I’ve had your menopause palpitations on my mind this week. According to new research that arrived in my in-box last week, menopause palpitations are more common than women think. [Carpenter, Sheng, et al, 2022].
As the authors noted, ‘compared with the abundance and breadth of research on menopausal vasomotor symptoms (hot flushes) and sleep, there is a relative scarcity of research on menopausal palpitations. However, up to 42% of perimenopausal women and 54% of post-menopausal women report having palpitations.’
Although 44%–87% of women aged 40–59 years living in America believed their palpitations required treatment, a systematic review found no Level 1 evidence for managing menopause palpitations. This and other evidence suggests palpitations in peri- and post-menopausal women are common yet relatively understudied in comparison to Vasomotor Symptoms (Hot Flushes).
As such, the authors contend that, like other symptoms, they may be normalized and/or trivialized, as they have mostly been attributed to psychosomatic (e.g. anxiety, stress) determinants, rather than cardiac causes. (Carpenter et al, 2022).
This is a shame, because when it comes to menopause-related palpitations, (yes, you need to get your Doctor to check them out), there is something that the Sports Medicine doctors might not be sharing with the menopause Doctors …. and that is, that when women are low in iron, or over-training with all the exercise they are doing, this can lead to palpitations too.
So too does low body fat, inadequate calorie intake (how much fasting are you doing?), lack of sleep and of course, the inevitable stress, anxiety and inflammation that is known to arrive during peri-menopause. Afterall, this life-stage is now known to be a period (excuse the pun) when women are most at risk for systemic (all around the body), inflammatory changes occurring. (McCarthy & Raval, 2020).
Whether you are experiencing menopause-related palpitations or not, then it’s also important to have some focus on your anxiety levels. Yes, HRT can help (talk to your Doctor about this), but research also indicates that a specific type of rhythmic, slow breathing may help to claim back calm, remove the chaos in your mind and reduce your heart rate when ‘life’ and menopause-related anxiety and/or palpitations distract you.
Menopausal palpitations are described as loud, racing, or skipped heart beats, flip-flops, fluttering, or pounding that occurs with or without dizziness and/or lightheadness. They are associated with demographic, clinical, symptom, and quality of life (QOL) factors states a report released in 2020 by the Journal of Women’s Health (Carpenter, Tisdale et al, 2020).
If this is you, then first and foremost, get to your Doctor for a check-up. Ask for Vitamin D, calcium, magnesium, potassium and of course, B12 and iron levels. All of these nutrients are important for your cardiac health as you move through menopause and I’ve written about this HERE.
The other thing to do is to practice slowing down your breathing – especially if you are someone who has a lot on your plate and your ‘to-do’ jobs are endless!
6-10 breaths per minute and diaphragmatic breathing is best. I describe how to do this below. I just wish that I knew to do this type of breathing when I was feeling anxious and overwhelmed at work and was experiencing palpitations. Yoga helps, so does meditation, but if you aren’t one for these activities, then perhaps you can consciously slow down your breathing with some swimming or just take a few minutes daily to do the breathing sequence below.
The Physiological Effects of Slow Breathing on your Anxiety and Cardiovascular System as you Age
If you’ve got a lot going on in your life, have you ever given the rate of your breathing a thought? No, I never used to either.
Slowing down the rate of our breathing is an important tool for managing menopause symptoms such as anxiety and palpitations. Health and longevity research on HOW to change physiological parameters such as blood pressure, heart rate and anxiety with improved breathing practices has only emerged in past decade. This is despite the fact that the act of controlling one’s breathing for the purpose of restoring or enhancing one’s health, has been practiced for thousands of years in Eastern cultures.
Slower breathing allows your heart rate to decrease as well as your blood pressure. This is important if your stress levels are high at work or at home, especially in light of all the changes you’ve had to cope with over the past couple of years with the pandemic and if you’re experiencing challenges with long-covid syndrome.
The type of breathing I’m talking about is known as ‘autonomically optimised respiration’. This term refers to the rate of breathing that has a beneficial effect on:
- the lowering of heart rate,
- the lowering of blood pressure and
- reduced stomach vagal tone – this refers to the anxiety we often feel in our stomach when we are stressed).
To achieve these positive benefits, we need to slow down our rate of breathing to 6-10 breaths per minute, with an increased tidal volume (inspiratory and expiratory capacity) achieved by diaphragmatic activation.
Nasal breathing is also considered an important component of optimised respiration for health. [Russo, Santerelli & O’Rourke, 2017].
It’s important for women going through menopause and into their post-menopause years to understand that their lungs are ageing and therefore, becoming less efficient. This can be problematic, because the biomechanics of lung ventilation are carefully co-ordinated with blood oxygen, carbon dioxide and pH homeostasis (balance). How we breathe not only reduces anxiety, blood pressure and palpitations, but also has an effect on our moods and hot flushes too. And the slower we breathe, the better.
In fact, 6-10 breaths per minute has the most effect on slowing your heart rate and lowering your blood pressure. (Russo et at, 2017).
If you are feeling anxious, whether at work or not, then please take note of the strategy of slow breathing, including alternate nostril breathing. It’s been a busy, anxious year for many of you, and if you understand that your menopause transition is also a time whereby your lungs and nerves are changing, then you can use this strategy to feel calmer.
If you feel busy, time-poor, over-whelmed, over-weight and you experience, depression, anxiety, dizziness or cardiac palpitations (yes please, get these checked out), then can I motivate you to focus on controlled slow breathing at a rate of 6-10 breaths per minute? I want you to re-learn how to breathe.
Diaphragmatic breathing is best. Whilst I teach women how to do this on my 12 week MyMT™ programmes, there are also incredible coaches who are trained as Breathing Practitioners now. If you can, find one in your area for some hands-on lessons.
The beauty about knowing that the research has defined ‘effective’ breathing which has physiological benefits for our health, as a rate of 6-10 breaths per minute is ‘gold’.
Because even if you only manage a few minutes at the end of the day lying quietly on the floor or in bed, closing your eyes and concentrate on pulling your abdominal muscles in when you exhale and allowing them to expand when you inhale and slowing down your rate of breathing as much as you can, you will be on your way to reducing anxiety, heart-rate, blood pressure and yes, reducing your belly fat too.
How Do the MyMT™ Programmes Work?
From a biological point of view our menopause transition means that the reproductive hormones, oestrogen and progesterone, are declining as part of our ageing. We all know that puberty is the period when oestrogen and progesterone first arrive, so in effect menopause is the opposite or the book-end to puberty.
As I mention in my online Masterclass on Menopause, your menopause symptoms are your body attempting to compensate for the changing balance between your hormones. Sometimes, those same hormones end up fighting each other instead of adjusting. But every one of your symptoms is reversible if you change your lifestyle and allow your body to adapt to its ‘new normal.’
This is what MyMT™ teaches you – all the scientifically evidenced step-by-step lifestyle strategies which help you to understand how to work with your changing hormones in menopause and post-menopause, not against them.
I have two main programmes – one focused on reducing the severity of menopause symptoms called Circuit Breaker and the other on stopping and then reducing uncontrolled menopause weight gain called Transform Me. When you have time, my video below explains how each programme works.
Carpenter JS, Sheng Y, Pike C, Elomba CD, Alwine JS, Chen CX, Tisdale JE. (2022). Correlates of palpitations during menopause: A scoping review. Womens Health (Lond). 18:17455057221112267.
Carpenter, J. S., Tisdale, J. E., Chen, C. X., Kovacs, R., Larson, J. C., Guthrie, K. A., Ensrud, K. E., Newton, K. M., & LaCroix, A. Z. (2021). A Menopause Strategies-Finding Lasting Answers for Symptoms and Health (MsFLASH) Investigation of Self-Reported Menopausal Palpitation Distress. Journal of women’s health, 30(4), 533–538. https://doi.org/10.1089/jwh.2020.8586
Harvard Health Publishing (2018). Breathing life into your lungs. Online Version.https://www.health.harvard.edu/lung-health-and-disease/breathing-life-into-your-lungs.
Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei, G. X., & Li, Y. F. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in psychology, 8, 874. https://doi.org/10.3389/fpsyg.2017.00874
Romieu, I. (2005). Nutrition and Lung Health. Int. J. of Tuberc Lung Dis. 9(4), 362–374.
Russo, M., Santarelli, D. & O’Rourke, D. (2017). The physiological effects of slow breathing in the healthy human. Breathe, 13, 298-309.