and help keep your heart stable. You may not need any further treatment.

When To Talk To A Healthcare Provider

Most instances of irregular heartbeat don't require medical treatment. They aren't a sign that anything is wrong with your heart and while annoying, they can typically be managed with the techniques above.

However, you may want to talk to a doctor if you have prolonged or severe symptoms. This includes:

1. Symptoms that last more than a few minutes at a time. This could indicate that something is wrong.
2. Frequent episodes that are disrupting your daily life and interfering with your ability to work or care for family.
3. Other symptoms such as dizziness, chest pain, or shortness of breath.

Your doctor can do tests to eliminate other issues such as a heart murmur or other abnormality, as these can make arrhythmia more dangerous. Finally, if you are worried, your doctor can reassure you that your irregular heartbeats are normal and give you appropriate help.

You may be put on medication to support your heart. If your arrythmia is caused by menopause, your doctor can help you with lifestyle changes. You should also consider HRT which can relieve your symptoms and help you get back to your life. It can be particularly helpful if your heart palpitations are in concert with hot flashes, which is common.

Another potential treatment is therapy to help you lower your stress and develop better coping strategies. Therapy can also help with the anxiety and depression that often accompanies menopause.

Listening To Your Heart (Literally!)

Irregular heartbeats are a common symptom of menopause. They are also manageable, often with simple lifestyle changes. Whether or not you are experiencing these symptoms, incorporate stress-reducing practices and regular exercise into your lives. Pay attention to your heart and know when to get medical attention and how to stay calm and give your heart what it needs to settle down.

Take care of yourself and, of course, seek help when needed, whether it's from medical professionals, your therapist, or your friends. Remember that this is a normal part of your life and you will get through it.