Formication in menopause: crawling skin, tingling, pins and needles and electric shocks

It can feel as if ants are walking across your arms, or something is moving just under your skin. Or your hands and feet tingle for no reason. Some women get sudden, tiny jolts, like small electric shocks. It's strange and unsettling, and it's hard to explain to anyone else.

The crawling feeling has a name: formication. Formication in menopause is listed as a possible symptom by UK menopause organisations, along with tingling and electric shock feelings. So you're not imagining it, and you're not the only one.

But the research on these symptoms is thin. And tingling or numbness can have other causes, a few of them serious. So please read the box below first.

What does formication feel like?

Women describe these feelings in different ways. You might notice:

• Crawling. A menopause at work toolkit on the Women's Health Concern website describes formication as feeling like something crawling about under the skin.
• Pins and needles. The Menopause Charity describes a tingling or prickling feeling, like when your foot "falls asleep". It says these are usually short-lived.
• Tingling hands or feet. The Menopause Charity lists this as a separate symptom.
• Electric shocks. The Menopause Charity describes a sudden, brief feeling of electric shocks on the skin. It says they're not usually painful, but can be startling, especially if they happen often.
• Prickly, itchy skin. The charity says dry skin can feel prickly and itchy, and be more sensitive.

You might have one of these, or several. They can come and go.

Is formication a symptom of menopause?

Possibly, but nobody has studied it properly. Here's what we found.

The Women's Health Concern toolkit lists formication alongside general itchiness, thinning skin and allergies. Its checklist of symptoms includes "tingling extremities" (hands and feet) and "electric shocks". The Menopause Charity's A to Z of symptoms includes pins and needles, tingling hands or feet, and electric shocks.

But the NHS list of menopause symptoms doesn't mention formication, tingling or electric shocks. Its only skin symptom is "skin changes, including dry and itchy skin".

We looked for studies on formication or tingling in menopause, and couldn't find any good ones. So we can't tell you how common these feelings are, or how long they last. They're on the symptom lists because women report them, and that matters. But it isn't the same as knowing the menopause is the cause.

Why might menopause cause tingling or crawling skin?

No one knows for sure. These are possible links, not proven causes.

Dry skin. The Menopause Charity says changes in skin moisture can lead to dryness or itchiness, and dry skin can feel prickly and more sensitive. If your crawling feeling comes with itch, our page on perimenopause itchy skin explains more.

Nerves. The Women's Health Concern toolkit says nerve function may be affected during the menopause. It doesn't say how.

Anxiety and fast breathing. Anxiety is common in perimenopause. The NHS menopause page says hot flushes can cause palpitations or anxiety. And the NHS lists hyperventilation (fast breathing), with trembling hands, as one cause of pins and needles.

Electric shock feelings in menopause

These are perhaps the least understood of all. Some women feel a sudden zap on the skin, often lasting only a moment. The Menopause Charity lists them as a menopause symptom. We couldn't find any research explaining them.

If the shocks are more like shooting or stabbing pains, especially in your feet or hands, mention it to your GP. The NHS lists "burning, stabbing or shooting pain" as a sign of peripheral neuropathy, which is damage to the nerves in your arms and legs.

What else causes tingling, numbness or pins and needles?

Please don't assume it's "just the menopause". The NHS says pins and needles usually happens when there's pressure on a nerve, like sitting or sleeping on an arm or leg. It usually passes once the pressure is off. Other causes include:

Cause	What you might notice
Carpal tunnel syndrome	Tingling, numbness or pain in your fingers, hand or arm. Often worse at night. A weak thumb, or trouble gripping
Diabetes	Numbness, tingling or pain in your feet and hands. Diabetes is the most common cause of nerve damage in the UK
Low vitamin B12	Pins and needles, numbness, muscle weakness, problems with balance. Often with tiredness and a sore, red tongue
Raynaud's	Fingers or toes that change colour
Sciatica, or a trapped nerve in your back or neck	Pain running from your back down your leg to your foot
Multiple sclerosis (MS)	Pins and needles in different parts of the body
Medicines, or heavy drinking	Tingling or numbness that lasts longer

Raynaud's, sciatica, MS, medicines and drinking are all on the NHS pins and needles page. The NHS says carpal tunnel is more likely if you're overweight, have arthritis or diabetes, or often bend your wrist or grip hard.

Low B12 is worth knowing about. The NHS says it's more common in older people. Some medicines, including proton pump inhibitors (for indigestion) and anticonvulsants, can affect how you absorb it. A vegan diet can also lead to low B12. The NHS says it should be found and treated as soon as possible, because the longer it goes untreated, the higher the chance of lasting damage.

If you think a medicine might be causing your symptoms, talk to your GP or pharmacist. Don't stop or change any prescribed medicine on your own.

What can help with tingling and crawling skin?

There's no proven fix for formication itself. But these steps can help you, and your GP, work out what's going on.

Keep a short diary. Note where you feel it, when it happens, how long it lasts, and anything that seems to set it off. Write down any other symptoms too, like hot flushes, poor sleep, tiredness or itching.

Look after dry skin. If the crawling comes with dry, itchy skin, the tips on our itchy skin page may help.

If it's your hands at night, think about carpal tunnel. The NHS suggests wearing a wrist splint at night, cutting back on things that bend your wrist or need a hard grip, and trying hand exercises. It can take up to 6 weeks to feel better.

Cut down on alcohol. The NHS says heavy drinking can damage nerves, and cutting down may help.

Notice your breathing. If tingling comes on when you're anxious or breathing fast, tell your GP. It's useful for them to know.

What your GP can do

Your GP will ask about your symptoms and may examine you. They may arrange blood tests. The NHS says low B12 can often be diagnosed from your symptoms and a blood test.

If you have other menopause symptoms too, you could ask about HRT. But we couldn't find any studies testing HRT for tingling or crawling skin. So no one can say whether it would help this symptom. It's one to talk through with your GP.

When to see a GP about tingling or crawling skin

See your GP if:

• you keep getting pins and needles, or it lasts a long time
• numbness or tingling is in both feet or both hands, and doesn't go away
• numbness spreads, or comes with weakness or balance problems
• you have burning, stabbing or shooting pains
• you also feel very tired, or have a sore, red tongue
• you have diabetes and notice tingling or numbness in your feet
• it's affecting your sleep or your daily life

And use the box at the top of this page for anything sudden. Our symptoms checklist can help you list everything you've noticed before you go.

You may also find these pages useful: perimenopause itchy skin, restless legs in menopause and skin changes in menopause.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms