Could i have perimenopause symptoms i wake up sweaty and rapid heartbeat. right before menses. i get hot and sweaty first then the palpitations come?

Interesting: At 41 a premenopausal state would be premature, unless you started menstruating at an early age. Now, there could be other causes. Off the cuff, i would put carcinoid syndrome, panic attacks, and pheochromocytoma in my differential diagnosis list. Talk to your doctor. Keep a log of the timing of your episodes and associated foods and activities. Good luck.