Menopause and Nerve Pain: Causes, Relief Strategies & Management

Estrogen is crucial for maintaining the health of various bodily systems, including the nervous system. Its influence extends to the very nerves that carry information throughout the body. As women enter the menopausal transition, the natural decline in estrogen levels can lead to various bodily changes, which may include peripheral neuropathy.⁽¹⁾ This condition causes damage to the nerves outside the brain and spinal cord, leading to symptoms that can significantly affect quality of life.

Symptoms may include tingling, burning, cold or numb sensation, and the feeling of pins and needles. For some individuals, these sensations are merely annoying and intermittent, but for others, they can be intense and chronic, disrupting sleep and daily activities.

Interestingly, while a significant number of women will experience these neurological changes during menopause, many will transition through this phase without any long-term adverse effects. 

For those experiencing neurological symptoms during menopause, consulting a doctor is recommended to receive guidance on managing these symptoms effectively and improving overall quality of life. Effective treatment options range from lifestyle adjustments or vitamin supplementation to a holistic approach, incorporating hormone replacement therapy (HRT) and other medications to manage menopause symptoms effectively.

What is nerve pain?

Nerve pain arises from damage or disease, affecting the nerves and structures that help us feel sensations. Conditions like diabetes, viral infections, autoimmune disorders, and physical trauma can disrupt the nervous system, leading to pain. Common symptoms of nerve pain include unusual and intense responses to pain and odd sensations like tingling or numbness. This pain can significantly affect a person's well-being and profoundly impact their mental health and quality of life.⁽²⁾

Does menopause cause nerve pain?

The link between menopause and nerve pain is a complex one. Menopause itself may not directly cause nerve pain, but the interplay of hormonal and physical changes during this phase can contribute to its development. Studies indicate that postmenopausal women might be more prone to peripheral neuropathy, resulting in nerve pain.⁽¹⁾

How can menopause increase the risk of nerve pain?

During the menopausal transition, hormonal fluctuations, metabolic changes, and increased inflammation can collectively contribute to nerve pain.

Hormonal Fluctuations

Hormonal changes occurring during menopause, particularly in estrogen levels, can impact the peripheral nerves that connect the central nervous system to the body. These nerves are crucial for managing sensations and movements in the extremities. Reduced estrogen levels can slow the transmission of signals along these nerves and impair their function, potentially causing neuropathic symptoms like abnormal sensations or pain, which are signs of neuropathy.⁽³⁾

Increased Inflammation 

Studies have shown that estrogen has protective properties against inflammation. Persistent inflammation during menopause can harm nerves and create an unfavorable environment for nerve regeneration, leading to long-standing nerve pain and other neuropathy symptoms.⁽⁴⁾

Metabolic Changes

During the menopausal transition, hormonal fluctuations can cause metabolic changes in some women, such as increased abdominal weight and higher blood pressure. These changes are risk factors for type 2 diabetes, a condition that may contribute to nerve pain.⁽⁵⁾

Carpal Tunnel Syndrome 

Perimenopausal women are more likely to develop carpal tunnel syndrome (CTS), a condition that causes nerve pain. Research suggests that estrogen plays a role in CTS by affecting tissues in the wrist. Studies have found that estrogen receptors (ER) are more abundant in the transverse carpal ligament (TCL).

Elevated ER levels can lead to an increase in fibroblasts, cells that produce collagen and other fibers. As a result, the TCL may thicken. Additionally, high levels of ER can activate immune responses and increase inflammatory proteins, causing inflammation in the carpal tunnel. These changes can exert pressure on the median nerve, leading to the symptoms commonly seen in CTS.⁽⁶⁾

Other Potential Causes of Nerve Pain

Hormonal fluctuations and other changes during the menopausal transition can exacerbate preexisting conditions that may cause nerve pain.

Autoimmune Diseases

Estrogen has protective effects against autoimmune diseases, but its decline during menopause can influence the onset and progression of conditions like rheumatoid arthritis, which can affect nerve health and function.⁽⁷⁾

Vitamin Deficiencies

Aging is one of the common reasons for vitamin B12 deficiency, as the body's ability to absorb this vitamin decreases over time. This decline is often due to reduced stomach acid production, which is essential for releasing B12 from food. B12 plays a crucial role in maintaining nerve health by aiding in the formation of red blood cells and DNA synthesis. It also helps the nervous system function effectively. Thus, B12 deficiency can cause nerve damage, leading to symptoms such as tingling, numbness, and nerve pain. 

Magnesium deficiency can also cause nerve pain. Magnesium is essential for nerve function, and a lack of it can lead to increased nerve excitability and pain.⁽⁹⁾

Shingles

Shingles is caused by the herpes zoster virus, which also causes chickenpox. After the initial infection, the virus lies dormant in the nerve cells. ⁽¹⁰⁾

Years later, under certain conditions, the virus can reactivate, reproduce, and travel to the skin via sensory nerve fibers. Hormonal changes during menopause can weaken the immune system, making it easier for the virus to reactivate and cause symptoms like nerve pain and a blister-like rash. Injuries or Surgeries

Surgery or injury can cause nerve pain by directly damaging nerves or through the formation of scar tissue, which can compress and irritate the nerves. This type of nerve pain, known as neuropathic pain, can result in symptoms such as tingling, burning, or shooting pain.

Diagnosing Nerve Pain During Menopause

Diagnosing nerve pain during menopause requires a comprehensive assessment by a physician. The doctor will review the patient's symptoms, medical history, and lifestyle factors, followed by a physical examination to evaluate nerve function and pinpoint any specific areas of pain or discomfort.

The doctor may also order laboratory tests to determine the underlying cause of the nerve pain. For instance, if a vitamin B12 deficiency is suspected, a B12 blood test will be conducted. Additional tests could include checking blood glucose levels to rule out diabetes and conducting nerve conduction studies to assess nerve health more precisely.

Managing Nerve Pain During Menopause

Here are some strategies to manage nerve pain during menopause:

Lifestyle Modifications

The following lifestyle modifications can help manage nerve pain during menopause:^(11,12)

• Exercising regularly: Working out improves muscle tone, reduces neuropathy symptoms, helps manage blood sugar levels, and improves blood flow by reducing pressure on blood vessels.

• Eating a healthy diet: Consuming more antioxidant-rich foods (blueberries, walnuts, fatty fish, flaxseed oil), high-fiber foods, and foods that the body absorbs slowly (certain vegetables, fruits, and nuts) help support nerve health.

• Quitting smoking: Smoking narrows and damages peripheral blood vessels, worsening neuropathy symptoms. Quitting smoking improves blood flow and nerve health.

• Practicing relaxation techniques: Deep breathing, meditation, progressive relaxation, yoga, tai chi, and gentle stretching can help manage pain, reduce stress, improve posture, and soothe nerve pain.

Medication

Common medicines that can help manage nerve pain include the following:⁽²⁾

• Pain relievers: Over-the-counter pain medications can help alleviate mild symptoms.

• Anti-seizure medications: Certain medications originally developed for epilepsy can often improve nerve pain, although they may cause side effects like drowsiness and dizziness.

• Topical treatments: Creams or patches applied to the skin can help reduce pain. However, potential side effects include drowsiness, dizziness, and numbness at the application site.

• Antidepressants: Some antidepressants can disrupt pain-causing chemical processes in the brain and spinal cord, helping to manage pain.

Physical Therapy

Researchers have found that physical therapy can significantly reduce neuropathy symptoms and improve overall quality of life. Physical therapy helps by enhancing muscle strength, coordination, and mobility. Regular sessions can alleviate pain, reduce the risk of falls, and promote better blood flow essential for nerve health. Additionally, tailored exercises and stretches can help manage and prevent further nerve damage.⁽¹³⁾

Alternative Therapies 

Alternative therapies like acupuncture, chiropractic techniques, and herbal remedies may help alleviate nerve pain, improve circulation, and promote relaxation.⁽¹⁴⁾ Pairing these alternative treatments with traditional approaches like medication and exercise can maximize their benefits.

Hormone replacement therapy (HRT)

HRT is widely recognized as the gold standard for managing menopausal symptoms. Studies have shown that postmenopausal women who do not take HRT have a higher incidence of neuropathy compared to those who do.⁽¹⁾ HRT helps manage neuropathy by balancing hormone levels and alleviating other menopause-related symptoms.

Different types of HRT are available. Estrogen-only HRT is recommended for women who have had a hysterectomy. On the other hand, combined HRT, which includes both estrogen and progesterone, is given to women with a uterus to lower the risk of endometrial hyperplasia. In this condition, the lining of the uterus becomes too thick.

When to See a Doctor Immediately

Individuals experiencing menopausal symptoms that impact their quality of life should consult a doctor. Aside from that, the following scenarios may demand immediate medical attention:

• Symptoms abruptly worsening

• Nerve pain becoming severe

• Pain or other symptoms spreading to other parts of the body

• Sores or injuries on the feet

• Swelling, fever, or other signs of an infection

Experiencing nerve pain during menopause? Discover if HRT is right for you.

If you’ve entered the menopause transition and are struggling with nerve pain, you don’t have to suffer in silence. Take our brief menopause quiz to see if you’re an eligible candidate for HRT. Get started with Winona to take the first step toward feeling better.