Perimenopause symptoms can sneak up on you, and some — like tingling — may be unexpected. But hormonal changes during perimenopause can affect many parts of the body, including nerves, which can cause a tingling sensation.

If you’ve experienced tingling with perimenopause or other symptoms that affect your quality of life, be sure to reach out to a doctor with expertise in menopause and women’s health. Many perimenopausal symptoms can be effectively treated in most women.

Here’s more on perimenopause tingling and what you can do to manage this bothersome symptom.

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Why Perimenopause Causes Tingling Sensations

Perimenopause is the transition into menopause, when your menstrual periods permanently stop. During this transition — which can take several years — estrogen, progesterone, and other hormone levels fluctuate and decline.

Changes in hormone levels affect many systems in the body, including the nervous system, which is made up of the brain, spinal cord, and nerves.

Perimenopause is usually thought of as a condition that affects the reproductive system, but many perimenopausal and menopausal symptoms are actually neurological. Common neurological symptoms of perimenopause include sleep disturbance, brain fog, and changes in body temperature (thermoregulation) such as hot flashes.

Declining estrogen levels have been found to affect neurological signaling and are associated with neurological dysfunction in perimenopause. Both estrogen and progesterone, the main female sex hormones, are known to be neuroprotective, meaning they protect brain and nerve function.

Perimenopause can affect blood flow in the brain and the myelin sheath, which is the protective covering around nerves. The myelin sheath protects nerves from damage and helps nerves function properly.

When the peripheral nervous system (nerves outside the brain and spinal cord) is affected by hormonal changes in perimenopause, a condition known as peripheral neuropathy can develop. This causes nerve pain primarily in hands and feet. This pain can feel like a burning sensation, numbness, or tingling in some people.

Peripheral neuropathy due to declining estrogen occurs more commonly in postmenopausal women. The most common type of peripheral neuropathy in postmenopausal women is distal sensory polyneuropathy. It typically affects feet or toes with tingling and numbness and may or may not be painful.

Sensations That Are Similar To Tingling

Some sensations may feel somewhat like tingling, but are different. It’s important to get unusual symptoms evaluated by a doctor.

Formication, sometimes referred to as skin crawling, is the sensation that insects are crawling on or underneath your skin. This is a type of tactile (touch) hallucination that can be caused by conditions such as mental health problems, substance use and withdrawal, vitamin B deficiency, and certain medical conditions.

Lhermitte’s sign is the sensation of a painful electric shock that quickly travels down the spine from the neck and can radiate through the arms or legs. This is a symptom of multiple sclerosis and should be reported to your healthcare team.

Some sensations that feel like an electric shock or body zap can be caused by peripheral neuropathy and are sometimes linked to hot flashes in perimenopausal women.

How To Manage Perimenopausal Tingling

Healthy lifestyle choices can help protect nerve health. These include:

• Eating a healthy diet that has plenty of fruits and vegetables, lean protein, and whole grains to help ensure that you’re getting all of the nutrients you need
• Exercising regularly to promote overall health and good circulation
• Avoiding factors that can damage nerves, such as tobacco, excessive drinking of alcohol, repetitive motions, and exposure to dangerous or toxic chemicals

Your doctor can test your nutrient levels and determine if you may need vitamin or mineral supplements to help with tingling. Always get medical advice before taking supplements to be sure they won’t interfere with any medication you’re taking, and to ensure you understand the proper dosage.

Emotional or psychological stress can also affect blood flow to nerves and may cause sensations such as tingling or nerve pain. Finding ways to manage stress can help prevent this symptom. If you need help managing stress, it’s important to talk to your healthcare provider.

Hormone Therapy

If tingling or other perimenopausal symptoms are affecting your quality of life, it’s good to talk to a doctor who specializes in menopause about your treatment options.

Hormone therapy, also known as hormone replacement therapy (HRT) or menopause hormone therapy (MHT), can be effective in treating symptoms of perimenopause in many women. This treatment works by replacing declining estrogen levels.

Research has shown that HRT lowers the risk of distal sensory polyneuropathy in postmenopausal women who are 40 years of age or older.

Progestogen, a synthetic hormone related to progesterone, is sometimes included in HRT. Your doctor can discuss potential benefits and risks of HRT and help you determine if it is appropriate for you.

If your individual risk factors prevent you from taking HRT, your doctor can tell you about nonhormone treatment options for perimenopause symptoms.

Treating Peripheral Neuropathy Itself

If you experience tingling that doesn’t improve with lifestyle changes or treatment of perimenopause, you should reach out to your healthcare team.

A number of medications, therapies, and procedures are used in the treatment of peripheral neuropathy. Depending on your particular symptoms and condition, your doctor may recommend a treatment plan, or may refer you to a neurologist for further evaluation.

When To Seek Medical Care

If sensations of tingling change or worsen, it’s important to talk to your doctor. It’s especially important to seek medical advice if tingling is accompanied by:

• Neck pain or pain in the forearm or fingers
• Frequent urination (peeing)
• A rash
• Muscle spasms
• Dizziness

In some cases, tingling or numbness may be a sign of a medical emergency that needs immediate attention. It’s essential to seek emergency care if you experience tingling or numbness with symptoms such as:

• Weakness or an inability to move
• Head or neck injury
• Loss of control of an arm or leg, or difficulty walking
• Loss of bowel or bladder control
• Confusion or loss of consciousness
• Problems with speech or vision

Unusual or unfamiliar symptoms should always be discussed with a healthcare provider to make sure you’re properly evaluated and treated in a timely manner if needed.