Menopause and palpitations

I have experienced hard heart beats since I quit menstruating - 10 years ago.  I have worn a Holter monitor on two occasions and do not have irregular heart beats.  For 4 months I have tracked the days the hard heart beats occur and they happen for 3-4 days every 4 weeks - the menstrual cycle I maintained over my life.  I had Graves disease and had 3 radiation treatments and now am hypo and take levothyroxine.  In the past while I was still menstruating, I would have had migraines or spasms of the esophagus on these 4 weeks cycles and now it is the hard heart beat.  I believe that estrogen-high and low is the culprit.  I have learned this is not life threatening it is just disconcerting and an agitation.  Any reading I could do on the estrogen issue would be appreciated.

With menopause, women often report episodes of heart palpitations — an irregular heartbeat or pounding pulse that may make them feel their heart is going to jump right out of their chest. These heart palpitations are often accompanied by hot flashes or anxiety.  They are the result of diminished estrogen levels that can cause an  over-stimulation of your heart. For some women this reduction in hormone production is associated with an increase in heart rate and an increased frequency in palpitations and non-threatening arrhythmias, such as premature ventricular contractions (PVCs). A Premature Contraction is when a single heartbeat occurs earlier than normal.

Though palpitations associated with a decrease in estrogen are usually harmless, this doesn't mean that they should be ignored. Your doctor should evaluate any new or recurrent irregular heartbeats to rule out any abnormalities, especially when these palpitations are linked to a shortness of breath, dizziness or chest discomfort. Since have are treated for Grave's disease (an autoimmune disorder that leads to over-activity of the thyroid gland (hyperthyroidism), it will be important to make sure your present thyroid hormone production is still appropriate for your needs.

Estrogen and the Cardiovascular System effects the:

  • Metabolism and disposition of cholesterol
  • Plasma levels of high and low density lipoproteins (H/LDL).
  • Smooth muscle cell proliferation in the arterial wall.
  • Stimulates widening and inhibits constriction of coronary arteries.
  • Modulates autonomic nervous system,  which works to regulate heartbeat.

For menopausal women who are experiencing irregular heartbeats caused by changes in estrogen production, the treatment is often a combination of lifestyle changes and natural remedies. The decreased estrogen production also puts you at an increased risk for coronary artery disease, particularly if associated with other risk factors such as a high cholesterol, smoking, hypertensiondiabetes,  metabolic syndrome and/or obesity .

You may to check your risk for heart disease here:

Lifestyle changes that may help to reduce the incidence of irregular heartbeats during menopause:

  • Reducing intake of caffeine,
  • Limiting   consumption  of stimulants, cigarettes, and alcohol,
  • Practicing yoga, breathing exercises, or other relaxation techniques.

Hope this helps,
Dr T


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