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Muscle twitching, medically referred to as muscle fasciculation, is an involuntary contraction and relaxation of fine muscles that can occur anywhere in the body. While twitching is usually benign and goes unnoticed, it can sometimes be caused by a hormonal imbalance. This is especially true for perimenopausal and menopausal women, who experience a decline in muscle force and motor function due to fluctuating hormone levels.
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What You'll Learn
Hormonal changes during menopause
Menopause is a natural process that occurs when a woman's ovaries stop producing reproductive hormones and she permanently stops having menstrual periods. The transition phase before menopause is called perimenopause, during which the production of estrogen and progesterone decreases. This hormonal fluctuation can cause a wide range of symptoms, including muscle twitching.
During menopause, the body's production of estrogen, progesterone, and testosterone decreases significantly, while follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels increase. Estrogen plays a crucial role in regulating the female reproductive system, affecting sexual development, female characteristics, menstruation, pregnancy, and menopause. Progesterone, on the other hand, is primarily produced by the ovaries after ovulation and is responsible for controlling menstruation along with estrogen.
The decrease in estrogen levels during menopause can lead to a variety of physical and emotional symptoms. Physically, women may experience vaginal dryness, decreased bone mass, increased risk of cardiovascular disease and stroke, and changes to the skin. Emotionally, menopause can cause mood swings, irritability, anxiety, depression, and a lack of interest in usual activities. Many women also experience night sweats, hot flashes, and sleep disturbances, which can further impact their daily lives.
The hormonal changes during menopause can also impact muscle function and nerve activity, leading to muscle cramps and twitches. These symptoms may be related to the disruption in estrogen and progesterone levels, as well as electrolyte imbalances, particularly in calcium and magnesium levels, which are essential for muscle function. While muscle twitching during menopause is common, it is important to consult a healthcare professional if it interferes with sleep or daily life, as there may be underlying causes that require attention.
While menopause is a natural process, it can cause significant discomfort and distress due to the hormonal changes and associated symptoms. It is important to seek medical advice and explore treatment options, such as hormone therapy, medication, or lifestyle adjustments, to manage menopause and improve overall well-being during this life stage.
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Oestrogen and progesterone levels
Oestrogen has a significant impact on musculoskeletal function, and any hormonal imbalance may cause changes in the excitability of muscle fibres. For instance, during perimenopause, the phase before menopause, crucial hormones like oestrogen and progesterone fluctuate and decline, causing an imbalance. This can lead to muscle cramps and twitches. Perimenopause can begin as early as the late 30s for some women, and it can last between five to ten years. During this time, women may experience a variety of symptoms, including muscle twitches, due to hormonal fluctuations.
The menopausal transition exposes women to an early decline in muscle force and motor function, particularly in the lower limbs, increasing the risk of falls. Studies have shown that perimenopausal women exhibit modulation of excitatory and inhibitory neuromuscular mechanisms, with a decrease in twitch force potentiation and a reduction in muscle twitch force. The decrease in hormonal levels during menopause is a risk factor for sarcopenia, a condition characterised by muscle loss and weakness.
Oestrogen, specifically estradiol, appears to play a role in modulating force potentiation mechanisms. While the decrease in oestrogen during menopause may accelerate the ageing process and contribute to muscle deterioration, the modulation may not be significant enough to detect between perimenopausal stages. However, the EP group, representing early perimenopause, showed higher plantar flexion strength than the LP group, indicating early modulation in muscle function.
Hormonal changes during perimenopause can also impact the body's electrolyte balance, particularly calcium and magnesium levels, which are essential for muscle function. This imbalance can further contribute to muscle cramps and twitches. While muscle twitching due to hormonal imbalances is often benign, it is important to consult a healthcare professional if it interferes with sleep or daily life to rule out any underlying causes.
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Thyroid hormones
While muscle twitching can be caused by factors such as physical exertion, caffeine overload, dehydration, and stress, hormonal imbalances can also be a factor. In particular, thyroid hormones play a pivotal role in metabolism, growth, and organ function, influencing the musculoskeletal system.
Hypothyroid Myopathy
Hypothyroid myopathy is a condition that occurs when the thyroid gland does not produce enough thyroid hormones. This results in inadequate thyroid hormone levels, leading to muscle weakness, fatigue, and other symptoms. Proximal muscles, such as those in the thighs, hips, shoulders, and neck, are particularly affected, impacting activities such as climbing stairs, rising from a seated position, and lifting objects. Severe or untreated hypothyroidism can lead to substantial muscle disease and severe functional limitations.
Hyperthyroid Myopathy
On the other hand, hyperthyroid myopathy is caused by the overproduction of thyroid hormones. This disease commonly involves weakness and wasting of muscles around the shoulders and sometimes the hips. It can also affect the muscles of the face, throat, and respiratory muscles. In rare cases, hyperthyroid myopathy can cause life-threatening rhabdomyolysis, or acute muscle breakdown.
Treatment
Treatment with thyroid hormone replacement medication, such as Synthroid (levothyroxine), can help improve symptoms of both hypothyroid and hyperthyroid myopathy. However, it may take several months for muscle weakness to improve.
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Cortisol
Hormonal imbalances can indeed cause muscle twitching. Oestrogen, for instance, has a significant effect on musculoskeletal function, and any hormonal imbalance may lead to changes in the excitability of muscle fibres. Other hormones that influence the excitability of muscles and nerves include thyroid hormones and cortisol.
Stress and anxiety can cause elevated cortisol levels, which can, in turn, lead to muscle twitching. When the body is under stress, it activates the fight-or-flight response, releasing stress hormones such as cortisol. This response prepares the body for emergency action, but when it occurs too frequently, the body can remain in a state of semi-stress response readiness, a condition known as stress-response hyperstimulation. This hyperstimulation can cause muscle twitching, even when a person is not feeling anxious.
Anxiety disorders can also contribute to muscle twitching. Muscle twitching is a common symptom of anxiety, and it can be frightening, especially for those whose anxiety stems from a fear of health concerns. Treating anxiety can help manage muscle twitching, and improving sleep hygiene can also help reduce cortisol levels and associated muscle spasms or twitches.
While muscle twitching can be benign, it may also be associated with more serious health concerns. It is important to consult a healthcare professional if you are experiencing muscle twitching to rule out any underlying causes.
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Neurological disorders
Muscle twitching, medically referred to as muscle fasciculation, is an involuntary firing of a single motor neuron and all of its innervated muscle fibres. This small, spontaneous muscle contraction and relaxation of fine muscles can occur anywhere in the body. Many of these actions go unnoticed and are generally not large enough to register a jerk action.
In rare cases, eye twitches can be a sign of brain or nerve disorders like Bell's palsy, multiple sclerosis, and Tourette's syndrome. However, these conditions will cause other symptoms, too. Peripheral neuropathy is a result of damage to the peripheral nerves of the body (not the spinal cord or brain). The peripheral nerves are responsible for sending messages from the brain and spinal cord to the rest of the body and sensory information to the central nervous system. Damage to nerves can occur for many reasons, including diabetes, metabolic disorders, autoimmune disorders, trauma, infection, tumours, or inherited disorders.
If you are experiencing persistent muscle twitches, contact your healthcare provider. They will take a medical history and perform a physical exam.
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Frequently asked questions
Yes, hormonal imbalances can cause muscle twitching. Hormones have a major effect on musculoskeletal function and any changes in hormonal balance may cause alterations in the excitability of muscle fibres.
Muscle twitching can be caused by physical exertion, caffeine overload, dehydration, stress, poor nutrition, neurological disorders, and adverse reactions to certain drugs.
Hormonal imbalance can cause a variety of symptoms such as irregular menstrual cycles, increased fatigue, mood changes, night sweats, hot flushes, and muscle stiffness.
If you are experiencing muscle twitching, it is important to consult a doctor to rule out any underlying causes. They may recommend lifestyle changes, medication adjustments, or other treatments to address the issue.
