SYMPTOM · PERIMENOPAUSE
Heart palpitations
A racing heart, a skipped beat or a stronger beat for no obvious reason: palpitations are one of the most unsettling symptoms of perimenopause, though they're rarely dangerous.
Why it happens
Fluctuating oestrogen affects the nervous system that regulates heart rhythm, which can make your heartbeat feel faster, stronger or irregular. Palpitations often come along with hot flushes and, in the vast majority of cases, they aren't linked to an underlying heart problem.
What tends to trigger palpitations
- Caffeine or alcohol.
- Stress or anxiety.
- Hot flushes, often accompanied by palpitations.
- Lack of sleep.
In the moment
- Breathe slowly and deeply to help your heart rate settle.
- Sit down for a moment rather than carrying on with what you were doing.
- Avoid caffeine if you feel a palpitation coming on.
Day to day
- Cut back on caffeine and alcohol if you notice they're linked to your episodes.
- Be physically active on a regular basis to look after your cardiovascular balance.
- Manage stress with breathing or relaxation techniques.
Palpitations that are frequent or worrying you?
A healthcare professional can check there's no underlying cardiac cause and reassure you about what's normal in perimenopause.
For information only. This does not replace a personalised medical assessment.
If several of these symptoms ring true, it's no coincidence.
Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.
Click on a symptom to find out more.
Brain fog
You search for words, reread the same sentence twice, lose the thread mid-conversation. Nothing to worry about: your brain is simply running slower, with less glucose to fuel it as oestrogen levels fall.
Sleep problems
Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.
Anxiety
Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.
Joint pain
Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.
Hot flushes
A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.
Mood swings
You laugh, and thirty seconds later you could cry or tell everyone where to go. Hormones rise and fall faster than before, and your mood follows, without warning.
Weight gain
Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.
Low libido
Desire takes longer to arrive, or barely arrives at all. Oestrogen and testosterone fall, and sensitivity with them. The desire is still there; it just takes longer to get going.
Vaginal dryness
A feeling of dryness, sometimes a little discomfort day to day. Tissues lose their natural moisture as oestrogen falls. It is a common symptom, and still too rarely talked about.
Irregular periods
One cycle shorter, another dragging on, a month skipped altogether. Ovulation becomes less regular as the ovaries slow down. It is often the very first sign of perimenopause.
Night sweats
Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.
Pain during sex
Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.
Dry skin
Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.
Chronic fatigue
Tiredness that will not lift, even after a good night. Broken sleep, falling hormones: your body runs less efficiently, and you feel it from morning to night.
Hair loss
More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.