The Drummer in Your Chest: Navigating Heart Palpitations in Midlife
You’re sitting on the sofa, mid-sentence or perhaps just mid-thought, when it happens. A sudden, heavy thud in your chest. Or maybe it’s a fluttering, like a trapped bird trying to find its way out of your ribcage. Your breath hitches, your pulse quickens, and for a terrifying second, your mind jumps to the worst-case scenario.
If you’ve experienced this "unannounced drummer" in your chest, you aren't alone. Heart palpitations are one of the most unnerving, yet frequently reported, experiences of the perimenopause transition. While they often feel like an emergency, for many women, they are a physiological signal of the significant hormonal recalibration taking place.
Understanding the Oestrogen-Heart Connection
To understand why this happens, we have to look at biology. Oestrogen isn't just a reproductive hormone; it has receptors throughout the body, including the heart and the vascular system.
Research suggests that oestrogen plays a role in keeping the heart’s electrical impulses steady and the blood vessels flexible. As oestrogen levels fluctuate during perimenopause, the heart’s internal "metronome" can sometimes react to these shifts. This might manifest as "skipped beats" or a racing sensation.
The Priority: Medical Clearance First
As a health coach, my first and most important piece of advice is this: Any new or changing heart symptom must be evaluated by a medical professional. While many midlife palpitations are related to hormonal shifts, it is vital that your GP rules out any underlying clinical issues first. Once your doctor has confirmed that your heart is healthy and your symptoms are likely related to the menopause transition, we can then look at the lifestyle factors that help calm the nervous system.
Please see your GP if:
Palpitations are accompanied by chest pain or pressure.
You experience fainting or severe dizziness.
You have a pre-existing heart condition.
The "racing" feeling is persistent and doesn't settle with rest.
The Coaching Zone: Supporting Your System
Once you have the "all-clear" from your doctor, there is much we can do from a lifestyle perspective to help manage the frequency and intensity of these episodes:
Identifying Personal Triggers: Many women find that certain substances act as high-octane fuel for palpitations. We can work together to track whether caffeine, alcohol or specific high-sugar foods are "poking the bear."
Stress Management & The Vagus Nerve: When your heart flutters, your body often dumps adrenaline into your system, which can worsen the sensation. Learning tools like "box breathing" or vagus nerve stimulation can help act as a manual "brake" for your nervous system.
Nutrition & Hydration: Dehydration and imbalances in key minerals like magnesium and potassium can contribute to heart excitability. While I don't prescribe supplements, we can focus on a "food-first" approach to ensure your diet supports heart health.
The Clinical Conversation: If you choose to discuss Menopause Hormone Therapy (MHT) or specific supplements with your doctor, I can help you prepare for that appointment so you feel confident asking the right questions.
The Bottom Line
That skipped beat is often a signal that your autonomic nervous system is under pressure. By prioritising medical check-ups and then layering in robust lifestyle support, you can help that "drummer" in your chest settle back into a steady, quiet rhythm.
Need help navigating the "midlife flutter"?
If palpitations are adding a layer of anxiety to your journey, let’s work together to build a lifestyle foundation that supports your heart and your head. I can help you prepare for your GP visits and create a personalised plan to manage stress, nutrition and energy.
References
Maas, A.H.E.M., et al. (2021). "Cardiovascular health after menopause transiton etc." DOI: 10.1093/eurheartj/ehaa1044
Carpenter, J.S., et al. (2025). "Palpitations in midlife women: the Menopause Racing Heart Pilot Study" DOI: 10.1097/GME.0000000000002538
UK Health Coaches Association. "Scope of Practice and Code of Conduct for Health and Wellness Coaches."
Rettberg, J.R., et al. (2013). “Estrogen: A master regulator of bioenergetic systems in the brain and body.” PMID: 23994581
