Magnesium in Perimenopause: Should You Take It?

If you’re waking at 2 or 3am…or feeling more aches and pains than you used to…
it’s completely understandable to start wondering whether magnesium might help.

So many women in perimenopause tell me the same thing, “Nic, I feel like I’m doing everything right, but my sleep is still terrible and my body feels different.”
And because magnesium gets talked about so much right now, it’s easy to think it might be the missing piece. Here’s what the research says.

Why Magnesium Matters in Perimenopause

Magnesium is an essential mineral involved in hundreds of body functions, including:

• Muscle and nerve regulation
• Bone strength
• Sleep quality
• Mood balance
• Stress response
• Energy production

During perimenopause and menopause, magnesium needs may increase due to hormonal changes, stress, disrupted sleep and changes in bone metabolism. Magnesium deficiency is also fairly common in postmenopausal women and has been linked to lower bone density and a higher risk of fractures.

What the Research Says

The evidence for magnesium’s role in menopause is promising but mixed:

• Bone Health: Strong (and the most consistent) evidence supports magnesium’s benefits for bone mineral density and reducing fracture risk.
• Sleep, mood, relaxation: Some studies show improvements, especially in women who were low in magnesium. But it’s not an instant fix. It works best as part of a bigger picture (nutrition, stress, routine).
• Hot flushes and night sweats: The evidence is mixed. Some small studies found improvement, but larger trials showed no significant difference compared to placebo.
• Vitamin D: Magnesium helps activate vitamin D, which supports bone and immune health.

Overall: magnesium can be useful and may help with some perimenopausal symptoms. Supplements are most clearly beneficial for women who are deficient, which can be confirmed with a simple blood test. It’s important to be mindful of high doses, which can cause side effects like diarrhoea if you’re already meeting your magnesium needs through diet!

Types of Magnesium and Their Benefits

Not all magnesium supplements are created equal. The form you choose matters:

• Magnesium Glycinate: Gentle on the stomach and calming. Often recommended for sleep, relaxation, and mood balance.
• Magnesium Chelate: Well-absorbed and may help with muscle aches, cramps, and recovery. Ideal if you’re dealing with tension or soreness.
• Magnesium Citrate: Mild laxative effect, useful for constipation.
• Magnesium Oxide: Poor absorption, which is why it’s used for bowels.
  The new UK constipation guidelines list magnesium oxide as an option when fibre + fluids haven’t worked. Good for constipation only (not helpful for sleep).

A reminder about B6

Many “magnesium complex” supplements include vitamin B6, which helps with absorption. However, excessive B6 can cause nervous system issues over time, so avoid stacking multiple supplements containing it.

 Do You Actually Need a Supplement?

Before adding another supplement, check whether your diet provides enough magnesium. Great dietary sources include:

• Leafy greens (spinach, kale)
• Nuts and seeds (almonds, pumpkin seeds)
• Whole grains
• Legumes
• Avocado
• Tofu
• Dark chocolate

A plant-rich, Mediterranean-style diet usually covers most people’s needs.
But things like stress, caffeine, alcohol, low appetite, or digestive issues can reduce absorption or increase requirements.

If you experience:

• middle-of-the-night wake-ups

• muscle cramps or tightness

• constipation

• low mood

• fatigue

• tension headaches

…then magnesium might be worth considering.
A simple blood test can help guide you.

My final thoughts (from a gut-health perspective)

Magnesium supplements can be beneficial for women in perimenopause, particularly for supporting bone health, sleep, mood, and muscle function. Their effectiveness for hot flushes and other classic menopausal symptoms is less certain.

Focus on a magnesium-rich, Mediterranean-style diet, manage stress, and supplement only if deficiency or specific symptoms are present. As always, listen to your body and seek professional guidance before adding new supplements.

References

Porri, D., Biesalski, H., Limitone, A., Bertuzzo, L., & Cena, H. (2021). Effect of magnesium supplementation on women's health and well-being. NFS Journal, 23, 30-36. https://doi.org/10.1016/j.nfs.2021.03.003.

Rondanelli, M., Faliva, M., Tartara, A., Gasparri, C., Perna, S., Infantino, V., Riva, A., Petrangolini, G., & Peroni, G. (2021). An update on magnesium and bone health. Biometals, 34, 715 - 736. https://doi.org/10.1007/s10534-021-00305-0.

Vázquez-Lorente, H., Herrera-Quintana, L., Molina-López, J., Gamarra-Morales, Y., López-González, B., Miralles-Adell, C., & Planells, E. (2020). Response of Vitamin D after Magnesium Intervention in a Postmenopausal Population from the Province of Granada, Spain. Nutrients, 12. https://doi.org/10.3390/nu12082283.

Cao, Y., Zhen, S., Taylor, A., Appleton, S., Atlantis, E., & Shi, Z. (2018). Magnesium Intake and Sleep Disorder Symptoms: Findings from the Jiangsu Nutrition Study of Chinese Adults at Five-Year Follow-Up. Nutrients, 10. https://doi.org/10.3390/nu10101354.