Restless legs syndrome is common. It is estimated to affect 5-10% of adults, with 2-3% experiencing moderate to severe symptoms. It is twice as common in women than men, usually starting in the 30’s and 40’s.
The key symptom is an overwhelming urge to move your legs during periods of rest or inactivity, especially at night. It is associated with restlessness and distressing paraesthesia-like (burning, prickling, numbness, tingling) sensations in the lower legs. The symptoms follow a circadian (sleep-wake) pattern and tend to be worse in the evening. Periodic leg movements can also occur, whilst asleep and also during the day. Symptoms and severity can vary enormously and the symptoms may disappear for periods of time and then recur.
The 5 essential diagnostic criteria for restless legs syndrome (you must have all 5) are:
- An urge to move the legs usually accompanied by unpleasant sensations in the legs
- This usually occurs during periods of rest or inactivity
- The urge to move and accompanying sensations are eased by movement
- Symptoms are worse in the evening and night than during the day
- The features are not explained by another condition e.g. leg oedema, arthritis etc
In most cases we cannot explain why restless legs syndrome happens, half of people have a family history of this condition, so you may know a relative who suffered with this. Sometimes it is due to another medical condition like iron deficiency, renal disease or peripheral neuropathy. Some commonly prescribed drugs can make it worse, such as antihistamines, beta blockers and SSRI antidepressants.
What can ease Restless Legs Syndrome?
In cases where is it mild good sleep hygiene, reduce caffeine and alcohol before bedtime, stop smoking, increase daytime exercise, walking, stretching and relaxation exercises can help.
In cases which are moderate or severe medication like dopamine agonists and gabapentinoids, which are both effective at helping the sensory symptoms. Some people need to be referred to a neurologist for further investigations.
Blood tests are needed to exclude other causes, and we guide treatment by the severity of your symptoms and the impact upon your quality of life. Ensuring that your serum ferritin levels are high enough is important and we can test for this at Rowena Health.
If you are suffering with this symptom please do talk with us at your appointment. Restless legs syndrome can significantly affect your sleep, which can be difficult for lots of reasons in perimenopause. We can help with this at our midlife appointments when we discuss all of your symptoms in detail. Do reach out for an appointment if you feel we can help.
Book an appointment at Rowena Health
Further information
Restless Legs Syndrome, UK support & information charity
Last updated: Dr Carys Sonnenberg September 2023
This is really helpful, thank you. I have suffered for years with RLS both in perimenopause and post menopause. Once I feel that urge I know I’m going to have to get out of bed and go for a wander around the house. Our cold stone floors and the coir doormats are helpful! I have noticed though, that it’s the days I don’t go for a walk that will mean it’s worse at night.
Dear Racheal, thank you so much, do make sure your iron level is high enough, as this has been shown to ease symptoms. Best wishes Carys
Hi
I have suffered with restless leg syndrome for over 25 years starting initially when I was pregnant with my first child. I have been taking pramipexole for around 20 years now and it’s the only thing that allows me to have any form of sleep. I have tried lots of things to see if they help, exercise, magnesium, iron supplements and nothing makes a difference really. I am menopausal and haven’t had a period for around 3 years. I feel that the restless legs have become worse during this time and I have, with instruction from my gp increased my dose.
My concern is the length of time I have been prescribed this medication and wonder if there is anything else you can suggest, or if this medication would contraindicate with hrt?
I have tried hrt and felt really anxious so decided to stop. However my mood is really low at the moment along with lots of other symptoms like fatigue, bone pain, headache, brain fog etc and I’m considering another attempt at hrt.
Any suggestions or help would be greatly appreciated
Thankyou
Dear Geraldine, I am so sorry that you are suffering with this symptom, sometimes it runs in families. I would be happy to see you in clinic for a holistic assessment, it is difficult to advise further without your full medical history, I’m afraid.
Best wishes Dr Carys Sonnenberg