Perceived severity of restless legs syndrome across the female life cycle

As with migraine, female sex hormones may explain the high prevalence of restless legs syndrome (RLS) in women and therefore influence RLS severity across the female life cycle.

To test this hypothesis, we performed a questionnaire-based transversal survey in female members of the French Association of patients with RLS. Five hundred thirty-six women fulfilled the RLS criteria and completed the International RLS Severity Scale (IRLSSS) and questionnaire about reproductive behaviour, RLS history and perception of RLS symptom severity during pregnancy, menses and menopause.

Patients with at least one child showed a significantly higher mean IRLSSS score than women without children and 23% of the patients declared having perceived worsening of symptoms during pregnancy. Perceived RLS severity was increased during menses in 29% of non-menopaused patients and 69% of the patients reported worsening of symptoms following menopause. In these patients, a tendency towards higher IRLSSS scores was noted. Regression analysis revealed a correlation between higher IRLSSS scores and an early age at onset of RLS.

Female hormonal changes do not account for the variation in perceived severity in women with RLS during their hormonal milestones and their role in the pathophysiology of RLS is unlikely.