Palpitations Before Menstruation: Causes and Solutions - Cardiology

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Palpitations are commonly experienced before menstruation?


I am a person who tends to worry and feel anxious.
Since receiving my second dose of the BNT vaccine on December 22, I have experienced palpitations before my menstrual period.
Sometimes my heart feels like it suddenly stops, or it beats very fast.
The day after the second dose, I felt discomfort in my heart and, due to excessive anxiety and hyperventilation, I went to see a doctor.
After drawing blood, the doctor said everything was fine, and I went home.
The next day, I experienced chest tightness and shortness of breath, so I went to the emergency room again.
They drew blood once more, and after the tests, there were no significant issues.
The doctor suggested that if I was still concerned, I could be admitted for observation.
I stayed there for about 3 to 4 days, during which I had a total of four blood draws and an electrocardiogram.
Aside from mild mitral valve prolapse, there were no major problems.
The doctor prescribed medication for my palpitations, which has indeed helped a lot.
However, I still experience palpitations in the week leading up to my period.
Today, on January 28, I visited a gynecologist who performed a pelvic ultrasound, and everything was normal.
The doctor mentioned that having only palpitations does not seem typical of premenstrual syndrome and suggested that it might just be a coincidence.
They recommended that I see a cardiologist for further evaluation, but since I had previous tests that showed no issues, the doctor questioned whether I should go to a cardiologist again.

Xiao Ya, 10~19 year old female. Ask Date: 2022/01/28

Dr. He Dongjin reply Cardiology


Hello, it is not uncommon to experience palpitations before menstruation due to hormonal changes.
Since you have previously been hospitalized and tested without any issues, and considering your young age, the likelihood of a problem is low.
It is advisable to monitor the situation for now.
Changhua Hospital cares about you.

Reply Date: 2022/01/28

More Info


Palpitations before menstruation can be a concerning experience, especially for individuals who are already predisposed to anxiety. In your case, it seems that the onset of palpitations coincided with your second dose of the BNT vaccine, which may have heightened your awareness of bodily sensations, particularly if you are already anxious.
Palpitations are defined as the sensation of having a fast-beating, fluttering, or pounding heart. They can occur for various reasons, and understanding these causes can help alleviate concerns. Common causes of palpitations include anxiety, stress, hormonal changes, caffeine intake, and certain medications. In your situation, the timing of your palpitations with your menstrual cycle suggests that hormonal fluctuations could be a contributing factor.
Premenstrual syndrome (PMS) can lead to a variety of symptoms, including mood swings, anxiety, and physical symptoms such as bloating and breast tenderness. While your doctor mentioned that your symptoms do not align perfectly with PMS, it is important to note that hormonal changes can still influence heart rhythm and anxiety levels, potentially leading to palpitations.

The fact that you have undergone multiple tests, including blood tests and an electrocardiogram (ECG), and that these have returned normal results is reassuring. The mild mitral valve prolapse you mentioned is a common condition and is often benign, meaning it typically does not lead to serious health issues. However, it can sometimes be associated with palpitations, particularly in individuals who are more sensitive to changes in their body.

Your experience of feeling your heart "stop" or racing can be alarming, especially when accompanied by chest discomfort and shortness of breath. These symptoms can be exacerbated by anxiety, which can lead to hyperventilation and further feelings of discomfort. It is essential to manage anxiety through relaxation techniques, mindfulness, or cognitive behavioral therapy, which can help reduce the frequency and intensity of palpitations.

Given that your gynecologist has ruled out any significant issues with your reproductive health, and considering your previous cardiac evaluations were normal, it may be beneficial to follow up with a cardiologist for further reassurance. They may suggest additional tests, such as a Holter monitor, which records your heart's activity over 24 hours or longer, to capture any palpitations that occur during your daily activities.

In summary, while palpitations can be distressing, they are often benign, especially when associated with anxiety and hormonal changes. It is crucial to continue monitoring your symptoms and maintain open communication with your healthcare providers. If your palpitations persist or worsen, seeking further evaluation from a cardiologist may provide additional peace of mind and help you explore management strategies tailored to your situation.

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