Does magnesium help with muscle tension during perimenopause?

Muscle tension, tightness, cramping, and that persistent sense of being physically wound up are symptoms many perimenopausal women experience without fully connecting them to hormonal changes. Estrogen supports muscle recovery and elasticity, and its decline can leave muscles feeling stiffer and more reactive. Magnesium has some of the strongest and most direct evidence of any supplement for muscle-related symptoms, and the biological rationale is well established.

Magnesium's relationship to muscle function is rooted in the calcium-magnesium balance that governs the entire contraction and relaxation cycle. Calcium is the signal that triggers a muscle fiber to contract. Magnesium is the signal that tells it to let go. When magnesium is sufficient, this cycle proceeds efficiently: muscles contract when needed and fully relax between contractions. When magnesium is low relative to calcium, muscles can become stuck in a partially contracted state, producing tension, tightness, cramps, and even spasms.

This is not speculative physiology. It is the mechanism that underpins the well-established use of magnesium intravenously in hospital settings to stop uterine contractions in preterm labor and to manage severe muscle spasms in conditions like eclampsia. While supplemental oral magnesium works more gradually and at lower concentrations than IV magnesium, the underlying biology is the same.

For muscle cramps specifically, a Cochrane review examined magnesium for leg cramps and found mixed results, noting that evidence was stronger for pregnancy-related cramps than for other populations. However, the mechanistic rationale remains strong, and many women report meaningful relief from nighttime leg cramps and general muscle tension with consistent magnesium supplementation. Anecdotal reports are not clinical trials, but they carry weight when supported by a clear biological explanation.

Magnesium also reduces the cortisol-driven muscle bracing that comes with chronic stress. The HPA axis is the body's stress response system, and when it is activated chronically, muscles throughout the body maintain a low-level contraction as part of the fight-or-flight preparation. Magnesium helps modulate the HPA axis, reducing this background tension. For perimenopausal women who are simultaneously managing sleep disruption, mood volatility, and significant life changes, the stress load can be considerable, and the physical toll on muscles reflects that.

For migraine-related tension, the evidence is particularly noteworthy. A 1996 randomized controlled trial by Peikert and colleagues found that 600 mg of magnesium per day reduced migraine frequency by 41.6% compared to placebo. Many migraines are accompanied by significant cervical and cranial muscle tension, and magnesium appears to address both the vascular and muscular components of migraine physiology.

Magnesium glycinate and magnesium malate are the forms most often discussed for muscle comfort. Glycinate is well absorbed and easy on the digestive system; malate contains malic acid, which is involved in the Krebs cycle and may offer additional energy benefits relevant to muscle function. Research has examined supplemental doses ranging from 200 mg to 400 mg daily for musculoskeletal applications. Talk to your healthcare provider about the right dose for your situation.

PeriPlan lets you track muscle tension severity day by day alongside your supplement use, sleep quality, and stress levels, which helps you build an accurate picture of what is actually helping over time.

Safety is generally favorable. The tolerable upper limit from supplements is 350 mg per day for most regulatory standards. The primary side effect of higher doses is diarrhea, which is uncomfortable but not dangerous in otherwise healthy women. Women with significant kidney impairment should not supplement without medical supervision, as the kidneys are responsible for excreting excess magnesium. Space magnesium at least two hours apart from quinolone or tetracycline antibiotics if you take them.

When to see a doctor: Occasional muscle tension and cramps are common during perimenopause, but some patterns need evaluation. Severe or sudden muscle weakness (not just tension), muscle pain accompanied by dark urine, or cramps that are extremely frequent and not responding to any intervention should be assessed medically. Persistent muscle pain in a specific region, such as the neck, back, or a limb, may have a structural cause that needs imaging or physical therapy.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.