Perimenopause tingling and numbness are neurological symptoms driven by estrogen's role in maintaining the myelin sheath — the insulating coating around nerve fibres. When estrogen fluctuates, nerve signals misfire: pins and needles, burning skin, electric shocks. A 2025 study in the International Journal of Molecular Sciences confirms estradiol actively promotes myelin repair. Cathy explains the full mechanism and what evidence-based strategies actually reduce symptoms.