Does evening primrose oil help with heart palpitations during perimenopause?

Evening primrose oil has very limited evidence as a remedy for heart palpitations, and it should never be the first or primary response to this symptom. Before considering any supplement for palpitations, the most important step is having them properly evaluated by a healthcare provider. Heart palpitations can be benign and hormonal, but they can also reflect cardiac or thyroid conditions that require treatment, not supplementation.

Heart palpitations during perimenopause, those sensations of a racing, fluttering, or skipping heartbeat, are genuinely common and are usually linked to declining estrogen. Estrogen has direct effects on the heart and blood vessels, including regulating the autonomic nervous system that controls heart rate variability. As estrogen fluctuates, the autonomic system can become less stable, producing irregular beats that feel alarming even when they are clinically benign. Hot flashes can also trigger palpitations by activating the sympathetic nervous system in a sudden surge, creating a chain reaction of flushing, sweating, and a racing heart that can be frightening even when it is not dangerous.

Evening primrose oil contains gamma-linolenic acid (GLA), which converts in the body to dihomo-gamma-linolenic acid (DGLA) and then to prostaglandin E1, an anti-inflammatory compound with some general cardiovascular effects. Prostaglandin E1 has vasodilatory properties and may support blood vessel health in a general anti-inflammatory sense. However, there are no controlled trials specifically testing EPO for palpitations in perimenopausal women. The evidence that does exist is general and indirect. Positioning EPO as a palpitation remedy would significantly overstate what the science currently supports.

The more important point is this: palpitations during perimenopause, while often benign, can in some cases reflect an underlying cardiac arrhythmia, thyroid disorder, anemia, or electrolyte imbalance that needs proper diagnosis and treatment. An ECG, thyroid panel, and basic blood work including iron and electrolytes are typically the appropriate starting point. Trying a supplement first and waiting to see whether palpitations resolve is not the right approach for a cardiac-adjacent symptom.

If your provider has evaluated your palpitations, confirmed they are hormonally driven and benign, and you are looking for additional supportive measures, magnesium has considerably stronger evidence for supporting cardiac rhythm regulation than EPO. Some research suggests magnesium deficiency contributes to heart rhythm irregularities, and magnesium intake often declines during high-stress periods, which perimenopause can represent for many women. Reducing caffeine, managing stress, and improving sleep quality also have more direct evidence for reducing benign palpitations than any supplement.

If your palpitations are clearly tied to hot flash episodes, managing your vasomotor symptoms more effectively, whether through lifestyle changes or with your provider's guidance on treatment options, may reduce palpitation frequency as a secondary benefit. Alcohol and dehydration can both worsen palpitations by affecting electrolyte balance and autonomic nervous system tone, so monitoring these variables alongside any supplement change gives you a fuller picture of what is driving your symptoms. Keep a simple palpitation log noting when they occur, how long they last, and what you were doing or feeling beforehand.

In EPO studies for perimenopausal symptoms generally, doses of 3,000 to 4,000 mg per day have been used, divided across meals. Talk to your healthcare provider about the right dose for your situation, and make sure they are aware you are considering EPO specifically in the context of a cardiac symptom, since this affects how they weigh the risks and benefits.

Evening primrose oil may interact with blood thinners and anticoagulants. It may also lower the seizure threshold, so discuss with your provider if you take any seizure medications. If you take blood thinners, antidepressants, or any prescription medications, check with your provider before adding this supplement.

If you have or have had a hormone-sensitive condition such as breast cancer, endometriosis, or uterine fibroids, discuss evening primrose oil with your healthcare provider before using it.

See your doctor if palpitations are frequent, prolonged, accompanied by chest pain, shortness of breath, dizziness, or fainting, or if they feel like a very rapid heartbeat lasting more than a few minutes. These are red flag symptoms that need prompt cardiac evaluation, not a supplement trial. Even palpitations that ultimately turn out to be benign deserve to be evaluated medically before you begin managing them with supplements.

The PeriPlan app (https://apps.apple.com/app/periplan/id6740066498) lets you log heart palpitations daily so you can spot whether patterns shift over time, which provides useful information for your provider about frequency, duration, and possible triggers.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.