Magnesium and Menopause
Magnesium is having a moment. Does it actually help relieve menopause symptoms?
Understanding Magnesium
Among minerals, magnesium is a giant.
Magnesium is involved in about 300 bodily functions including muscle and nerve function, blood glucose control, blood pressure regulation, bone health, reducing inflammation, and protecting cells from damage. It’s also required for energy production, making DNA, nerve impulse conduction, muscle contraction, and a normal heart rhythm, among other functions.
About 20 percent of magnesium is found in skeletal muscle. Most magnesium is stored in bone, where it supports skeletal strength and serves as a magnesium reserve. Although just one to two percent of magnesium is found in the blood stream, it’s vital for survival. Blood magnesium concentrations are tightly controlled, and when levels dip, the body taps bone reserves to normalize them.
Let’s dive into the research about magnesium and some common menopause symptoms.
Magnesium and Sleep
For midlife women, a restful night’s slumber can be as elusive as winning the lottery. Some menopausal women swear by magnesium supplements for better sleep. Here’s why more magnesium may work.
Magnesium may play a role in sleep by regulating a brain chemical called GABA which helps steady your central nervous system. Magnesium can also help relax muscles which may help with better sleep.
Animal studies show that a magnesium deficiency reduces blood levels of melatonin, a hormone that promotes sleep, suggesting that adequate magnesium is necessary for sleep – at least in animals. In a 2021 study with young adults published in Sleep, a higher magnesium intake was associated with better sleep quality and with sleeping between seven and nine hours nightly, which is the suggested amount. However, a 2022 review of nine studies with more than 7,500 participants published in Biological Trace Element Research revealed conflicting findings for magnesium’s effect on sleep quality and sleep disorders, including insomnia.
Although some women may sleep better with more magnesium, larger, well-designed and longer-term studies are needed to determine if magnesium is truly related to better sleep during the menopause transition and beyond.
Magnesium and Hot Flashes
There’s no evidence for a link between magnesium and hot flashes, but there are also very few studies looking at the relationship between the two.
Women with a history of breast cancer who are receiving therapies such as tamoxifen or aromatase inhibitors often report hot flashes. Two pilot studies suggested that taking magnesium oxide supplements might reduce the number and intensity of hot flashes, but that didn’t pan out in a randomized controlled trial, which is considered the gold standard of research.
In the study, published in Menopause in 2016, postmenopausal women with a history of breast cancer and frequent or severe hot flashes took either 800 milligrams (mg) or 1200 mg daily of magnesium oxide while other women took a placebo. After eight weeks, the supplements failed to improve hot flashes.
Given the limited and inconclusive evidence, further research is needed to establish a link between magnesium supplements and hot flash reduction. The Mayo Clinic is running an ongoing clinical trial to evaluate the effect of magnesium on menopausal symptoms, specifically hot flashes in breast cancer patients and women at an elevated risk of breast cancer.
Magnesium and Mood
Menopause is a time of tremendous change, and it increases the likelihood for depression, anxiety, and stress.
Although one study found an association between higher magnesium intake and a lower risk for depression in the general U.S. population, and another study found women with depressive symptoms had lower magnesium levels, the association between magnesium and mental health is largely inconclusive according to a 2020 Nutrients review. A 2018 systematic review in the British Journal of Psychology Open that pooled the results of 58 studies found no evidence that magnesium supplements were associated with a decline in depressive symptoms.
According to a 2020 Clinical Endocrinology study, taking 350 mg of magnesium citrate reduced cortisol levels in the blood in postmenopausal women and men as compared to taking a placebo for 24 weeks. Cortisol is a hormone that manages the body’s stress response and lowering it may help to calm the nervous system. Cortisol levels typically increase and stay elevated when you’re feeling stressed for a prolonged period of time.
Magnesium and Muscle
It’s more difficult to make muscle as you age. In women, lower levels of estrogen promote inflammation and other changes, such as the build-up of fat within muscle tissue, that lead to reduced muscle mass and muscle tissue quality.
A combination of adequate dietary protein and challenging resistance exercise helps to offset some of the effects of aging and menopause on muscle, and adequate magnesium also plays a role. Magnesium is involved in making muscle tissue in several ways and it plays a role in protecting muscle quality by helping reduce muscle cell damage.
Magnesium may also help you feel more energetic during exercise. In a 2002 Human Nutrition and Metabolism study, 10 postmenopausal women ate a controlled diet with adequate magnesium for 35 days. In the second phase of the study, they consumed less than half the recommended daily intake for magnesium for 93 days. The last phase of the study provided a diet adequate in magnesium for 49 days. After consuming the low-magnesium diet, the women lost significant amounts of magnesium from their muscle and blood. The researchers also found that during moderate physical activity, those with low magnesium levels in the muscle tired more quickly than those with adequate levels, and that their hearts beat more during exercise.
Magnesium and Bone Health
Magnesium levels in bone decrease with age and menopause. Low magnesium intake could be a risk for osteoporosis.
A higher magnesium intake may increase bone mineral density in postmenopausal women. In a 2010 randomized controlled trial published in Biological Trace Element Research, postmenopausal women with osteoporosis took either an extra 290 milligrams daily of elemental magnesium (as a dose of 1,830 milligrams of magnesium citrate) or no magnesium supplements. The women that took the extra magnesium had a reduced rate of bone loss compared to those who didn’t take more magnesium.
Magnesium and Your Brain
Aging is associated with the loss of brain matter, which is considered a risk factor for cognitive impairment. It’s unclear whether magnesium supplements can help you remember why you walked into a room or where you put your car keys, but adequate magnesium intake may help in the long run.
A 2023 European Journal of Nutrition study of men and women 40 to 73 years old found that a higher magnesium intake was associated with a greater brain volume, and that the link was stronger in women than men. Though it’s unclear exactly how magnesium contributed to brain volume in this study, the mineral is known for helping to deflect cell damage and inflammation that could harm brain cells.
Do You Get Enough Magnesium?
The body cannot make magnesium so you must consume it on a regular basis. Experts suggest 320 mg of magnesium daily for women. Nearly half of all Americans consume less magnesium than suggested. Women and adults over the age of 71 have the lowest intakes.
Aging decreases the body’s ability to absorb magnesium and increases magnesium losses in the urine. However, there is no expert recommendation for magnesium intake in older people.
Check the chart below to see if you get enough magnesium every day. The amount of magnesium is listed in milligrams:
Do You Need a Magnesium Supplement?
If you don’t get the daily suggested amount of magnesium from food, you probably need a supplement. However, it’s unlikely that you require a blood test to determine your magnesium status. Measuring magnesium levels in the blood is not an accurate way to tell if you’re deficient in magnesium because it doesn’t reflect total body magnesium, most of which is in bones and muscle tissue. However, blood levels are a good way to tell if there have been sudden changes in your magnesium status, which could reflect chronic illness such as kidney disease, poorly controlled diabetes, and gastrointestinal disease.
Experts suggest limiting magnesium from supplements to 350 mg per day. High doses of magnesium from supplements or medications such as laxatives and antacids that contain magnesium can result in diarrhea, nausea, and cramping. People with chronic conditions, such as kidney disease, should check first with their doctor or nurse practitioner before taking magnesium supplements.
Magnesium is always bound to another compound in dietary supplements. You may find that magnesium glycinate is gentler on your stomach, while supplements such as magnesium oxide, used to treat constipation, may cause diarrhea.
It’s important to note that magnesium supplements can interact with certain types of antibiotics and bone-building medications, reducing their effectiveness. On the other hand, some medications, such as diuretics used to treat high blood pressure, and common drugs used to treat gastric reflux disease called proton pump inhibitors (PPI), can cause magnesium loss from the body.
You may need a magnesium supplement if you take PPIs such as omeprazole, esomeprazole magnesium (Nexium) and lansoprazole (Prevacid). When these drugs are consumed for prolonged periods, they can cause magnesium loss. According to the Food and Drug Administration (FDA), magnesium supplements raise the low blood magnesium levels caused by PPIs in most, but not all cases. The FDA advises health care professionals to consider measuring patients’ blood magnesium levels before they start on a PPI and to check magnesium levels in these patients periodically.
If you’re taking a magnesium supplement and even if you’re not, make sure to consume the recommended amount of vitamin D daily, which is 15 micrograms. Magnesium and vitamin D work together in the body. Vitamin D improves magnesium absorption, and a magnesium deficiency can lower vitamin D levels. Your body makes vitamin D, and magnesium is required for converting vitamin D to its active form and getting vitamin D where it needs to go in the body.
The Bottom Line on Magnesium
As a dietitian, I always recommend getting nutrients from food first. Foods rich in magnesium also offer an array of other nutrients that are necessary for overall health, so it’s important to make an effort to get the magnesium you need from food when possible. That said, a lot of women, including me, have trouble fulfilling the suggested magnesium intake every day with food alone. That’s why I take a magnesium supplement daily.
Though many women swear by magnesium supplements to ease menopausal symptoms, the research doesn’t justify their effectiveness in most cases. That said, it’s likely safe, and possibly effective, for healthy women to take upwards of 350 mg of magnesium supplements daily to support health and possibly relieve certain menopausal symptoms.
What do you think? Do you take magnesium supplements?
Great article! I’m a dietitian living in Switzerland and I will definitely share this article with my clients!
Excellent article- thank you! I take both magnesium glycinate and Vitamin D. I eat lots of the foods you list. I take tamoxifen and have a Herceptin Hylecta injection every three weeks. I find that magnesium helps with muscle cramping that tends to accompany the Herceptin. My experience has been that only acupuncture helps with the hot flashes, but who knows, maybe they are not as bad as they could be . . . Ugh!