Briefly explained (TL;DR)
Heart palpitations and a racing heart are common and usually harmless during menopause – but not always. At least one in five women in perimenopause and postmenopause experiences palpitations. These are often caused by an extrasystole, i.e., an extra heartbeat. Symptoms should be investigated immediately if they are accompanied by dizziness, shortness of breath, chest pain, or fainting.
The cause has not been definitively determined. These symptoms frequently occur alongside hot flashes, stress, and low mood. According to a systematic review, estradiol is the only treatment that can be recommended with caution; the evidence is insufficient for herbs, supplements, and other approaches.
In practical terms: Get a one-time medical check-up (ECG, blood tests), review triggers such as alcohol, caffeine, and lack of sleep, and only supplement nutrients if a deficiency is confirmed. In one small study, magnesium reduced extrasystoles – but this is not robust enough for a general recommendation.
Important medical note
This article is for health information purposes and does not replace a medical examination. If you experience a racing heart or palpitations combined with chest pain, shortness of breath, severe dizziness, or fainting: call 112 (emergency services). Recurrent, intensely noticeable rhythm disturbances or a pulse that does not calm down also require prompt medical attention.
Dietary supplements are not medication and do not treat heart rhythm disorders. Anyone taking heart medication, blood thinners, or thyroid medication, or who already has a heart condition, should discuss any supplementation with their doctor beforehand.
How common are palpitations and a fluttering heart during menopause?
At least one in five women in perimenopause or postmenopause experiences heart palpitations. This is the conclusion of a systematic review that evaluated five survey studies from five countries – including Bangladesh, Malaysia, Nigeria, the UK, and the USA.
The ranges are broad: for premenopausal women, the proportion was between 3.7 and 40.2%, in perimenopause between 20.1 and 40.2%, and after menopause between 15.7 and 54.1%. In three out of five studies, heart palpitations were significantly more frequent during perimenopause and after surgically induced menopause than before or after the transition. The authors explicitly call for standardized measurement methods because each study used different criteria.
The research group led by Janet S. Carpenter classified two of the five studies as good and three as moderately reliable; sample sizes ranged from 356 to 12,425 women. Important for context: these are symptom surveys, meaning they refer to the sensation of palpitations, not ECG-confirmed heart rhythm disorders.
The SWAN longitudinal study in the USA shows how this develops over the years. Carpenter and colleagues analyzed data from 3,276 women and found three typical patterns: about one in six women had a high probability of palpitations around perimenopause and early postmenopause, well over one in three had a moderate probability, and nearly half had a consistently low probability.
Two things follow from this. Firstly, heart palpitations during menopause are a common symptom that should not be ignored. Secondly, it is not an inevitable fate: half of women experience very little of this during this phase, and for many, it occurs in waves.
Why the heart flutters during menopause: What research knows – and what it doesn't
There is no single, proven cause as of yet. What is certain is that palpitations during menopause occur more frequently alongside other complaints, especially hot flashes, stress, and low mood.
In the SWAN evaluation, women with a high probability of palpitations had more vasomotor symptoms (hot flashes and night sweats), more depressive symptoms, higher stress levels, and higher blood pressure at baseline. This is a correlation, not proof of cause and effect: stress can trigger palpitations, and palpitations can trigger stress. You can find more about the hot flashes themselves in our article Hot flashes in menopause.
Fluctuating estrogen levels are frequently cited as a trigger. The studies reviewed here do not directly prove this. Consistent with this, estradiol is the only therapy with a cautious recommendation in the systematic review – this supports the hormonal hypothesis, but does not prove it.
The American Heart Association describes the menopausal transition in its scientific statement as a period of accelerated cardiovascular risk. Vasomotor symptoms affect about 80% of midlife women and are associated with less favorable blood lipids, insulin resistance, and a higher risk of high blood pressure. Palpitations or rhythm disorders are not addressed as a separate topic in the document.
In the SWAN evaluation, palpitation patterns were not associated with atherosclerosis or vascular stiffness (1,559 women with corresponding measurements). This is somewhat reassuring, but does not replace an individual assessment. General information on women's heart risk: Heart health in women and heart attack symptoms.
Harmless or dangerous? These warning signs require immediate investigation
Heart fluttering is usually harmless – it becomes urgent with four accompanying symptoms: dizziness, shortness of breath, chest pain, and fainting. This is the summary provided by cardiologist Prof. Dr. Thomas Meinertz of the German Heart Foundation. If stress, caffeine, alcohol, or electrolyte loss due to sweating are behind it, no treatment is necessary, according to Meinertz.
Warning signs – do not wait
- Racing heart or fluttering combined with chest pain or a feeling of pressure
- Racing heart with shortness of breath
- Racing heart with severe dizziness or fainting
- Racing heart that persists for a long time or does not calm down at rest
- Frequent, clearly noticeable missed beats, even without other symptoms: have it checked by a cardiologist once
In case of chest pain, shortness of breath, or loss of consciousness: call 112.
Even without these signs, the rule remains: anyone who experiences frequent and clearly noticeable rhythm disturbances should have a check-up to rule out underlying heart disease. According to Meinertz, extrasystoles are the most common rhythm disorder and are almost always harmless. More dangerous atrial fibrillation, on the other hand, manifests as a suddenly completely irregular, often very rapid heartbeat of up to 160 beats per minute (the normal range is 60 to 90) and affects around 1.8 million people in Germany.
→ Source: Apotheke Adhoc – Heart rhythm disorders: When should you see a doctor? (Prof. Dr. Thomas Meinertz)
Extrasystoles, racing heart, atrial fibrillation: How to recognize the types
The feeling of a "fluttering heart" is usually caused by extrasystoles – extra heartbeats that are perceived as missed beats or fluttering. The table classifies the most important forms. It serves as a guide; a diagnosis is always made via ECG.
| Form | How it feels | Typical progression | Classification |
|---|---|---|---|
| Extrasystoles | Missed beats, fluttering, single powerful beat | Single or clustered, usually short-lived | Most common rhythm disorder; almost always harmless according to heart foundation cardiologists |
| Atrial fibrillation | Completely irregular, often rapid pulse, up to about 160 per minute | At least 30 seconds; minutes to days, can worsen | Medical check-up required; stroke risk and treatment must be determined individually |
| AV block | Very slow pulse, pauses, sudden dizziness | More common in older people | Long-term ECG detects pauses; pacemaker only necessary for longer pauses |
| Persistent racing heart with warning signs | Racing pulse, accompanied by dizziness, shortness of breath, chest pain, or fainting | Persistent or recurrent | Seek medical attention on an emergency or timely basis |
The information is based on explanations by Prof. Dr. Thomas Meinertz (German Heart Foundation). The definition of atrial fibrillation requires a duration of at least 30 seconds; an AV block only requires a pacemaker if the heartbeat pauses for longer than five seconds.
→ Sources: aponet.de – Heart palpitations: Do not ignore these four warning signs (Prof. Dr. Thomas Meinertz, German Heart Foundation) · Apotheke Adhoc – Cardiac arrhythmias: When to see a doctor? (Prof. Dr. Thomas Meinertz)
Caffeine, alcohol, sleep, stress: Triggers you can influence yourself
In a randomized study, coffee increased the number of extra heartbeats in the ventricles, but not atrial arrhythmias – with alcohol, a stronger signal for atrial fibrillation was observed. In the CRAVE study by Gregory Marcus (UCSF), 100 adults (median age 38, 51% women) drank coffee or abstained for 14 days, monitored by an ECG device and Fitbit.
Result: 54% more ventricular premature beats while drinking coffee, 3% more atrial extra beats per additional cup, but no increase in atrial arrhythmias. Furthermore, participants slept 36 minutes less per night and took about 1,058 more steps. Lack of sleep is itself considered a trigger for premature beats.
→ Sources: Marcus GM et al. – CRAVE Study (Coffee and Real-Time Atrial and Ventricular Ectopy), American College of Cardiology · Health Lexicon – Premature beats: Causes
With alcohol, the signal effect is stronger. Marcus and colleagues tracked 100 study participants using wearable heart monitors and alcohol skin sensors. After one drink, the probability of an atrial fibrillation episode within four hours was approximately six times higher (OR 6.5; 95% CI 1.9–14.8), and after two or more drinks, it was about twenty times higher (OR 19.6; 95% CI 1.9–206.6).
The very wide confidence intervals show: The study is small, and the figures are uncertain. The researchers emphasize that there is no clear threshold and causality cannot be derived from the data.
Meinertz also lists stress and electrolyte imbalances due to sweating as harmless triggers. Those who sweat heavily at night during menopause may have an additional issue – however, this has not been specifically studied for women in menopause. On the interplay of stress and hormones: Stress and cortisol in women; on sleep: Sleep hygiene and magnesium.
What should be medically ruled out: Thyroid, anemia, electrolytes, medications
Before attributing heart palpitations to menopause, treatable causes should be checked. These primarily include hyperthyroidism, anemia, low potassium or magnesium, and medications that affect the pulse.
A compilation of the causes of premature beats lists hyperthyroidism, anemia, febrile infections, heart valve disease, heart failure, and sleep apnea, among others, as potential diseases. Medications mentioned include fluoroquinolones, macrolide antibiotics, theophylline, tricyclic antidepressants, and sympathomimetics, as well as nicotine and energy drinks. Abnormal lab values include low hemoglobin, potassium, or magnesium levels and altered thyroid hormones.
→ Source: Health Lexicon – Premature beats: Causes
| Possible cause | Symptoms that may fit | How it is checked |
|---|---|---|
| Hyperthyroidism | Additionally rapid heartbeat, weight loss, inner restlessness | TSH and thyroid hormones in the blood; more here: Thyroid and Hashimoto in women |
| Anemia / Iron deficiency | Fatigue, paleness, shortness of breath during exertion | Blood count with hemoglobin, ferritin; more here: Iron deficiency in women |
| Electrolyte imbalance | Muscle cramps, heavy sweating, diarrhea | Potassium and magnesium in the blood |
| Medications and stimulants | Onset after new medication, energy drinks, nicotine | Review list of medications with the doctor |
| Sleep apnea and lack of sleep | Snoring, breathing pauses, non-restorative sleep | Consultation with family doctor, possibly sleep lab |
Hot flashes that occur alongside rapid heartbeat and weight loss, diarrhea and skin flushing, or before age 40, should be medically evaluated. More on this in the article Hot flashes in menopause.
What happens during examination: ECG, Holter monitor, blood values – and the smartwatch
An ECG shows the heart rhythm at the moment of the examination, a Holter monitor records it over days – and is therefore often more informative for pauses that occur only sporadically. According to Meinertz, the Holter monitor identifies, for example, AV block pauses that last longer than five seconds.
→ Source: Apotheke Adhoc – Cardiac arrhythmias: When to see a doctor? (Prof. Dr. Thomas Meinertz)
Additionally, blood values are determined to rule out the aforementioned causes. A brief symptom log is helpful for the discussion: when it happens, how long, how fast the pulse was, what happened shortly before (coffee, alcohol, stress, after eating, at night).
Smartwatches can provide clues. In the Apple Heart Study (Marco Perez, Mintu Turakhia, and colleagues), 0.52% of 419,297 participants received an alert for an irregular pulse. Of the participants who subsequently wore an ECG patch, 34% actually had atrial fibrillation; the positive predictive value of the alert was 84%. The study was not specifically focused on menopausal women.
Practically: A watch can provide a reason for a doctor's visit. It is not an "all clear" ("the watch shows nothing").
What helps according to studies? Treatment options at a glance
For heart palpitations in menopause, estradiol is the only treatment that a systematic review can recommend with caution. Ying Sheng, Janet Carpenter, and colleagues evaluated 37 studies. They tested estradiol, moxonidine, atenolol, isoflavones, sage, cognitive behavioral therapy, and ear acupressure.
Most studies provided only level II and III evidence, with methodological weaknesses and small sample sizes. For all approaches other than estradiol, the data were insufficient for a clinical recommendation. The authors call for well-planned randomized studies that specifically target heart palpitations in menopause.
Estradiol is a prescription hormone preparation. Whether it is suitable for you depends on your symptoms, age, pre-existing conditions, and risks, and is a medical decision. We have summarized what is known about hormone therapy for hot flashes in the article Hot flashes in menopause.
Magnesium for heart palpitations: What one small study shows – and what it doesn't
In a single small placebo study, magnesium reduced premature beats and symptoms; this is not enough for a recommendation, but it is enough for an informed discussion with your doctor. The research group around Cristina De Falco and Francisco Darrieux examined 60 symptomatic patients (33 women, 16 to 70 years old) without heart disease.
They received 3.0 g of magnesium pidolate per day (equivalent to 260 mg of elemental magnesium) or a placebo for 30 days. In the magnesium group, the number of premature beats decreased by more than 70% in 76.6% of patients; under placebo, 40% improved slightly. Symptoms improved in 93.3% versus 16.7%.
The authors themselves note limitations: 30 people per group, a single center, no validated symptom score, no long-term observation, and only serum, not intracellular, magnesium values. A follow-up publication reported that symptoms returned in 17 out of 45 treated individuals (37.8%) during the 15-month observation period.
→ Sources: De Falco CNML et al. – Successful improvement of frequency and symptoms of premature complexes after oral magnesium administration, Arq Bras Cardiol 98(6):480–487 (2012) · De Falco CNML et al. – Late outcome of a randomized study on oral magnesium for premature complexes, Arq Bras Cardiol (2015)
Regarding the dosage: The DGE (German Nutrition Society) states an estimated value for an adequate intake of 300 mg of magnesium per day for women aged 19 and older, and 350 mg for men. Those who eat a balanced diet often achieve this through food; whether a supplement makes sense is best determined by a blood test. General information on the effects of magnesium can be found in the article Magnesium: What studies on muscles, sleep, and stress really show.
→ Source: German Nutrition Society (DGE) – Magnesium reference values
If magnesium is an option for you, for example because a low level has been measured, a supplement like the Multi-Magnesium Bio-Complex may be a consideration: According to the product label, one tablet contains 200 mg of elemental magnesium from four magnesium forms. It is not a treatment for cardiac arrhythmias, and the dosage should be discussed with your doctor – especially if you have kidney disease or are taking heart medication.
Omega-3 and atrial fibrillation: Why higher doses are not a harmless self-experiment
Fish oil supplements can increase the risk of atrial fibrillation – and the risk increases with the dosage. A meta-analysis by Baris Gencer, JoAnn Manson, Christine Albert and colleagues evaluated 7 randomized studies with a total of 81,210 participants.
Overall, the risk of atrial fibrillation with marine omega-3 was 25% higher (HR 1.25; 95% CI 1.07–1.46). At a dosage of up to 1 g per day, the hazard ratio was 1.12 (1.03–1.22), and at more than 1 g per day, it was 1.49 (1.04–2.15). Anyone already prone to arrhythmias should therefore only take high-dose omega-3 under medical supervision.
The significance for women in menopause: Omega-3 is considered heart-healthy, but not every dose is suitable for every rhythm. You can read more about the data situation and everyday doses in our article Omega-3: Heart, Brain and Atrial Fibrillation; a broad overview of heart health can also be found in Lowering Blood Pressure Naturally and Lowering Cholesterol Naturally.
Evidence Map: What plays a role in heart palpitations during menopause
| Approach | Purpose | Evidence level | What does not follow |
|---|---|---|---|
| ECG and Holter monitoring | Record rhythm, detect atrial fibrillation and pauses | Standard diagnostic procedure (German Heart Foundation/cardiologist) | A normal check-up does not rule out rare irregularities |
| Blood tests (thyroid, blood count, potassium, magnesium) | Find treatable causes | Recognized list of causes | Normal values do not rule out a link to menopause |
| Reduce alcohol | Fewer atrial fibrillation episodes | Small study, broad uncertainty (OR 6.5 after one drink) | No clear threshold, no statement on menopausal palpitations |
| Reduce coffee | Fewer ventricular extrasystoles | One RCT with 100 adults (+54% with coffee) | No increase in atrial arrhythmias, coffee is not generally prohibited |
| Estradiol | Heart palpitations during menopause | Cautious recommendation, evidence level II/III | No routine therapy, medical assessment required |
| Magnesium | Extrasystoles in healthy individuals | One small RCT (n = 60), single center | Not standard therapy, no substitute for diagnostics |
| High-dose Omega-3 | General heart health | Meta-analysis: more atrial fibrillation (HR 1.25) | Not suitable as a treatment for heart palpitations |
| Isoflavones, sage, acupressure, behavioral therapy | Palpitations during menopause | Insufficient data | No proof of efficacy, but also no proof of ineffectiveness |
The VEYT Heart Check: 5 steps in the right order
- Check warning signs: Chest pain, shortness of breath, severe dizziness or fainting? If so, do not wait – call emergency services (112) or seek medical help immediately.
- Note symptoms: Date, time, duration, pulse (if measurable), triggers like coffee, alcohol, stress, meals, night time. This saves time at the doctor's office.
- Test reducing triggers: Avoid alcohol and energy drinks for a few weeks, reduce coffee, protect your sleep. Observe if anything changes.
- Seek medical evaluation: ECG, Holter monitoring if necessary, blood tests (TSH, blood count, potassium, magnesium). Bring a list of current medications.
- Only then supplement as needed: Only compensate for proven deficiencies and coordinate dosages with your medical provider.
The VEYT product for this article
A VEYT product can compensate for a diagnosed magnesium requirement. It is not a treatment for cardiac arrhythmias and is not a substitute for diagnostics or medical therapy. We intentionally show only this one product: there is no evidence in the studies reviewed here that Vitamin D, herbs, or other supplements are effective against menopausal heart palpitations.
VEYT Multi-Magnesium Bio-Complex
60 tablets with 200 mg of elemental magnesium per tablet from four magnesium forms (according to product label). Suitable if a low magnesium level has been diagnosed or if your diet does not reach the DGE estimated value of 300 mg. Not a treatment for cardiac arrhythmias.
View VEYT Multi-Magnesium Bio-Complex →Dietary supplements are not a substitute for a balanced diet or medical treatment. Please consult a doctor in case of pregnancy, breastfeeding, kidney disease, heart disease, or regular medication use. Shipping from Germany within 1–3 business days, 14-day right of withdrawal, and 60-day satisfaction guarantee.
Expert Perspectives & Protocol Breakdown
Prof. Dr. Thomas Meinertz (Cardiologist, German Heart Foundation)
His perspective: In the interviews we reviewed, Meinertz classifies heart palpitations as usually harmless. He emphasizes that they are only urgent in cases of dizziness, shortness of breath, chest pain, or fainting; stress, caffeine, alcohol, and electrolyte imbalances due to sweating do not necessarily require treatment. For frequent, clearly noticeable arrhythmias, he recommends a cardiological evaluation.
→ Sources: aponet.de – Heart palpitations: Do not ignore these four warning signs (Prof. Dr. Thomas Meinertz, German Heart Foundation) · Apotheke Adhoc – Cardiac arrhythmias: When to see a doctor? (Prof. Dr. Thomas Meinertz)
Prof. Gregory Marcus (Cardiologist, UCSF)
His perspective: Marcus investigates the triggers of arrhythmias using wearables and randomized designs. His CRAVE study argues against a blanket ban on coffee, and his alcohol study supports avoiding alcohol if prone to atrial fibrillation – without naming a safe threshold.
→ Sources: Marcus GM et al. – CRAVE Study (Coffee and Real-Time Atrial and Ventricular Ectopy), American College of Cardiology · Marcus GM et al. – Acute Alcohol Consumption and Discrete Atrial Fibrillation Events (ACC 2021, report on HCPLive)
Janet S. Carpenter and Ying Sheng (Research on menopausal symptoms)
Their perspective: The group has systematically reviewed the frequency, course, and treatment options for palpitations during menopause. Their conclusion: Heart palpitations affect at least one in five women, data on treatments are limited, only estradiol is cautiously recommended, and targeted studies are lacking.
→ Sources: Carpenter JS et al. – A Systematic Review of Palpitations Prevalence by Menopausal Status, Current Obstetrics and Gynecology Reports (2021) · Carpenter JS et al. – Palpitations across the menopause transition in SWAN, Menopause 30(1):18–27 (2023) · Sheng Y et al. – Effect of menopausal symptom treatment options on palpitations: a systematic review, Climacteric (2022)
Dr. Eric Berg (Wellness Author, USA)
What he advocates: Berg attributes heart palpitations to anxiety, stress, caffeine, and alcohol, and cites low vitamin D levels as a possible contributing factor. He recommends vitamin D3 in combination with vitamin K2 and magnesium; he suggests a dose of 600 to 800 IU daily for healthy adults, and more in individual cases under medical supervision, along with regular blood tests.
→ Source: Dr. Eric Berg – Heart Palpitations
Where They Differ
Meinertz, Marcus, and the research team led by Carpenter rely on investigations, studies, and guidelines; they agree that warning signs and medical evaluation should precede any self-treatment. Berg focuses more on nutritional protocols. We did not find any study in our research showing that vitamin D3 and K2 reduce cardiac arrhythmias in menopausal women. For magnesium, there is at least one small, placebo-controlled study – in patients without heart disease, and not specifically during menopause.
What the Evidence Says
It is proven that heart palpitations are common during menopause, occur frequently alongside hot flashes and stress, and are usually harmless. It is also proven that high-dose omega-3 increases the risk of atrial fibrillation and that alcohol is temporally linked to atrial fibrillation episodes. It is not proven that any dietary supplement reliably alleviates heart palpitations during menopause. Expert opinion and protocols are not a substitute for evidence of efficacy.
Myths about palpitations and heart skips in menopause
"It's just the hormones, I don't need to get it checked out"
False. Thyroid issues, anemia, electrolyte imbalances, and medications can trigger the same symptoms, and atrial fibrillation does not automatically fall into the "menopause" category.
"Coffee is the trigger, so I'll cut it out completely"
In the CRAVE study, extra heartbeats of the ventricles increased with coffee, but not atrial arrhythmias. Trying a period without coffee makes sense, but the study does not support a blanket ban.
"Magnesium cures heart skips"
One small study with 60 patients showed improvement, but a follow-up publication reported a relapse in 37.8%. This is an indication, not a guarantee of a cure.
"If my smartwatch doesn't report anything, everything is fine"
A watch provides clues, not a diagnosis. In the Apple Heart Study, only 0.52% of participants received a notification; a lack of notifications does not rule out arrhythmias.
"More omega-3 is always better for the heart"
In meta-analyses, the risk of atrial fibrillation increases at higher doses (HR 1.49 at over 1 g per day). Dosage and a history of heart rhythm issues should be discussed with a doctor.
Conclusion
Heart skips during menopause are common and usually harmless – but they deserve a proper medical evaluation instead of the assumption that "it's just the hormones." Warning signs such as dizziness, shortness of breath, chest pain, and fainting require emergency medical attention.
Alcohol and high-dose omega-3 are the most thoroughly researched factors, while coffee and lack of sleep are obvious candidates; there is one small study for magnesium, but no evidence for other nutrients. Estradiol is the only treatment with a cautious recommendation – and is a decision to be made by a doctor.
Frequently Asked Questions about cardiac arrhythmias in menopause
Are cardiac arrhythmias normal during menopause?
Heart palpitations and skipped beats are common during menopause: A systematic review estimates that at least one in five women in perimenopause and postmenopause is affected by them. However, "common" does not automatically mean "harmless." Anyone noticing dizziness, shortness of breath, chest pain, or fainting should have it evaluated by a doctor immediately.
How many women have heart palpitations during menopause?
The data vary significantly depending on how the questions were asked: In the review by Carpenter and colleagues, the prevalence in perimenopausal women ranged between 20.1% and 40.2%, and in postmenopausal women between 15.7% and 54.1%. In the SWAN longitudinal study, 15.9% of women had a high probability and 34.3% had a moderate probability of experiencing palpitations around the menopause transition.
When is a racing heart dangerous during menopause?
A racing heart or heart skips should be urgently evaluated if accompanied by dizziness, shortness of breath, chest pain, or fainting. In the case of chest pain, shortness of breath, or loss of consciousness: call emergency services (112). Even without these signs, frequent, clearly noticeable arrhythmias should be examined by a cardiologist at least once.
Can magnesium help with heart skips?
A small, placebo-controlled study with 60 patients without heart disease found fewer extrasystoles and significantly fewer symptoms with 260 mg of magnesium per day over 30 days. The study was small, single-center, and not specifically conducted on menopausal women. Magnesium is therefore not an established standard therapy, but an option to discuss with your doctor, ideally after a blood test.
Does hormone therapy help with heart palpitations during menopause?
In a systematic review of 37 studies, estradiol was the only treatment that could be recommended with caution. For all other options tested, the data were insufficient to support a recommendation. Whether hormone therapy is an option is an individual medical decision.
Do coffee and alcohol make heart skips worse?
In the CRAVE study with 100 adults, daily coffee consumption led to 54% more extra heartbeats of the ventricles, but not more atrial arrhythmias. For alcohol, one study showed a significantly increased occurrence of atrial fibrillation episodes in the hours after drinking, though with a very wide margin of uncertainty. If you notice heart skips, it may be useful to reduce both for a few weeks and observe the effects.
Can a smartwatch detect atrial fibrillation?
Yes, as an indicator. In the Apple Heart Study with 419,297 participants, 0.52% received a notification of an irregular pulse. Of those who subsequently wore an ECG patch, 34% actually showed atrial fibrillation. A smartwatch is no substitute for a medical diagnosis or an ECG.
Which examinations make sense for heart skips?
An ECG and, depending on the course of symptoms, a Holter ECG (long-term ECG) are standard, as well as blood tests to rule out other causes, such as thyroid levels, hemoglobin, potassium, and magnesium. The practice will decide which examinations are necessary in your individual case based on your symptoms.
Why do palpitations often occur at night during menopause?
We have not found a robust study that explains a nocturnal increase in menopausal palpitations. It is known that hot flashes and night sweats are very common in menopause and that sleep apnea and poor sleep are considered triggers for extrasystoles. Anyone who regularly wakes up at night with a racing heart should have it evaluated by a doctor.
Does having heart skips during menopause mean my heart is sick?
Not necessarily. In the SWAN study, palpitation patterns were not associated with atherosclerosis or vascular stiffness. At the same time, the American Heart Association describes menopause as a phase of accelerated cardiovascular risk. Therefore, a one-time medical evaluation is worthwhile, even if the symptoms are usually harmless.
References & Scientific Citations
- Carpenter JS et al. – A Systematic Review of Palpitations Prevalence by Menopausal Status, Current Obstetrics and Gynecology Reports (2021)
- Carpenter JS et al. – Palpitations across the menopause transition in SWAN, Menopause 30(1):18–27 (2023)
- Sheng Y et al. – Effect of menopausal symptom treatment options on palpitations: a systematic review, Climacteric (2022)
- El Khoudary SR et al. – Menopause Transition and Cardiovascular Disease Risk, AHA Scientific Statement, Circulation (2020)
- Marcus GM et al. – CRAVE Study (Coffee and Real-Time Atrial and Ventricular Ectopy), American College of Cardiology
- Marcus GM et al. – Acute Alcohol Consumption and Discrete Atrial Fibrillation Events (ACC 2021, report on HCPLive)
- Gencer B et al. – Marine Omega-3 Fatty Acids and the Risk of Atrial Fibrillation, meta-analysis, Circulation (2021)
- De Falco CNML et al. – Successful improvement of frequency and symptoms of premature complexes after oral magnesium administration, Arq Bras Cardiol 98(6):480–487 (2012)
- De Falco CNML et al. – Late outcome of a randomized study on oral magnesium for premature complexes, Arq Bras Cardiol (2015)
- Perez MV et al. – Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation, N Engl J Med (2019)
- German Nutrition Society (DGE) – Reference Values for Magnesium
- aponet.de – Heart skips: Don't ignore these four warning signs (Prof. Dr. Thomas Meinertz, German Heart Foundation)
- Apotheke Adhoc – Cardiac arrhythmias: When to see a doctor? (Prof. Dr. Thomas Meinertz)
- Health Encyclopedia – Extrasystoles: Causes
- Dr. Eric Berg – Website (Expert perspective)
Source Transparency: The doctors, researchers, and authors mentioned are used as sources of perspective. Statements regarding diagnosis and treatment are primarily classified based on systematic reviews, meta-analyses, randomized studies, and professional societies; expert opinion, observational data, and clinical efficacy evidence are not considered equivalent. Figures have been verified against the linked pages. Individual studies (CRAVE, alcohol study) were reviewed via reports from the organizers or specialized media, rather than the full-text manuscript. As of: October 3, 2026.
