Why your resting heart rate rises in perimenopause

Resting heart rate is how many times your heart beats per minute when you are still and calm. Most wearables estimate it from your quietest periods, usually overnight. It is one of the more stable numbers a device produces, which is why a steady climb over weeks tends to mean something, even when a single high night does not.

The rate is set largely by your autonomic nervous system, the part of you that runs in the background without instruction. It has two sides, one that speeds the heart up and one that slows it down. Resting heart rate reflects the balance between them.

Oestrogen does more than regulate your cycle. It has a hand in how blood vessels relax and how the autonomic nervous system holds its balance. As oestrogen declines and fluctuates through perimenopause, that balance tips, often towards the side that raises heart rate. Reviews of cardiac autonomic function in perimenopausal and postmenopausal women describe exactly this shift, and link it to the rise in cardiovascular risk that follows menopause.

So a resting heart rate that drifts up by a few beats over a year is not a fault in your tracker. It is often the visible edge of a real physiological change.

One night proves very little. Alcohol the evening before, a late meal, a warm room, a hard workout, a cold coming on, a stressful day, all of these lift resting heart rate for a night or two and then let it settle. If you look at a single reading you will worry for no reason. If you look at the trend across several weeks, you can see the signal underneath the noise.

That is the difference between watching a number and understanding it. A tracker gives you the number. What you want is the pattern, and what the pattern means for you at this stage of life.

Many women also notice palpitations in perimenopause, a fluttering, pounding, or skipped-beat feeling, often alongside hot flushes or in the evening. These are common and usually harmless, but they are not something to read a graph about and dismiss.

Please speak to your GP if your resting heart rate climbs sharply and stays high, if palpitations come with chest pain, breathlessness, dizziness, or fainting, or if you simply feel that something is wrong. A raised resting heart rate has causes beyond hormones, including thyroid changes, anaemia, and others, and those are worth ruling out. anna does not diagnose, and this article is not medical advice. It is here to help you understand what your body is showing, so you can bring a clearer picture to someone who can.