Menopause and Restless Legs: What’s Going On?

Medically reviewed by Amy Harris, APRN, CNM · Written by Destiny Nkechi, M.D. · August 26, 2026

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Key Takeaways

Restless legs syndrome (RLS) is a nervous system condition that causes an overwhelming urge to move your legs, and it becomes more common in women during and after menopause.

Healthy sleep helps your body manage stress, regulate mood, and function well the next day. But when your legs won’t stop crawling, tingling, or aching the moment you lie down, sleep can feel completely out of reach.

If restless legs started or got worse after menopause, you’re not imagining the connection. Here’s what’s known so far and what may help.

What Is Restless Legs Syndrome?

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a nervous system condition. People with RLS feel an overwhelming urge to move their legs, usually when they’re resting or trying to sleep in the evening or at night.

Moving your legs by walking, stretching, or shaking them out usually provides quick, temporary relief.

Common Signs That You Have RLS

Talk to your healthcare provider about RLS if you’re postmenopausal and can relate to these symptoms:

Strong urge to move your legs
Crawling, creeping, tingling, pulling, or aching sensations deep in the legs
Discomfort that starts when sitting or lying down
Relief when walking, stretching, or moving
Trouble falling asleep or staying asleep

RLS is twice as common in women as in men. You’re more likely to notice RLS — or notice it getting worse — shortly before or after menopause.

What’s the Connection Between Restless Legs and Menopause?

A 2023 study found that restless legs syndrome was one of the most common sleep complaints among postmenopausal women.

RLS often runs in families. About 40 percent to 90 percent of people with RLS have a close family member who also has it. But if RLS starts for the first time after age 45, it’s more likely to be triggered by factors such as age, menopause, anemia, or certain medical conditions.

Several changes that happen during the menopause transition may explain the link between RLS and menopause.

Hormone Changes

During menopause, your body makes less estrogen, a hormone that supports many functions throughout the body, including the brain.

Estrogen helps dopamine, a brain chemical that controls movement and other body functions, work properly.

Researchers believe that RLS may be linked to problems with dopamine signaling. While overall estrogen levels fall during perimenopause and menopause, the irregular fluctuations in estrogen during this time influence dopamine. For some women, this can show up as restless legs.

Low Iron Levels

Iron deficiency is one of the most well-known causes of RLS. During perimenopause, many women lose more iron than usual because of heavy or irregular periods.

Iron is also important for dopamine to work properly in the brain. When iron levels are low, dopamine signaling may be disrupted, which can trigger RLS symptoms in some people.

Researchers are still studying exactly how hormone changes and low iron contribute to RLS during menopause.

How RLS Affects Sleep and Daily Life During Menopause

While there’s no direct link between poor sleep and restless legs, they can both be part of a vicious cycle during menopause.

When you’re sleep-deprived, your nervous system stays in a hyperaroused state. Sensations that would normally be minor start to feel much stronger. Erratic estrogen and progesterone levels further destabilize sleep and dopamine regulation at the same time.

RLS keeps you up at night, and the sleep loss makes you more reactive. This can lead to a rougher flare-up the next night, and the feedback loop repeats.

Many women experiencing postmenopausal RLS report:

A crawling sensation that starts the moment they lie down
Frequent waking from involuntary leg jerks occurring repeatedly through the night
Other vasomotor symptoms like hot flashes and night sweats in the same stretch of night

Impact on Daily Life

Living with menopause and RLS at the same time can lead to sleep debt. This can cause the following symptoms:

Fatigue — Bad nights may cause exhaustion the next day.
Mood changes — RLS during menopause is linked to more reported depression and anxiety, on top of poor sleep and even insomnia.
Less activity — Constant tiredness makes exercise, socializing, and daily tasks harder to keep up with.

Managing Restless Legs During Menopause

You may see some home remedies online about managing RLS during menopause, and not all of them hold up. Here’s what’s actually worth trying and what you should ask your healthcare provider about.

Explore Lifestyle Strategies

Some simple daily habits may help ease RLS.

Warm baths and massage — Soak your legs in warm water and massage your calves before bed to help ease muscle tension.
Temperature packs — Apply a warm heating pad or a cold ice pack on your legs to find what feels best.
Moderate exercise — Perform gentle calf and hamstring stretches before bed. Light daytime activity like walking or yoga can also help, but intense workouts too close to bedtime may backfire.
Hydration — Make sure to drink enough water. Dehydration can worsen muscle cramps and restless legs.
Trigger reduction — Limit potential RLS triggers like caffeine, alcohol, and nicotine. They can all worsen RLS, especially when consumed in the evening.
Good sleep hygiene — Limit screen time before bed, keep a sleep diary, and sleep in a cool, dark room.

Ask About Iron Screening

A simple blood test that checks your ferritin levels (a marker of stored iron) can point to whether supplementation might help.

While you can eat foods rich in iron, including spinach, lean red meat, iron-fortified cereals, and lentils, don’t start iron supplements on your own. Too much iron can cause problems. A healthcare provider is in the best position to recommend when iron supplements make sense.

Consider Natural and Dietary Supplements

Not every online RLS remedy is backed by high-quality scientific research. Some are just word of mouth. Here are a few remedies backed by science.

Magnesium and Vitamin B6 Supplements

A recent review found that taking magnesium oxide and vitamin B6 supplements for a minimum of two months eased RLS symptoms and helped people sleep better. But they’re not a guaranteed fix, and the research is still growing. Always check with your provider before taking any supplements.

Magnesium-Rich Foods

Bananas and pumpkin seeds are natural sources of magnesium and potassium. Some women say that eating these regularly helps keep mild symptoms in check.

Vitamin B12

Vitamin B12 is worth paying attention to if you’re vegetarian or vegan since it’s mainly found in fish, poultry, dairy, and fortified plant milks. Studies are inconclusive on whether vitamin B12 supplementation makes any difference in RLS symptoms.

Discuss Medical Treatment With Your Healthcare Provider

Medication options for treating RLS symptoms have shifted in recent years. While there is still no cure, current treatment guidelines now recommend a class of drugs called alpha-2-delta ligands as the first choice for RLS.

This class of medications includes gabapentin, pregabalin, and gabapentin enacarbil. They’re considered safer than older options.

If you have infrequent symptoms, your healthcare provider may consider giving you dopamine agonists — medications that act like dopamine — such as levodopa. Older ones like pramipexole can still help, but they can cause more side effects than newer medications.

If you’re taking hormone replacement therapy (HRT), let your healthcare provider know if you notice any RLS changes. Studies don’t indicate that HRT affects restless legs syndrome. Hormone therapy is not an established or recommended treatment for RLS in menopausal women.

Your own personal experience is important in helping your healthcare provider make any connections between your symptoms and the medications you’re taking. Your healthcare provider can help you choose the medication, dose, and timing fit your medical history. Together, you can create a plan to manage RLS during menopause.

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