What those affected can really doIs your heart racing or stumbling? Why things get out of sync during menopause

“I don't recognize myself at all anymore”

My patient, 49 years old, sits in front of me in complete despair. Tears stream down her face and she sobs. “I don't recognize myself at all anymore. I don't know what else to do.” She has been on sick leave for a few weeks now. It all started at work. Out of nowhere, she suddenly felt her heart start to race. At times it almost felt as if it would stop for a moment, she says.

My patient's hands were sweaty and shaky. A feeling of panic rose within her. She went out for some fresh air and waited for the haunting to stop. He did that after a while, but the shock was still in her bones hours later.

Her family doctor wrote an EKG in the afternoon. There were no abnormalities. Maybe she just needs some rest, the doctor explained sensitively. My patient thought that was entirely possible. The last few weeks had been stressful. In addition, she had been sleeping very poorly for several months and lay awake for hours. She decided to take things a little slower from now on.

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A normal everyday life is no longer possible

A few days later, when she was lying in bed reading a book in the evening, it happened again: her heart was pounding restlessly in her chest. She tried to calm herself down, but was barely able to do so. The next day, her family doctor referred her to a cardiologist, who performed a cardiac ultrasound, a long-term ECG and a stress ECG. Apart from a few small and irregular extra beats, also known as extrasystoles, everything is fine. She is “heart healthy”. My patient's reassurance only lasted for a short time because her heart kept getting out of rhythm. A normal everyday life was no longer possible. Now everything she did was accompanied by the fear that an “attack,” as she called it, might occur. Her family doctor wrote her off sick, but she didn't feel any better. Now she is sitting in front of me in my consulting room and is surprised that I am not at all surprised by what she is telling me.

A hormone status creates clarity

I first ask her about her cycle. It had changed a lot in the last year. She hadn't had any bleeding at all in the past two months. “I’m probably going through menopause,” she says. “That’s the right word!” I replied. After a thorough gynecological examination, we take blood to perform a hormone analysis. After a few days we have the result: My patient's estrogen level, more precisely the 17-ß-estradiol, is reduced. The hormone progesterone is no longer detectable in your blood.

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The influence of the hormone estradiol on the heart

So my patient was actually in menopause, perimenopause. What I had already suspected based on the symptoms and my cycle history could now be confirmed with a hormone analysis. “Somehow it didn't even occur to me that I was going through menopause, I don't have any hot flashes! And what does menopause have to do with my heart?” she asks me. I'll explain it to her.

Many people still believe that the main symptom of perimenopause is classic sweating. Unfortunately, many of my colleagues do not realize that the symptoms are much more colorful. During the change, headaches, joint and muscle pain, concentration and memory problems, dizziness, sleep disorders, etc. can occur – and cardiac arrhythmias. Around 40 percent of all women between the ages of 45 and 54 suffer from palpitations and/or palpitations.

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Hormonal fluctuations are typical of menopause

Estradiol is a very important hormone for cardiovascular health. Among other things, it ensures that the blood vessels relax and blood pressure drops. If the hormone level falls, the vessels narrow. Hormonal fluctuations are typical for menopause, which cause the coronary arteries to change between widening and narrowing. Many women notice this as a palpitating or fluttering heart and are understandably very worried.

Although this form of heart palpitations is harmless, it is very important to have the symptoms clarified by a cardiologist and to rule out serious heart disease.

And that really helps!

My patient seems very relieved. She is happy to have finally found a cause for her problems. We talk about what she should pay attention to now to relieve her symptoms.

You should:

• don't drink too much coffee

• also avoid nicotine and alcohol

• Make sure you get enough rest and keep stress levels low

• Regularly incorporate exercise and sports sessions into your everyday life

• rely on a healthy diet

I also inform you about the possibility of bioidentical hormone replacement therapy. Here, the missing hormones are replaced with natural, i.e. the body's own, hormones. My patient decides immediately that she wants to start doing this. I therefore prescribe her an estradiol gel, which she applies to her forearm in the morning, and progesterone capsules, which she takes in the evening before going to bed. When she came to me for a check-up a few weeks later, she was symptom-free. The racing heart and stumbling as well as the sleep disorders are no longer present.