There may be a logical explanation for why perimenopause or menopause is linked to twitching muscles, but it’s probably not what you think.

Have you noticed lately that your new-onset muscle twitching seems to have coincided with your entrance into “peri” or menopause?

CAN perimenopause or menopause itself cause a woman to experience twitching muscles?

“So, I tried to do some research into this question and honestly, I can’t find any reason hormonal or otherwise that women would experience increased muscle twitches in menopause,” explains Lindsay Appel, MD, an OB-GYN with the Family Childbirth & Children’s Center at Mercy Medical Center in Baltimore.

“I can’t come up with a theoretical reason for this either. Bone and muscle density does change after menopause (it usually decreases as fat increases), but this should not cause an increase in muscle complaints.

“Usually, women complain of gaining weight despite doing the same exercises or observing the same diet or sometimes, increased skin laxity.”

So what’s up with the muscle twitches occurring at about the same time as perimenopause or at some point during “the change”?

There’s a logical explanation for this. It has to do with a well-known fallout of these milestones in a woman’s life.

And it’s anxiety.

Dr. Appel explains, “Anxiety and depression is a very common symptom of menopause.


“The cause for this is unclear, but seems to be at least partially related to the drop in estrogen that occurs with menopause.

“In some studies, women who received hormone replacement therapy for menopausal symptoms also had an improvement in mood symptoms.

“In addition, the hot flashes that occur with menopause can lead to sleep disturbances which can worsen anxiety and depression.”

So now we’re looking at anxiety.

Why is this important? Because it’s well-documented in the medical literature that anxiety is a leading cause of twitching muscles.

If hormones are somehow involved in the anxiety that comes with perimenopause or menopause, this doesn’t mean that these chemical messengers are the only cause of the anxiety.

Leaving Youth Behind

A woman, upon facing the reality that she’s “in” perimenopause, may begin experiencing anxiety that is psychological in origin.

Perimenopause may be perceived as a gateway to middle age.

If she’s single, this can trigger even more anxiety, as she may start questioning her desirability as the premenopausal phase tempts her to start counting grey hairs or inspecting signs of aging on her face.

Twitching muscles are often caused by anxiety. It’s that simple.

What if a woman starts suspecting that she has entered menopause, or especially if this has been confirmed by her doctor?

The anxiety could hit like a backhand to the face. To many women, this change in life is associated with “getting old.”

She may suddenly start feeling old if she hasn’t been working out.

The realization that she’s now infertile can hit hard, even if she doesn’t want to get pregnant.

The hot flashes, thinning hair, weight gain and other symptoms can really compound the anxiety.

So that’s where the new-onset muscle twitches are coming from: anxiety, worry, stress.

And the more you fret about your twitching muscles, the more they’ll twitch!

They think you’re facing some kind of threat. So they gear up for the fight or flight—by twitching – kind of like a car engine revving up for that tear down the racetrack.

Only the fight or flight never comes, but the anxiety continues as you sit at your office desk or home computer. So the muscles continue to twitch.

Feeling old and depressed? Hit the gym!

I’ve said it before and I’ll say it again: It’s impossible to feel old if you can pick up heavy weights.


Menopause or perimenopause do not, via a direct pathway, cause muscles to twitch.

The anxiety that comes with these changes, however, are most likely the cause.

Magnesium deficiency, dehydration and rigorous exercise can also cause twitching muscles.

When exercise is the cause, there is nothing at all wrong with this.

It’s normal. Think of the twitches as nature’s way of massaging worked muscles.

Dr. Appel addresses a full range of obstetric and gynecologic needs for women. She has participated in several OBGYN research presentations at professional conferences.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/fizkes

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