Does melatonin help with muscle tension during perimenopause?

Muscle tension, tightness, and that feeling of carrying stress physically in your shoulders, neck, or jaw are symptoms many women notice escalating during perimenopause. The question of whether melatonin might help is worth thinking through carefully, because the connection is indirect but grounded in real physiology.

Melatonin's primary role is regulating circadian rhythm, the biological timing system that controls sleep and wakefulness. When melatonin signaling is disrupted, as research by Toffol et al. (2014) confirmed it is during perimenopause, sleep quality suffers. And poor sleep has a direct effect on muscle tension. During sleep, particularly during deep slow-wave sleep, the sympathetic nervous system quiets down and the body undergoes physical repair processes, including relaxation of muscles that have been held in tension throughout the day. When that restoration is incomplete because sleep is fragmented or shallow, muscle tension tends to persist and accumulate. People who sleep poorly consistently report higher levels of physical pain and physical tension the following day.

There is also a stress and cortisol dimension. Sleep deprivation raises cortisol, and elevated cortisol increases sympathetic nervous system activity. The sympathetic nervous system is the fight-or-flight system, and one of its effects is increased baseline muscle tone. In other words, chronically poor sleep creates a physiological state in which the body holds more tension, even at rest. Melatonin, by improving sleep continuity and supporting the natural overnight drop in sympathetic nervous system activity, may break this cycle for some women.

Zhdanova et al. (2001) demonstrated that low-dose melatonin (0.3 mg) improved sleep quality and continuity in middle-aged women. Better sleep continuity means more time spent in the restorative sleep stages where muscle recovery and nervous system quieting actually occur.

Melatonin also has anti-inflammatory and antioxidant properties, as documented by Rossignol and Frye (2011). Some muscle tension, particularly in people with perimenopausal joint changes, has an inflammatory component. Melatonin's ability to scavenge free radicals and reduce inflammatory cytokine activity could theoretically offer some modest anti-inflammatory benefit to muscles and connective tissue, though direct studies examining melatonin for muscle tension specifically are not available in the perimenopause literature. This mechanism is speculative in the context of muscle tension specifically.

It is also worth considering whether the muscle tension you are experiencing is tension-type and stress-related, or whether it involves muscle cramping or spasms, which can have different causes including magnesium deficiency, dehydration, or nerve-related changes. Melatonin's mechanisms are more relevant to the tension-type presentation than to cramps or spasms.

If muscle tension is a primary concern, magnesium is worth discussing with your provider alongside melatonin. Magnesium plays a direct role in muscle relaxation by regulating calcium transport across muscle cell membranes, and deficiency is common and underdiagnosed. Magnesium and melatonin have complementary rather than overlapping mechanisms, so some women find that addressing both, with guidance from their provider, gives better results than either alone. Gentle movement practices such as progressive muscle relaxation, yoga nidra, and slow stretching before bed can further reinforce the physical release that better sleep from melatonin makes possible.

Studies have used doses ranging from 0.3 mg to 3 mg. Talk to your healthcare provider about the right dose for your situation. Because melatonin is sold as an over-the-counter supplement in the US without drug-level regulation, potency and quality vary considerably between products. Choosing a brand with third-party testing verification gives you better confidence in what you are taking.

Drug interactions include warfarin (where melatonin may increase bleeding risk), immunosuppressant medications, antidiabetic drugs, and CNS depressants including sedatives. Discuss any of these interactions with your provider before starting melatonin.

Logging sleep quality alongside muscle tension ratings on the same day allows you to test for yourself whether poor sleep nights reliably correspond to higher tension the next day. PeriPlan supports this kind of multi-symptom daily tracking so you can build an evidence base from your own experience.

When to talk to your doctor: Occasional muscle tension is common and often manageable with sleep, stretching, and stress reduction. But see your provider if you experience muscle weakness (not just soreness), severe cramps that wake you at night repeatedly, tremor, or new muscle pain that is worsening progressively. These patterns can indicate thyroid dysfunction, electrolyte imbalances, or other conditions that need evaluation beyond lifestyle support.

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