When your foot falls asleep as a kid, it feels like the end of the world. Long moments pass as you wait for that awful pins and needles feeling to subside until, at last, sweet relief. It’s all very dramatic. So when paresthesia (that’s the technical term for pins and needles) reappears during menopause, it can be kind of a WTF moment. 

If you feel like your limbs are tinglier than usual, read on as we answer some of the most common questions, including why your foot keeps falling asleep in menopause. 

What is Paresthesia?

Chances are, you’ve felt paresthesia before, even if you don’t know it by name. It describes the unique feeling of burning or prickling on the skin, and typically doesn’t have an observable cause. Normally, it happens in your arms and hands or feet and legs—but occasionally, you’ll feel it in other spots, too. 

Because paresthesia doesn’t exactly roll off the tongue, this sensation is colloquially referred to as “pins and needles” or saying a particular limb “fell asleep.”

Typically, paresthesia is temporary—usually the result of nerve compression that occurs when one body part is lodged under another. (For example: Falling asleep with your arm under your side body, or sitting with your leg tucked underneath you at your desk, etc.) When your nerve is compressed, it loses its blood and oxygen supply—contributing to the tingly, unpleasant feeling. Thankfully, these moments of paresthesia can usually be shaken off if you stand up or walk around. 

Chronic paresthesia, where you experience it on a regular basis, is often due to abnormal nerve function. This can happen due to chronic illnesses like diabetes (since high blood sugar can damage nerves over time), nutritional deficiencies, disorders like multiple sclerosis or stroke, or carpal tunnel syndrome. Paresthesia can also be caused by certain medications, including certain antibiotics and chemotherapy drugs, or radiation treatment.

How are pins and needles related to menopause?

The short version: We’re not totally sure. Paresthesia is a relatively uncommon symptom of menopause, according to the Australian Menopause Centre. And unfortunately, it’s pretty under-researched, meaning we don’t know a whole lot more about why it happens during this time of life. 

Experts current believe that it could have to do with—you guessed it!—estrogen. Not only does the hormone play a key role in your menstrual cycle and overall reproductive health, it also helps regulate key processes in your central nervous system, including how your brain responds to stimuli and how nerves communicate with each other. As estrogen levels decline during the menopause transition, it might impact how well your nerves work—which could cause tingling and numbness. 

Additionally, some research has associated menopause with changes to a person’s cardiovascular health—including their peripheral vascular function. (Meaning: How well blood gets to and from your extremities.) Since impaired blood flow can trigger paresthesia, this could also be a reason why people might experience tingling and numbness during this time of life. But there needs to be more research to better understand this potential connection. 

You’re definitely not alone if you’re experiencing paresthesia during menopause: The topic has been highly discussed on forums like Reddit and Facebook Groups. Menopause research still has a lot of ground to cover, and this is one of those symptoms where the holes in the science are very evident. 

How is paresthesia treated? 

Like we’ve said, most cases of paresthesia are brief and harmless—although that makes it no less frustrating to live with. 

If your tingling and numbness is frequent and interfering with your life, talk to your health-care practitioner. Your doctor will likely try to get to the root cause of your paresthesia, which may require blood tests (to check for kidney disorders, diabetes, or vitamin deficiencies); imaging tests like X-Rays, CT Scans, or MRIs (to check for injuries in the nerves and spinal cord); nerve conduction studies (a test that determines if the nerves are firing properly); or electromyography (which detects damaged nerves in the muscles). 

From there, your doctor should be able to tell what’s messing with your nerves and come up with a treatment plan for that specific cause. For example, if a pinched nerve is the culprit behind your paresthesia, your doc may recommend rest or a splint. 

That said, there are a few situations in which you should seek medical attention for numbness ASAP:

• If your numbness co-occurs with weakness or paralysis
• If you feel confused
• If it’s difficult to speak
• If you’re feeling dizzy 
• If you have a headache
• If you experience vision changes

You should also get emergency attention if any of the following symptoms occur:

• The numbness comes on suddenly
• The numbness occurs in your thighs, butt, or genitals
• The numbness affects an entire leg, an entire arm, or the entirety of one side of the body (or below a certain level of the body, like below the chest)
• The numbness quickly spreads to other parts of the body. 

Outlook for paresthesia post-menopause

Just like many other menopause symptoms, there’s no set end date for paresthesia (insert “boo!” here). But as far as side effects of menopause go, paresthesia has a pretty brief life. Don’t let the pins and needles get you down. 

Sources:

Aine, B., et. al., Menopause. Cerebral and Peripheral Vascular Difference Between Pre- and Postmenopausal Women. February 2020.

Australian Menopause Centre. What Can You Do About Tingling Extremities During Menopause?, Undated.

Cleveland Clinic. Numbness. January 2019.

Harvard Health Publishing. Hands or feet asleep? What to do. February 2020.

Kristen N. Krolick, et. al.,  Progress in Molecular Biology and Translational Science. Effects of Estrogens on Central Nervous System Neurotransmission: Implications for Sex Differences in Mental Disorders. August 2018.

Mayo Clinic. Pinched Nerve. January 2022.

Mayo Clinic. Symptoms of Numbness. June 2021.

National Institute of Neurological Disorders and Stroke. Paresthesia Information Page. March 2019.

University of Rochester Medical Center. Understanding the "Pins and Needles" Feeling. Undated.

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