My hearts beats so hard at night,
am I having a heart attack?
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Every night, when I go to sleep,
I feel my heart beating so hard and strong
I think I’m having a heart attack.
Sometimes I even feel it during the day. I’ve told my doctor about this and he has checked my heart out with tests including an EKG, wearing a Holter monitor, and an echocardiogram. It cost me a fortune ! He found nothing wrong with me.
What causes this?
Is this a symptom of perimenopause?


A pounding, racing heart
is the second most common complaint associated with perimenopause. These palpitations scare a lot of women because of their sudden onset, unexpected arrivals, and seemingly no way to stop them. This partially accounts for the sleeping troubles during perimenopause.

It’s very important for a woman who is experiencing this symptom to report it to her doctor. This pounding can mean something other than perimenopause. Since other illnesses/diseases can present with the same palpitations it is crucial to definitely find out what is the cause. Once all other causes have been ruled out, then it can be attributed to perimenopause.

These perimenopausal palpitations are truly bothersome,
but aren’t damaging to your heart?
What cause these bouts? Researchers have yet to find the exact cause of the sudden, pounding, heartbeats. They believe, as stated in Lonnie Barbach’s book, "The Pause", palpitations and pounding are caused by the same mechanism that brings on hot flashes. Most women who have palpitations experience hot flashes at the same time. Some have described this dynamic duo as very similar to a panic attack. They find themselves with a racing heart, suddenly hot and jittery- all similar signs of a panic attack. In fact, many women who encounter this believe they are having a panic attack and report this to their doctor.

The doctor, in turn, may prescribe a tranquilizer like Paxil or Prozac. But the real reason for the sudden anxiety is not panic or fear, but an involuntary biological response to perimenopause. So these tranquilizers are probably not the best method for treating the hot flash/ pounding heart combo.

There are a couple of things you can do
when the pounding begins.
First relax and take deep breaths. Try to reassure yourself that this only a symptom of perimenopause and it will pass. If you are in bed when this occurs, change your position and do some deep breathing. Some women have found acupuncture and other homeopathic remedies to be helpful. Hormone replacement therapy is very effective in decreasing both the amount and intensity of these worrisome palpitations. Women who are having trouble sleeping or sustain many pounding spells should speak with their doctor about this effective option.

HotFlash FAQ:
How can birth control pills help symptoms of perimenopause?
There is a whole new group of BCPs like Loestrin that were created especially for women over 35 years of age.  Not only do they function to help with the often disruptive symptoms of perimenopause, they work as an effective means of birth control.  They contain just enough estrogen and progesterone to prevent pregnancies and help with perimenopause. Find out more.

Meet the author
Stephanie DeGraff Bender, MA
Author of "Power of Perimenopause"
She has been in the forefront of women's hormonal health for the last 20 years. Her work in unearthing the seemingly mysteries of PMS (premenstrual syndrome) has led to her current expertise in perimenopause. The Power of Perimenopause has sold thousands of copies and is a well respected women's health guide. Her appearances on Oprah, CBS Morning News, Donahue have left no doubt that she is a women's advocate in the best sense of the word.

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