Heart Palpitations During PMS: Normal or Not?

• Researched and written by: Dr Akshara CH, MBBS

• Edited by: Vaibhavi Kodnani

• Medical inputs by: Dr Yash Bahuguna, MBBS, MS, DNB, ISGE Certified Practitioner for PCOS

• Medically reviewed by: Dr Poonguzhali Liston, MBBS, MS OBG, FMAS, DRM, FRM, CIMP

 

TL;DR

• Heart palpitations before a period are a symptom of premenstrual syndrome (PMS).[1,2]

• They may feel like fluttering, pounding, racing, or skipped beats.

• Symptoms usually begin 1–2 weeks before the period and ease once menstrual bleeding begins.[1,2]

• Hormonal shifts and nervous system sensitivity are key drivers of premenstrual heart palpitations.[2,4]

• Breathing exercises, routine physical activities, hydration, and adequate rest can help manage this PMS symptom. 

• Heart palpitations with chest pain, fainting, or breathlessness need immediate medical care.

 

What Are Heart Palpitations and Are They Normal Before a Period?

Heart palpitations are the sensation of being unusually aware of your heartbeat. You may feel your heart racing, skipping a beat, pounding, or fluttering. They often occur during physical activity, periods of stress or with the intake of certain medicines. But you may also notice these sensations in the days before your period.

Hormonal changes during the menstrual cycle can influence how your heart feels and functions. Estrogen generally has a calming effect on heart rate, while progesterone may have the opposite effect. When progesterone levels rise and estrogen levels fall during the luteal phase, it may affect the heart rate. Some women may become more aware of these changes and notice the heartbeat more than usual.[1,2,3]

Signs and symptoms during premenstrual syndrome (PMS)

PMS-related heart palpitations usually appear in the luteal and premenstrual phase of the menstrual cycle, about 1–2 weeks before your period. They tend to occur alongside other premenstrual changes. It includes emotional and physical symptoms like mood swings, anxiety, hot flashes, dizziness, sleep disturbances, and bloating.[1,2,3]

Premenstrual heart palpitations may feel like:

• A fluttering or quivering feeling in the chest

• A sudden increase in heart rate or racing heartbeat 

• A sensation that the heart skips a beat

• Strong or pounding beats, especially when resting or lying down

• Mild chest tightness without pain

• Short episodes of breathlessness

• Increased anxiety or a sense of inner restlessness

• Fatigue or low energy

• Occasional mild dizziness

 

Premenstrual heart palpitations improve on their own once menstrual bleeding begins.

Red Flags to Seek Immediate Medical Help

Premenstrual heart palpitations are linked to hormonal changes and generally not a cause of concern. However, you should seek immediate medical attention if you experience the following symptoms in addition to palpitations:

• Chest pain, pressure, or severe discomfort

• Persistent dizziness

• Severe or persistent shortness of breath

• Persistent palpitation lasting more than a few minutes

• Fainting or feeling like passing out 

• Sudden changes in the frequency or severity of palpitations 

• Palpitations occur at unpredictable times and are not linked to the luteal or premenstrual phase of your cycle

 

These symptoms may indicate an underlying health condition. Seeing a doctor immediately can help with early diagnosis and timely care.[6]

How Common Are Palpitations During PMS?

Research suggests that PMS symptoms, including changes in the heart rate and perception of heartbeats, can occur due to normal hormonal fluctuations.[1,2] It means your heart may be functioning normally, but you become more aware of your heartbeat.

Heart palpitations during PMS are relatively common, but not widely discussed and one of the reasons could be that many women confuse PMS-related palpitations with anxiety, stress, or fatigue. One study has reported that palpitations occur in about 40.5% of women experiencing PMS symptoms, suggesting that cardiovascular-type sensations can be part of the broader emotional and physical changes that occur in the premenstrual phase.[10]

What Causes Heart Palpitations Before Your Period?

Heart palpitations in the days before your period are often linked to natural changes happening in your body during the menstrual cycle. Several factors can affect your heart rate and how strongly you feel your heartbeat during this time.

Hormonal fluctuations

Estrogen and progesterone have an effect on your heart rate. Estrogen has a calming effect and may stabilise the heart rate, while progesterone can have a stimulating effect that may increase the heart rate. 

Immediately after ovulation, as the luteal phase begins, estrogen drops and progesterone begins to rise. In the mid-luteal phase, both estrogen and progesterone levels increase as the body prepares for a possible pregnancy. If pregnancy does not occur, both hormones drop and your period begins.

These hormonal fluctuations can influence how the heart and blood vessels respond. As a result, some women may become more aware of their heart beat in the days leading up to their period.[1,2]

Changes in nervous system activity

The autonomic nervous system (ANS) of the body controls involuntary functions such as breathing, blood pressure, and heart rate. During the premenstrual phase, this system can become more active due to hormonal changes.

When this happens, your heart may beat a little faster or stronger than usual. Even if the rhythm is normal, you may feel like your heart is racing or fluttering more than usual.[2,4]

Fluid retention and electrolyte changes

Hormonal shifts before a period can also cause the body to retain fluid. At the same time, there may be small changes in minerals like magnesium and potassium, which help maintain a normal heart rhythm.

When these levels change slightly, some women may notice sensations such as fluttering or a brief irregular heartbeat.[4]

Can Anything Worsen Hormonal Palpitations?

If you experience heart palpitations before your period, certain everyday habits can make them feel stronger or happen more often. Being aware of these triggers can help you manage symptoms more comfortably.

Caffeine

Coffee, tea, and energy drinks are high in caffeine, which may stimulate the heart and nervous system. It can make your heart beat faster and make palpitations more noticeable, especially during the sensitive premenstrual phase.[1]

Stress and anxiety

Many women experience mood changes during PMS. Feeling stressed, anxious, or emotionally overwhelmed can trigger the release of stress hormones such as adrenaline.

These hormones can temporarily increase heart rate and make heart palpitations more noticeable. This is one reason palpitations can sometimes happen during moments of stress before your period.[2]

Dehydration

Not drinking enough fluids can affect circulation and the balance of important minerals in the body. This can sometimes make the heart more sensitive and increase the sensation of palpitations.[3]

Poor sleep and fatigue

Sleep problems such as insomnia or night sweats can also happen during PMS. When you are tired or sleep-deprived, your body may produce more stress hormones like cortisol, which can influence the heart rate and nervous system activity.

This can make you more aware of your heartbeat or increase the chance of experiencing heart palpitations during the premenstrual phase of the menstrual cycle.[2,3,5]

Smoking

Nicotine in cigarettes or other similar products has an effect on the cardiovascular system. It can affect the signals that control your heartbeat, which may trigger or worsen palpitations.[4]

Alcohol

Alcohol can disrupt normal heart rhythm and also interfere with sleep, both of which may increase the likelihood of experiencing palpitations.[5]

High salt intake

Eating large amounts of salt can increase fluid retention, a common premenstrual symptom. This may contribute to changes in circulation that make palpitations more noticeable.[3]

Is It Possible to Stop Heart Palpitations Immediately?

If your heart suddenly feels like it’s fluttering, racing, or pounding before your period, the first step is to help your body relax. Hormonal palpitations often improve once the nervous system calms down.

Here are a few things you can try right away.

Sit in a quiet space

If you are in a busy or stressful environment, try to step away and sit in a calm and peaceful space for a few minutes. Reducing stimulation can help the nervous system settle and may make the heartbeat feel less intense.

Sip some water

Mild dehydration can sometimes make palpitations feel worse, and restoring fluid balance may help the body stabilise them. While you’re seated, slowly drink a few sips of water. Remember not to gulp it too quickly as that can put strain on your heart.[3]

Try the physiological sigh

The physiological sigh is a breathing technique that emphasises two-breath inhalation followed by a longer exhalation. It can help calm the nervous system and reduce the body’s stress response.[7,8,9]

Here’s a step-by-step guide: 

Sit down comfortably and focus on your breathing.

• Take a deep breath in through your nose.

• Take a second short inhale through your nose to fully fill your lungs.

• Slowly exhale through your mouth.

 

Repeat this 3–5 times.

Important: If palpitations last longer than several minutes, happen very frequently, or occur with symptoms like chest pain, fainting, or severe dizziness, it’s important to seek medical advice.[6]

Berry’s Tips: How to Manage Heart Palpitations Before Your Period

Supporting your nervous system and heart health consistently throughout the month are key to managing heart palpitations before the period. Simple steps like daily relaxation, consistent sleep schedule, proper hydration, and routine exercise can help. 

Practice relaxation techniques

Doing 10-15 minutes of calming activities everyday may help lower stress levels and improve heart rate regulation over time.[2,3]

While there are various relaxation techniques, here are a few helpful ones you can begin with:

Practice box breathing for a few minutes 

Sit comfortably and breathe in through your nose for 4 seconds, hold for 4 seconds, and breathe out slowly through your mouth for 4 seconds. Pause for 4 seconds before the next breath. This steady breathing pattern can help calm the nervous system and regulate heart rate.[8]

Do 5–10 minutes of gentle movement

Try poses that gently stretch and relax the abdomen, hips, and lower back, such as:

• Cat–Cow pose (Marjaryasana–Bitilasana)

• Child’s pose (Balasana)

• Downward-facing dog (Adho Mukha Svanasana)

• Plank pose (Phalakasana)

• Cobra pose (Bhujangasana)

• Relaxation pose (Savasana)

 

Hold each pose comfortably without straining. Focus on slow, deep breaths while moving.

Yoga programs studied for PMS typically involve sessions of about 40–60 minutes practiced around 3 times per week.[11,12,13]

Add a short relaxation practice

Meditation, progressive muscle relaxation, or mindfulness can help regulate the nervous system. Here’s how you can put it into practice:

• How to meditate: Sit in a comfortable spot, close your eyes, and focus on your breathing. 

• How to practice progressive muscle relaxation: Lie down on your back and close your eyes. Tense and relax every muscle starting from feet all the way to the head. 

• How to practice mindfulness: Simply sit quietly for a few minutes and observe your thoughts or surroundings. 

 

Stay well hydrated

Not drinking enough water can affect circulation and electrolyte balance, which may make palpitations feel worse. Aim for around 2–2.5 litres of water per day, and consider increasing your intake slightly in the week before your period. Try to limit sugary drinks and excess caffeine, as they can contribute to fluid loss and make you dehydrated.[4]

Reduce caffeine and stimulants like nicotine

Caffeine can stimulate your heart and nervous system, which may worsen palpitations for some women before their period. One study found that women who drank more than five cups of coffee a day had a higher chance of premenstrual symptoms such as anxiety and mood changes. Other research also notes that while coffee may not explain all PMS symptoms, it can still influence anxiety and mood.

Because anxiety can trigger or worsen palpitations, reducing caffeine may help some women notice fewer symptoms during the premenstrual phase. As a guide, 200 mg of caffeine is roughly equal to about 1–2 cups of coffee or around 2–3 cups of Indian chai. It is also helpful to avoid nicotine, as it can affect heart rhythm and circulation.[3,6,14,15]

Prioritise sleep

Sleep plays an important role in regulating stress hormones and heart activity. Poor sleep can make the body more reactive and increase awareness of heartbeats. 

A good sleep routine is essential. You can consider the following tips to ensure good quality sleep every night: 

• Maintain a consistent sleep wake schedule, aim for 7–9 hours of sleep each night.[16]

• Try to avoid caffeine at least 6 hours before bedtime 

• limit screen use about 1 hour before sleep, as blue light can delay the release of sleep hormones and make it harder to fall asleep.

• Create a relaxing bedtime routine like journaling, reading, or taking a warm shower.[5]

 

Engage in regular exercise

Regular physical activity helps support hormonal balance, circulation, and stress management. Activities such as brisk walking, cycling, swimming, or Yoga can be particularly helpful. Aim for about 30 minutes of moderate activity most days of the week. If any workout feels intense and triggers uncomfortable palpitations, switch to gentler forms of exercise instead.[2]

Eat magnesium-rich foods

Low magnesium levels may contribute to palpitations and may worsen some premenstrual syndrome (PMS) symptoms. Magnesium supports nerve signaling, muscle relaxation, and mood-related neurotransmitters, which is why low levels may be linked to symptoms such as:

• Irritability and mood swings

• Anxiety or nervous tension

• Fatigue

• Headaches

• Breast tenderness

• Muscle cramps

• Sleep disturbances

 

Some studies suggest that magnesium supplementation may reduce overall PMS symptom severity. When combined with vitamin B6, the effect may be stronger because vitamin B6 helps regulate neurotransmitters such as serotonin and dopamine that influence mood. Together, magnesium and vitamin B6 may help reduce irritability, anxiety, and mood changes associated with PMS.[17]

Magnesium-rich foods and recommended intake

Magnesium-rich foods include:

• Leafy greens (spinach, amaranth)

• Pumpkin seeds

• Sesame seeds (til)

• Almonds

• Cashews

• Peanuts

• Lentils and chickpeas

• Rajma or black beans

 

Including a variety of these foods regularly can help maintain healthy magnesium levels and support nerve, muscle, and heart function. According to the Indian Council of Medical Research Nutrient Requirements for Indians (2020), the recommended dietary allowance for magnesium is about 370 mg per day for adult women and around 440 mg per day during pregnancy.[18]

Disclaimer: Some evidence suggests magnesium supplements may help improve PMS symptoms and support overall health. However, they are not a guaranteed treatment for heart palpitations specifically. Always consult your doctor before starting any supplement, especially if palpitations are frequent or severe.

When to See a Doctor?

Occasional heart palpitations around your period are often linked to normal hormonal fluctuations. However, it’s important to check in with your doctor if the symptoms feel concerning or interfere with your daily life.

You should consider medical advice if:

• Your symptoms do not improve with simple relief strategies or lifestyle changes

• Your palpitations are severe or worsening with time

• You experience discomfort at any time during the month, not necessarily just before your period

• Your daily activities or sleep is getting affected 

• Your symptoms are causing ongoing anxiety, worry, or fear

• You have red flag symptoms along with your palpitations like severe chest pain, shortness of breath, or fainting 

 

Talking to your doctor can help provide reassurance and rule out other possible causes. During the appointment, the provider may ask about the timing of your palpitations during your cycle, associated symptoms, lifestyle habits, and medications. 

If needed, your doctor may recommend tests to understand the cause of palpitations. This may include checking your heart rhythm with an electrocardiogram (ECG) or heart monitor, and blood tests to measure nutrient levels such as iron or magnesium and evaluate hormone patterns.

Your doctor may also ask about your sleep habits, stress levels, and menstrual cycle patterns to see whether symptoms are linked to PMS or lifestyle factors. The information can help understand whether your palpitations are related to your cycle or caused by another underlying condition. In either case, your doctor can guide you through the right treatment options and management strategies. 

The Bottom Line

Heart palpitations are a PMS symptom. They are usually caused by hormonal shifts and increased nervous system sensitivity during the luteal and premenstrual phases of the menstrual cycle. Understanding your patterns, supporting your nervous system, and making targeted lifestyle changes can significantly reduce symptoms. 

If your heart palpitations are severe, persistent throughout the month, or occur along with other red flag symptoms like chest pain or fainting, it’s best to see a doctor. Getting professional advice can help you understand what’s happening in your body and find the best way to manage it.

FAQs on Heart Palpitations Before Period

Are heart palpitations during PMS normal?

Yes, many women experience heart palpitations before their period. It happens due to estrogen and progesterone changes affecting the heart rate and nervous system.

Can PMS palpitations feel like anxiety or panic?

It’s possible. PMS-related palpitations can feel similar to anxiety or panic. In fact, the two are closely related. Anxiety can trigger or worsen palpitations before a period, which may make them more noticeable. 

How long do PMS palpitations last?

Heart palpitations before a period usually last a few seconds to a few minutes and often improve once your period begins.

Do PMS palpitations harm the heart?

No. Premenstrual palpitations are generally related to normal hormonal fluctuations. They are usually harmless and do not damage the heart. 

When should I seek medical care?

Seek medical advice if heart palpitations occur with chest pain, fainting, or shortness of breath. 

References

1. Schmalenberger KM, Eisenlohr-Moul TA, Jarczok MN, Eckstein M, Schneider E, Brenner IG, Duffy K, Schweizer S, Kiesner J, Thayer JF, Ditzen B. Menstrual cycle changes in vagally-mediated heart rate variability are associated with progesterone: evidence from two within-person studies. Journal of clinical medicine. 2020 Feb 25;9(3):617.

2. Rode MV, Kamble P, Phatak MS, Jadhao P, Tayde P. Effect of premenstrual stress on autonomic function. Annals of neurosciences. 2010 Jul;17(3):131.

3. Royal College of Obstetricians and Gynaecologists. Managing premenstrual syndrome (PMS). Accessed February 8, 2026.

4. Schmalenberger KM, Eisenlohr-Moul TA, Würth L, Schneider E, Thayer JF, Ditzen B, Jarczok MN. A systematic review and meta-analysis of within-person changes in cardiac vagal activity across the menstrual cycle: implications for female health and future studies. Journal of clinical medicine. 2019 Nov 12;8(11):1946.

5. Keeler ER, Morris Jr RK, Patolia DS, Toy EC. The evaluation and management of palpitations. Primary care update for ob/gyns. 2002 Nov 1;9(6):199-205.

6. Schmalenberger KM, Eisenlohr-Moul TA, Jarczok MN, Schneider E, Barone JC, Thayer JF, Ditzen B. Associations of luteal phase changes in vagally mediated heart rate variability with premenstrual emotional changes. BMC Women's Health. 2024 Aug 8;24(1):448.

7. Kromenacker BW, Sanova AA, Marcus FI, Allen JJ, Lane RD. Vagal mediation of low-frequency heart rate variability during slow yogic breathing. Biopsychosocial Science and Medicine. 2018 Jul 1;80(6):581-7.

8. Li C, Chang Q, Zhang J, Chai W. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension. Medicine. 2018 May 1;97(18):e0639.

9. Balban MY, Neri E, Kogon MM, Weed L, Nouriani B, Jo B, Holl G, Zeitzer JM, Spiegel D, Huberman AD. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine. 2023 Jan 17;4(1).

10. Raja AS, Venguidesvarane AG, Thangasamy KT. The Prevalence and Symptom Profile of Premenstrual Syndrome Among Medical Students in a South Indian Medical College: A Cross-Sectional Study. Cureus. 2025 Dec 11;17(12).

11. Vaghela N, Mishra D, Sheth M, Dani VB. To compare the effects of aerobic exercise and yoga on Premenstrual syndrome. Journal of education and health promotion. 2019 Aug 1;8(1):199.

12. Kamalifard M, Yavari A, Asghari-Jafarabadi M, Ghaffarilaleh G, Kasb-Khah A. The effect of yoga on women’s premenstrual syndrome: A randomized controlled clinical trial. International Journal of Women's Health and Reproduction Sciences. 2017 Jul 1;5(3):205-11

13. Tsai SY. Effect of yoga exercise on premenstrual symptoms among female employees in Taiwan. International journal of environmental research and public health. 2016 Jul;13(7):721.

14. AlQuaiz A, Albugami M, Kazi A, Alshobaili F, Habib F, Gold EB. Dietary, psychological and lifestyle factors associated with premenstrual symptoms. International Journal of Women's Health. 2022 Dec 31:1709-22.

15. U.S. Food & Drug Administration. Spilling the Beans: How Much Caffeine is Too Much? Accessed February 8, 2026.

16. Watson NF, Badr MS, Belenky G, Bliwise DL. Buxton. OM, Buysee, D.,… & Tasali, E.(2015). Recommended amount of sleep for a healthy adult: A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep.;38(6):843-4.

17. Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iranian journal of nursing and midwifery research. 2010 Dec;15(Suppl1):401.

18. Indian Council of Medical Research. Nutrient Requirements and Recommended Dietary Allowances for Indians. Accessed February 8, 2026.