Internal tremors and menopause: what you need to know

Feeling strange vibrations can be disconcerting but help is at hand

We know more than ever about the menopause but still some symptoms aren’t discussed or linked to this stage of life, including internal tremors. But what are internal tremors, and why do they happen?

Internal tremors explained

A tremor is an involuntary quivering movement or shake. The NHS says it’s normal to have a slight tremor – if you hold your hands out, they will not be completely still [1]. However, an internal tremor (also sometimes known as internal vibration) is felt within the body and cannot be seen by anyone. It can occur all over the body or can be localised.

What does it feel like?

Internal vibrations can feel like a buzzing, vibrating, shaking or quivering. Some women describe the sensation as feeling like a phone or bees are buzzing inside them. The sensation is not debilitating but it can be unnerving and act as a distraction from everyday life.

Is it linked to the menopause?

Newson Health GP and Menopause Specialist Catherine Shire says: ‘It can be linked to the perimenopause and menopause but is not a commonly recognised symptom. The underlying mechanism for these internal tremors is not understood. Women and health professionals often worry that these are caused by a neurological problem and women undergo extensive investigations.’

Compared to other menopause symptoms, not a lot is known about internal tremor and there is a lack of relevant studies on the potential link. However, we do know that oestrogen receptors are found in cells throughout your body and that oestrogen can interfere with nerve function. Hormonal fluctuations could be described like a type of misfiring, which causes the sensation of internal tremor.

Some women who are perimenopausal and still having periods might find they only get the internal tremors at a particular point in their cycle, which helps to indicate that fluctuating hormones are the culprit. However, as hormones fluctuate a lot throughout the cycle (even within the day) during perimenopause, some women may experience them throughout the month without a discernible pattern.

What else could cause it?

There is no diagnostic test for internal tremors and there could be a variety of reasons for experiencing them. It is important, therefore, to rule out other causes before assuming perimenopause is the underlying cause.

Researchers have suggested that anyone can experience internal tremors, but they are more pronounced in people with Parkinson’s, multiple sclerosis and essential tremor [2]. Other potential causes include low iron, vitamin B12 or vitamin D deficiencies or diabetes. You should speak to your doctor if you are experiencing internal tremors in order to rule these out.

Is there a treatment?

‘I recommend keeping a record of the tremors and any other symptoms you are experiencing,’ says Dr Shire. ‘Completing the symptom checker on the balance app can be very helpful for this. It is important to discuss all these symptoms with your GP who will decide if you require any investigations such as blood tests and scans.’

‘A trial of HRT may be helpful, particularly if you are experiencing other symptoms suggesting that you are perimenopausal or menopausal.’

That are some triggers for internal tremors that you can influence. Caffeine, foods that are high in salt or sugary can affect your nervous system so it’s worth completing a food diary to see if there any triggers for you. Stress can overstimulate the nervous system so try to build relaxation into your day.

Exercise can help improve nerve function but avoid intense exercise or doing it in heat, as this may have an impact. Similarly, hydration can affect the nervous system so ensure you are drinking enough.

Your healthcare professional will be able to advise if internal tremors are a side effect of any medication you are taking and you may be prescribed a vitamin B complex if you are low on B12. It is important to be aware that internal tremors are not a commonly recognised symptom of the perimenopause and menopause.

Some women find that their internal tremors improve when they find the right balance of hormones through HRT. Speak to your healthcare professional for an individualised conversation about treatment to suit you.

References

1. NHS: tremor or shaking hands

2. Cochrane G. et al. (2015), ‘Internal tremor in Parkinson’s disease, multiple sclerosis, and essential tremor’, Parkinsonism & Related Disorders, vol 21 (10), pp1127-1298, doi: 10.1016/j.parkreldis.2015.07.014