The Role of Magnesium in Perimenopause and Menopause

Magnesium is an essential mineral involved in hundreds of biochemical processes in the body. It’s crucial for creating proteins, supporting muscle and nerve function, regulating blood glucose, controlling blood pressure, producing energy, and even forming DNA and RNA. Despite its importance, many people—particularly older adults—are magnesium deficient due to factors like diet, medication, and age-related absorption challenges. Let’s dive into why magnesium is so critical during perimenopause and menopause and how it can help alleviate common symptoms and improve health.

Why Magnesium Deficiency is Common

As we age, our bodies absorb less magnesium, and many modern dietary habits exacerbate this issue. Here are some key reasons magnesium deficiency is prevalent:

• Dietary Challenges: Processed foods, which make up a significant portion of the Western diet, are stripped of magnesium during production. Additionally, modern farming practices have depleted magnesium in the soil, reducing its presence in many foods.

• Medications: Certain medications, including diuretics, proton pump inhibitors, and antibiotics, can interfere with magnesium absorption or increase its excretion.

• Health Conditions: Gastrointestinal issues such as Crohn’s disease, celiac disease, and type 2 diabetes can limit magnesium absorption.

• Stress: Chronic stress depletes magnesium levels, creating a cycle where low magnesium exacerbates stress and vice versa.

Recommended Intake and Food Sources

For women over 30, the recommended daily allowance (RDA) for magnesium is 320 mg per day. Here are some examples of magnesium in foods for reference:

• Pumpkin seeds: 156 mg per ounce

• Black beans: 60 mg per half cup

• Raw spinach: 24 mg per cup

Magnesium and Perimenopause/Menopause Symptoms and Risks

Sleep Improvement

Disrupted sleep is a common complaint. While research findings on magnesium’s direct effects on sleep are not robust, many women report improved rest after supplementation. Magnesium’s ability to relax muscles and regulate stress may play a role. Magnesium glycinate is often recommended for its calming effects and is best taken before bed.

Hot Flashes

Although no studies directly link magnesium to hot flashes, its role in stress management and cortisol regulation may help reduce the frequency or severity of hot flashes.

Stress and Anxiety

Magnesium is essential for managing stress. It supports the nervous system and activates GABA, a neurotransmitter that calms the body. Chronic stress depletes magnesium, which can create a cycle of heightened stress and low magnesium levels. Supplementing magnesium has been shown to reduce feelings of stress and improve resilience.

Depression

Magnesium plays a key role in brain health and mood regulation. Studies have consistently shown a correlation between low magnesium levels and depression. Supplementation can improve depressive symptoms, likely by supporting neurotransmitter function and reducing inflammation in the brain.

Headaches and Migraines

Women prone to migraines often have low magnesium levels. Supplementing with magnesium may help reduce the frequency and severity of migraines. Magnesium citrate has been seen as particularly beneficial for those experiencing migraines with aura. The therapeutic dosage of magnesium for migraine prevention is high and therefore should be done under the supervision of a doctor. 

Bone Health

Bone loss accelerates during menopause, increasing the risk of osteoporosis. Magnesium is crucial for bone density and works synergistically with calcium and vitamin D to maintain strong bones. Studies have linked magnesium deficiency to lower bone mineral density in postmenopausal women.

Blood Sugar Regulation

Magnesium plays a vital role in glucose metabolism. Deficiency can lead to insulin resistance and type 2 diabetes, both of which are more common during menopause. A diet rich in magnesium can help stabilize blood sugar levels and lower the risk of developing diabetes.

Heart Health

Heart disease risk increases after menopause due to declining estrogen levels. Magnesium supports heart health by regulating heart rhythm, blood pressure, and electrolyte balance. Adequate magnesium intake has been linked to lower blood pressure and reduced risk of heart arrhythmias.

Fatigue

Fatigue is a common symptom during menopause. Magnesium contributes to energy production and can improve feelings of tiredness by addressing underlying issues like poor sleep due to chronic stress or depression.

Constipation

Magnesium citrate is often used to relieve constipation. It helps relax intestinal muscles and draw water into the colon, promoting regular bowel movements. If you struggle with chronic constipation, this form of magnesium may be particularly helpful. However, it is first important to address any underlying reasons for the constipation first.

Inflammation

Chronic low-grade inflammation is linked to aging and many health conditions. Magnesium deficiency can exacerbate inflammation and increase oxidative stress, leading to poorer health outcomes. Ensuring adequate magnesium intake can help suppress inflammatory markers and improve overall health.

Tips for Supplementation

It is always best to get nutrients from our food first. Foods have a variety of compounds in them which work synergistically in our bodies. When adequate intake is not possible through diet, supplementation may be necessary. 

- Take supplements away from medications, coffee, or alcohol by 2-4 hours

- The upper daily limit for supplemental magnesium is 350 mg

- Different forms of magnesium work better for different symptoms and some are better tolerated than others

- Always consult with a healthcare provider before starting higher therapeutic doses

Sources:

1. Photo by Brooke Lark on Unsplash

2. Breus, Michael J. et al. Effectiveness of Magnesium Supplementation on Sleep Quality and Mood for Adults with Poor Sleep Quality: A Randomized Double-Blind Placebo-Controlled Crossover Pilot Trial. Medical Research Archives, [S.l.], v. 12, n. 7, July 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5410>. Date accessed: 13 Jan. 2025. doi: https://doi.org/10.18103/mra.v12i7.5410. Accessed January 13, 2025. 

3. Chou MH, Yang YK, Wang JD, Lin CY, Lin SH. The Association of Serum and Dietary Magnesium with Depressive Symptoms. Nutrients. 2023 Feb 2;15(3):774. doi: 10.3390/nu15030774. PMID: 36771478; PMCID: PMC9920676. Accessed January 13, 2025. 

4. National Institutes of Health. Magnesium. National Institutes of Health. Published June 2, 2022. Available at: https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional. Accessed January 25, 2025. 

5. Fiorentini D, Cappadone C, Farruggia G, Prata C. Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients. 2021 Mar 30;13(4):1136. doi: 10.3390/nu13041136. PMID: 33808247; PMCID: PMC8065437. Accessed Jan 25, 2025

6. Gröber U. Magnesium and Drugs. Int J Mol Sci. 2019 Apr 28;20(9):2094. doi: 10.3390/ijms20092094. PMID: 31035385; PMCID: PMC6539869. Accessed Jan 25, 2025.

7. Zhang Y, Chen C, Lu L, Knutson KL, Carnethon MR, Fly AD, Luo J, Haas DM, Shikany JM, Kahe K. Association of magnesium intake with sleep duration and sleep quality: findings from the CARDIA study. Sleep. 2022 Apr 11;45(4):zsab276. doi: 10.1093/sleep/zsab276. PMID: 34883514; PMCID: PMC8996025. Accessed Jan 25, 2025.

8. Gilca-Blanariu GE, Trifan A, Ciocoiu M, Popa IV, Burlacu A, Balan GG, Olteanu AV, Stefanescu G. Magnesium-A Potential Key Player in Inflammatory Bowel Diseases? Nutrients. 2022 May 3;14(9):1914. doi: 10.3390/nu14091914. PMID: 35565881; PMCID: PMC9102374. Accessed Jan 13, 2025.

9. In the News: Magnesium Supplements for Sleep Disorders. NCCIH. https://www.nccih.nih.gov/health/in-the-news-magnesium-supplements-for-sleep-disorders

10. Mathew AA, Panonnummal R. 'Magnesium'-the master cation-as a drug-possibilities and evidences. Biometals. 2021 Oct;34(5):955-986. doi: 10.1007/s10534-021-00328-7. Epub 2021 Jul 2. PMID: 34213669; PMCID: PMC8249833. Accessed January 25, 2025. 

11. Dominguez LJ, Veronese N, Barbagallo M. Magnesium and the Hallmarks of Aging. Nutrients. 2024 Feb 9;16(4):496. doi: 10.3390/nu16040496. PMID: 38398820; PMCID: PMC10892939. Accessed Jan 14, 2025.

12. Pickering G, Mazur A, Trousselard M, Bienkowski P, Yaltsewa N, Amessou M, Noah L, Pouteau E. Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients. 2020 Nov 28;12(12):3672. doi: 10.3390/nu12123672. PMID: 33260549; PMCID: PMC7761127. Accessed Jan 14, 2025. 

13. Maier JA, Pickering G, Giacomoni E, Cazzaniga A, Pellegrino P. Headaches and Magnesium: Mechanisms, Bioavailability, Therapeutic Efficacy and Potential Advantage of Magnesium Pidolate. Nutrients. 2020 Aug 31;12(9):2660. doi: 10.3390/nu12092660. PMID: 32878232; PMCID: PMC7551876. Accessed Jan 14, 2025.

14. Kirkland AE, Sarlo GL, Holton KF. The Role of Magnesium in Neurological Disorders. Nutrients. 2018 Jun 6;10(6):730. doi: 10.3390/nu10060730. PMID: 29882776; PMCID: PMC6024559. Accessed Jan 14, 2025.

15. Lyu C, Tsinovoi CL, Xun P, Song Y, Pu Y, Rosanoff A, Iribarren C, Schreiner PJ, Shikany JM, Jacobs DR, Kahe K. Magnesium intake was inversely associated with hostility among American young adults. Nutr Res. 2021 May;89:35-44. doi: 10.1016/j.nutres.2021.01.001. Epub 2021 Apr 21. PMID: 33894659; PMCID: PMC8098670. Accessed Jan 14, 2025.

16. Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020 Jun 3;12(6):1661. doi: 10.3390/nu12061661. PMID: 32503201; PMCID: PMC7352515. Accessed Jan 15, 2025.

17. Razzaque MS. Magnesium: Are We Consuming Enough? Nutrients. 2018 Dec 2;10(12):1863. doi: 10.3390/nu10121863. PMID: 30513803; PMCID: PMC6316205. Accessed Jan 21, 2025.

18. Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020 Jun 3;12(6):1661. doi: 10.3390/nu12061661. PMID: 32503201; PMCID: PMC7352515. Accessed Jan 21, 2025. 

19. Dietary Guidelines for Americans. Dietary Guidelines for Americans, 2020-2025 and Online Materials | Dietary Guidelines for Americans. www.dietaryguidelines.gov. Published December 2020. Available at: https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials. Accessed Jan 21, 2025.

20. Pickering G, Mazur A, Trousselard M, Bienkowski P, Yaltsewa N, Amessou M, Noah L, Pouteau E. Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients. 2020; 12(12):3672. https://doi.org/10.3390/nu12123672. Accessed Jan 22, 2025.