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Dr Emily Watters
GP 👩🏼‍⚕️ Perimenopause & Menopause
Founder of Pause Lumiere, F2F & đź“ž
Helping women navigate the Pauses with better health than when they started ✨

Palpitations are one of the most commonly reported symptoms in perimenopause — and often one of the most concerning.They...
04/05/2026

Palpitations are one of the most commonly reported symptoms in perimenopause — and often one of the most concerning.

They can feel like:
– a racing heart
– skipped or irregular beats
– a sudden “thump” in the chest
– or brief episodes of fluttering

In many cases, these are benign — but they should never be dismissed without appropriate assessment.

During perimenopause, fluctuating oestrogen levels affect the autonomic nervous system (fight/flight) and the heart’s electrical signalling. This can increase sensitivity to adrenaline and alter heart rhythm.

Other contributing factors are common at the same time:
– sleep disruption
– increased anxiety or hypervigilance
– caffeine or alcohol intake
– iron deficiency
– thyroid dysfunction

For many women, palpitations cluster at night or during periods of rest — when there are fewer distractions and internal sensations are more noticeable.

Importantly:
– most palpitations in this context are not dangerous
– a baseline assessment is essential

Management depends on the underlying driver, but may involve:
– addressing sleep and stress
– reducing stimulants
– correcting deficiencies
– hormone driven palpitations will often cease in response to menopausal hormone therapy

If you’d like to understand what’s driving your symptoms, and how to manage them safely and effectively, we can help. Visit Pause Lumiere - we can’t wait to meet you! ❤️

Ever feel your heart skip a beat? Or start acting like you just ran a 10km when you were sitting on the couch 🤔 there ar...
23/04/2026

Ever feel your heart skip a beat? Or start acting like you just ran a 10km when you were sitting on the couch 🤔 there are reasons why!

Estrogen and your heart are buddies. Everyone can struggle when they lose their buddy!
15/04/2026

Estrogen and your heart are buddies. Everyone can struggle when they lose their buddy!

This is one of the most common cognitive changes women notice during perimenopause.It can feel subtle at first — word-fi...
13/04/2026

This is one of the most common cognitive changes women notice during perimenopause.

It can feel subtle at first — word-finding difficulty, losing your train of thought, reduced concentration — and for many women, it’s deeply unsettling.

Importantly, this is not usually a sign of cognitive decline into dementia in your 40s!

During perimenopause, fluctuating estrogen affects key brain systems involved in memory, attention, and processing speed. Estrogen supports synaptic plasticity, neurotransmitter signalling, and how the brain produces and uses energy.

As levels become more variable, these systems become less efficient — particularly in areas such as the hippocampus and prefrontal cortex, important areas for memory and general function!

Sleep disruption and increased stress reactivity can further impair attention and memory consolidation, amplifying these symptoms.

And while there is a lot we can do to improve general brain function, NOTHING can take you out of perimenopause!

If you’d like to understand what’s happening in your brain — and how to support it — Pause Lumiere can help!

07/04/2026

Estrogen is throughout the brain, and this really shows up for many women in Perimenopause. If you’re struggling with mood or cognitive symptoms, Pause Lumiere can help. We can’t wait to meet you!

Dementia is a frightening and often emotionally charged prospect for many people, as we usually know someone who suffere...
31/03/2026

Dementia is a frightening and often emotionally charged prospect for many people, as we usually know someone who suffered or is suffering. There is a lot we can do to protect our brain as we age … sudoku is great, so are these things!

Did you know estrogen plays a critical role in how your brain produces energy?Estrogen helps regulate glucose metabolism...
25/03/2026

Did you know estrogen plays a critical role in how your brain produces energy?

Estrogen helps regulate glucose metabolism within brain cells — essentially influencing how efficiently your brain can generate and use energy.

As estrogen levels fluctuate in perimenopause, this process becomes less stable. The result can feel like:
• brain fog
• reduced concentration
• mental fatigue
• slower processing speed

This is not a lack of effort or ability. It reflects a shift in brain energy availability. These symptoms can improve significantly with appropriate hormone management, sleep, and exercise + dietary habits that address systemic insulin resistance.

Brain fog is one of the most common — and most misunderstood — symptoms of perimenopause. It is often far worse in perim...
23/03/2026

Brain fog is one of the most common — and most misunderstood — symptoms of perimenopause. It is often far worse in perimenopause than post-menopause, but can linger for many women far longer than acceptable … not that any period of timing suffering is acceptable!

It can show up as word-finding difficulty, reduced concentration, slower processing, and mental fatigue.

These changes are driven by fluctuating estrogen, which affects neurotransmitters, brain energy metabolism, and memory pathways. Sleep disruption and increased stress reactivity often compound the effect.

Importantly, this is not a sign of cognitive decline! Your brain is just as capable as it has always been, it’s in an altered neuroendocrine state which is making your life more challenging.

You’re not alone, and there is help available!

We know that estrogen is incredibly important for brain health, though more study is needed on the impacts of body-ident...
21/03/2026

We know that estrogen is incredibly important for brain health, though more study is needed on the impacts of body-identical HRT for dementia risk.

Cognitive symptoms can be incredibly debilitating and many women tell me about their struggles with work and relationships as a consequence.

Looking after our brains is so important! And we have a lot of control, more than we realise. One important piece is to consider how much of everyone else’s load you are carrying …

If you feel like your whole personality has shifted in Peri, you’re not alone. Irritability is one of the most common sy...
18/03/2026

If you feel like your whole personality has shifted in Peri, you’re not alone. Irritability is one of the most common symptoms I see, because during perimenopause, several hormonal changes affect emotional regulation.

Fluctuating estrogen destabilises serotonin, dopamine, and GABA signalling, while also increasing stress reactivity through the HPA axis. At the same time, progesterone levels often fall as ovulation becomes less consistent. Progesterone and its metabolites normally have calming effects on the brain through GABA receptors, so lower levels can reduce emotional buffering.

Sleep disruption also plays an important role. Insomnia and fragmented sleep reduce cognitive capacity and emotional tolerance, making it harder for the brain to regulate frustration and stress.

The combination of hormonal signalling changes and sleep disruption can lower the threshold for irritability.
Naturally, many women with existing PMS and PMDD will also find that these conditions worsen in perimenopause as well.

Importantly, managing sleep and our other tools to regulate like exercise and mindfulness will help. Appropriate MHT will too!

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Castle Hill Medical Centre
Murrumba Downs, QLD
4503

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