Up to 54% of perimenopausal women experience heart palpitations — the skips, flutters, and racing pulses that arrive without warning and produce some of the most acute anxiety of the entire hormonal transition. For most women, the EKG is completely normal. But the symptom is real, and so is the mechanism: estrogen has receptors inside the heart's electrical conduction system. When it fluctuates in perimenopause, the electrical system misfires. Here's the full science — and th