Hi Yellowflower,
like you I was very aware my heart rhythm was badly awry - could feel it in my chest, throat (made me cough) & it was easily confirmed on checking pulse in neck/wrist. I found it frankly terrifying, but it was some months before in my mid 40's I was admitted to a cardiac ward for a few days & had some of the investigations that confirmed the irregularity was down to harmless ectopics.
Because the palps started during peri when I'd already been on thyroid meds for many years, no-one was sure what was going on with me & this made the experience more frightening. As you know, heart rhythm disturbance can be related to thyroid probs or a consequence of under- or over-replacement with thyroid hormone. As I was also flushing by day, with extreme overheating at night, insomnia, weight loss & anxiety I was very afraid my long term thyroid hormone dose might be too high, which can result in such symptoms, confusing the picture at menopause & can be dangerous long term if not adjusted down.
My TFTs were within range but one unsympathetic, poorly informed GP told me in no uncertain terms that at 44, I was far too young to be in perimenopause, disregarding the fact that my mum had been postmenopause at 46. Other medics thought menopause
was likely behind my symptoms, but that no-one was sure just added to the worry.
After tests confirmed the irregularity was down to ectopics with no underlying cause found, one of the cardiologists on the ward told me I would likely have them for life, but suggested a trial of HRT, reasoning I could have many years of menopause ahead & that HRT might resolve the palpitations as well as my other meno symptoms. Still no-one was sure I was even in perimenopause, because as you'll know, sex hormone tests in peri often give little indication.
I was very afraid of HRT, given a long history of benign breast probs, my mum's death from breast cancer, my being a migraineur & knowing HRT could be difficult to balance with my thyroid meds. However, in desperation I agreed to a short trial of FemSeven in my late 40s, but this made all symptoms worse (especially the progesterone phase). The GP who put me on it knew little about HRT & thought a month on one type was long enough to prove it wouldn't help. At that time I didn't have access to MM, so didn't know it's often a case of much trial & error before finding a good fit. So I stopped & carried on without HRT for around a decade until several years postmenopause, by which time I was on my knees with symptoms showing no sign of easing.
I know well the sensation of missed beats you describe - the thing I found most unnerving was the long gap between some beats followed by an extra strong one, then a string of irregular beats when it feels as though the body's pacemaker is trying & failing to re-establish a regular rhythm. Some of the bouts of ectopics were seemingly random, though as time went on I also came to expect them at certain regular times of day. They were often worse at night when they'd wake me, after meals, after any form of activity that raised heart rate, in response to stress & in cold weather. I even had to stop swimming as the cold water sent my heart scarily haywire.
I'm so glad you're not overly bothered by yours - I think I'd have been more chilled had it not been for the worry about thyroid combined with the severity of other symptoms no-one was sure were down to menopause. I found the combination very stressful, which of course didn't help anything!
Beta blockers could be worth trying - they seem to work well for some people. I did take Propranolol for a while. It dulled the sensation of each beat but didn't right the irregularity & as it had other side effects, I stopped it after a few months with the approval of my Endocrinologist. As mentioned earlier it wasn't until I went on HRT again postmenopause that my ectopics stopped and other symptoms improved enough to make it feel worthwhile continuing.
I think your attitude is very sensible - you accept the ectopics are not harmful & you know you feel happier without HRT, which from what you say your other meno symptoms don't compel you to try.
If you haven't tried relaxation techniques to see whether that might help calm your system, those might well be worth looking into. Sorry - have to rush out for an appointment just now, so this is perhaps not worded quite as I'd wish!
Please PM me any time if it helps to compare notes further with someone who's been there & got the T shirt!