Muscle cramps and twitches in perimenopause and menopause



Menopause Advisor
eileentalksmenopause
Ask Eileen


04 December 2023

What causes muscle cramps and twitches?

Do you find that your muscles are twitching a lot or you're getting a lot of cramps, especially when you go to bed? As I mentioned above, this is really common in the perimenopause and the menopause, but it's not always caused by the hormonal shift.

Here are some possible causes of muscle cramps and twitches during perimenopause and menopause:

Hormonal changes: Firstly, yes, hormonal fluctuations can be a contributory factor. They can make you more prone to this sort of thing, as well as everything else compounding the issue.

If your oestrogen and progesterone levels are fluctuating, this can have quite a big effect on both muscle function and nerve activity. This kind of disruption can then trigger muscle cramps or muscle twitching.

Electrolyte imbalance: Hormonal changes may also impact the body's electrolyte balance, particularly calcium and magnesium, which are essential for muscle function. An imbalance in these electrolytes can lead to muscle cramps and twitches. However, there is a whole range of other factors that can also affect calcium and magnesium uptake in the body.

So, you're in a situation where you need more of both these minerals, but you're unable to get them, either through your diet or supplements, because of things like getting a lot of indigestion, or being on proton pump inhibitor medication, which may affect your uptake of calcium and magnesium. If you are stressed, that can use up a lot of your magnesium. And your nutritional needs go up generally as well, so that can be part of the problem too.

Stress and anxiety: As well as stress affecting your calcium and your magnesium uptake, you tend to get very tense when you're stressed and anxious. And that tension can keep your muscles really tense, which can trigger cramps as well.

Reduced physical activity: You are at a point where you may have joint aches and pains, you may be totally fatigued, you may find that you just can't be bothered to exercise, so all of that will affect your muscle-building activity too.

There is something called sarcopenia, which can happen to a lot of women, especially over the age of 50. And sarcopenia is the condition by which, as you age, your muscles shrink, which then affects the elasticity of the muscle. So, there's less muscle there to do everything that your muscles would normally do, and that can then lead to cramping and twitching.

Not enough protein: It can be a lack of protein in the diet as well, which is needed for building and repairing muscle. And if your muscles get really weak, then it can be due to that rather than anything else.

What can help?

To manage muscle cramps and twitches during perimenopause and menopause, consider the following strategies:

Stay hydrated: Drink plenty of water to prevent dehydration, because we know that dehydration can affect muscle function generally.

Look at your diet: You need a good balanced diet with plenty of magnesium and calcium-rich foods in it. The best thing to do is Google calcium and magnesium-rich foods. Nature is wonderful because a lot of foods will have a lovely balance of calcium and magnesium in the same food, so it's just a question of adding a little bit of these more into your daily diet.

Top up your calcium and magnesium: You can also look at our new Balance Perimenopause supplement. This is a perimenopausal multi-nutrient drink. So, this is a good strategy, just if you feel you need a little top-up of extra calcium and magnesium in your diet.


You need to look at your protein intake: Your protein needs go up at this time. You've got all these physical changes going on, and your body is needing more protein to shore everything up, so just make sure that you're having a bit of protein with each meal if you can.

If you are vegetarian or vegan, it can be a lot more difficult to add extra protein to your diet, so you can get really good plant protein powder. You can just add this to water, or nut milk, or something like that, once a day, and that will give you a really good extra serving of good-quality protein.

You can look at reducing stress and anxiety: If you find that muscle tension is a really big issue here, things like yoga, meditation, and deep breathing can be really, really helpful.

Stretching: A daily stretch can be really good for all sorts of reasons. Just go on to YouTube, and you'll get 10 minutes of stretching exercises to do on a daily basis, so you don't even need to leave your house. And it's something you can do, maybe first thing in the morning, or if you get cramps and twitches at night, you can do these stretching exercises before you go to bed.

A massage: If that's something you can get, it's so good, not only just to help with muscle relaxation, but it's such a good thing for general relaxation as well. And getting a regular massage can be a really super treat. Check for a properly trained practitioner, for example through the NAMMT.

Keep active: Keep that muscle mass up. Keep your muscles well serviced with things like walking, yoga, stretching, and a little bit of weight work as well, just to build up your muscle mass.

Arnica for muscles: You can look at our Atrogel Arnica Gel, which is one of our registered products for the relief of muscle aches and pains.

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When to consult your doctor

If the muscle twitching and cramping is very severe, if it's affecting your sleep, if it's affecting your daily life, then double-check with your doctor to make sure that there aren't any underlying causes that may be a factor.

I hope you found this one helpful. It seems a really common symptom because we get so many queries about this one. If you have had the same problem, what did you do to help yourself? What did you find really helped you?

I love reading all your stories and comments. And when you're posting a suggestion, you're helping other people as well, so it's a lovely circle of information and help here.

Until next time, take care and have a lovely week.

You may also find these topics helpful:

Does menopause affect your muscles? 8 ways menopause can affect your muscles

Menopause aches and pains & how to ease them

Is stiffness a menopause symptom?

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