Ultimately, these mixed results highlight the need for more research on menopausal palpitations and what might lead some women to experience them.
It isn’t clear why heart palpitations in perimenopausal or menopausal women are understudied and unrecognized compared with other menopausal symptoms, says Carpenter.
“It could partly be due to the fact that there’s been a historic bias against women in cardiology,” she says.
“There has been a historical and illustriously documented bias against women in cardiology, with poor understanding and trivialization of heart symptoms, including palpitations, that results in missed or delayed diagnosis of serious cardiac events,” says Parwani.
At the same time, symptoms of menopause have often been trivialized as “no big deal,” Carpenter says.
“Heart palpitations are at the intersection of these two things. If people have been attributing the palpitations to menopause, there may be a general feeling that these will probably go away, don’t worry about it,” she says.
Another reason that heart palpitations may not be recognized is that some previous research has grouped heart palpitations as part of a hot flash and not its own symptom, says Carpenter.
“There are some studies that define hot flashes in terms of heat, sweating, and heart racing or pounding, suggesting that palpitations occur at the same time as the hot flashes,” she says. “However, when I talk to women, these palpitations are often separate from the hot flashes. They’re feeling these when they lie down at night or in the middle of the day — sort of odd times that aren’t related to the hot flashes.”
This suggests that palpitations are a symptom separate from hot flashes, she says.