Changing hormone levels, such as estrogen, may cause your heart to pound and flutter. Palpitations typically start when you’re experiencing a hot flash, which is another common menopause symptom.

Palpitations feel like your heart is beating much faster than usual, almost as if you’ve been running very hard. Your heart might also skip beats or flutter. The pounding feeling can radiate from your chest all the way up into your neck and throat.

Along with palpitations, you’ll likely have other menopause symptoms, such as:

  • hot flashes, or a feeling of intense heat, along with sweating and red skin
  • night sweats
  • vaginal dryness
  • irregular periods, with spotting or bleeding in between periods
  • mood swings
  • trouble sleeping
  • dry skin and hair
  • memory problems
  • drop in sexual desire

Learn more: What are the symptoms and signs of menopause? »

During menopause, levels of the hormone estrogen rise and fall. By the end of menopause, your body will stop producing this hormone. Changing estrogen levels can set off heart palpitations.

Women can also experience palpitations during other times when hormone levels shift, like during their period or in pregnancy.

Palpitations in menopause often happen during hot flashes. Your heart rate might increase by 8 to 16 beats while you’re in the middle of a hot flash.

Other causes of palpitations include:

If you have palpitations occasionally and they only last for a few seconds, you probably don’t need to do anything about them. See your doctor if your palpitations:

  • start to happen more often
  • last for more than a few minutes
  • get worse over time

You might have a more serious heart problem that needs to be treated.

Get emergency medical help right away if you have these symptoms along with palpitations:

  • shortness of breath
  • chest pain
  • dizziness
  • fainting

To diagnose heart palpitations, your doctor may refer you to a cardiologist. This type of doctor specializes in treating heart problems.

Your doctor will start by asking about your overall health and any medicines you take. You’ll also be asked questions about your palpitations, such as:

  • When did the palpitations start? Did they begin when you started menopause?
  • What seems to trigger them? Possible triggers include exercise, stress, or certain medicines.
  • How long do they usually last?
  • What, if anything, seems to make them go away?
  • Have you had any other symptoms, like chest pain or dizziness?

Your doctor will listen to your heart with a stethoscope. You might also get one or more of these heart tests:

Electrocardiogram: During this test, electrodes placed on your chest monitor the electrical activity in your heart.

Echocardiogram: This test uses sound waves to make an image of your heart and show how well it’s working.

Stress test: You’ll run on a treadmill to make your heart beat faster. This test can see if exercise sets off your palpitations.

Holter monitor: You wear this device for one to three days. It continuously monitors your heart rhythm to help your doctor find any problems.

Event monitor: This monitor records your heart rhythm for about a month. You push a button to start the recording whenever you feel palpitations starting.

You might also see a gynecologist if you have other symptoms of menopause. Your doctor can do blood tests to check your hormone levels to see if you’ve started the menopause transition.

Palpitations caused by menopause are usually temporary. Many women find that their heart rhythm goes back to normal once they’ve finished the menopause transition.

Just because you’re done with menopause doesn’t mean your heart troubles are over, though. A woman’s risk for heart disease rises significantly after menopause.

Doctors believe this is because high estrogen levels before menopause protect the blood vessels from damage. Once estrogen production stops, this protection is lost, and your risk for a heart attack and stroke goes up. A healthy diet, exercise, and quitting smoking all help reduce this risk.

In some women, palpitations might be an early warning of heart problems. One study found that palpitations were related to hardening of the arteries, called atherosclerosis. This condition can lead to heart attack and stroke.

Learn more: What are the causes of coronary artery disease? »

To prevent palpitations, avoid things that make your heart race, such as:

  • coffee, chocolate, soda, energy drinks, and other products that contain caffeine
  • spicy foods
  • alcohol, nicotine, and recreational drugs like cocaine
  • cold medicines containing the stimulant pseudoephedrine

If stress sets your heart pounding, try relaxation techniques such as:

  • deep breathing
  • yoga
  • meditation
  • massage

Sometimes palpitations signal a heart problem. Your doctor might prescribe medicines such as beta-blockers or calcium channel blockers to keep your heart in its normal rhythm.

Some women find that hormone replacement therapy decreases their palpitations, as it treats other symptoms of menopause like hot flashes and vaginal dryness. Yet this treatment can pose an increased risk for heart disease, stroke, and blood clots, as well as breast cancer. Discuss hormone therapy with your doctor to see if it’s right for you.

During menopause and beyond, you need to be more aware of your heart health. Follow these tips to protect your heart:

  • Walk, ride a bike, swim, or do other aerobic exercises 30 minutes a day, at least five days a week.
  • Eat more fruits, vegetables, whole grains, fish, and low-fat dairy foods. Cut back on added sugar, salt, cholesterol, and saturated fat.
  • Manage your blood pressure, blood sugar, and cholesterol levels. If they’re high, your doctor might prescribe medicine to lower them.
  • Maintain a healthy weight.
  • If you smoke, ask your doctor about ways to quit.

Read more: The 10 best menopause blogs of the year »