Menopause marks the end of a woman’s reproductive years. It is a transitionary period when her periods stop, caused by a gradual loss in ovarian follicular function alongside a decline in estrogen levels. For many women, menopause is accompanied by a number of symptoms of ranging severity that can impact many aspects of life. Scientists recently totaled the number of menopause symptoms to 48, although not all women will experience all of these.
It is estimated that almost half of women experience skin issues during menopause. Reduced production of estrogen, progesterone, and testosterone, and increased production of cortisol during this period are responsible for the inevitable skin changes that women face. For some, however, these changes can be more significant or challenging.
Skin and Hair Changes During Menopause
One of the most common skin changes brought on by menopause is dry and itching skin. This is caused by the drop in estrogen that occurs in menopause. Estrogen acts as one of the skin’s natural hydration boosters as it facilitates the production of ceramides, natural hyaluronic acid, and sebum. In the absence of these substances, water easily evaporates from the skin, leaving it dry. Dry skin can then become irritated, causing itching.
Experts recommend that dryness and itching during menopause can be mitigated by avoiding products with soap, as soap dries the skin. They also recommend applying moisturizer to help the skin hold onto moisture.
Itching skin can also be an indicator of other problems such as iron deficiency and thyroid problems, for this reason, women are recommended to discuss these symptoms with their healthcare professional.
Reduced levels of estrogen can also cause the skin to become more fragile. Estrogen is required for collagen production, the protein that gives skin its elasticity and firmness. During the first five years of menopause, skin loses roughly 30% of its collagen, followed by a more gradual decline in the years that follow. While this can cause the skin to lose its look of plumpness and increases the appearance of wrinkles, it also makes skin more vulnerable to bruising. Collagen also plays an important role in wound healing, with less collagen, skin can take longer to heal.
The effect of reduced collagen levels can be addressed with hormone replacement therapy (HRT), which replaces the lost estrogen, however, not everyone is suitable for HRT. Women with a history of breast, ovarian or womb cancer, a history of blood clots, untreated high blood pressure, or liver disease may not be suitable for HRT.
While acne is associated with adolescence, it is increasingly being recognized as a condition that impacts people throughout life, including during menopause. While the cause of menopausal acne is multifactorial, hormonal imbalances have the most responsibility for these kinds of breakouts.
Often, women who had flare-ups of acne during adolescence can experience similar flare-ups during menopause. While estrogen replacement can be used to tackle hormone imbalances, some women continue to have acne following this treatment. More research is needed to fully understand the mechanisms underlying menopausal acne.
Hot flushes are one of the most common symptoms of menopause, almost all women experience flushes in this period. Menopause also seems to increase a woman’s likeliness of suffering from rosacea, in which the blood vessels in the skin become very reactive.
The redness caused by flushes and rosacea can be reduced with changes to lifestyle. Avoiding alcohol, caffeine, and spicy food, and using SPF can improve skin redness. Other techniques, such as creams or lasers are sometimes used to tackle rosacea.
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The growth of new, thicker facial hair is fairly common in women of menopausal age. One study from that around 40% of women aged 45 and over reported the growth of excess facial hair, particularly on the chin. The drop in estrogen that happens during menopause changes the balance of estrogen vs testosterone, this relative increase in testosterone can cause course facial hair to grow on the upper lip, chin, cheeks and jawline.
During menopause, signs of sun damage can become more salient. The skin can become more pigmented, often on the cheeks, upper lip and forehead, this pigmentation is known as melasma. Women with particular sun damage may experience an irregular skin tone and sun spots.
Finally, menopause can be a time when women find their appearance changes. The loss of bone density (which also affects the facial bones), and drop in collagen that occurs during menopause and beyond can alter the facial appearance. This can be a challenging process to endure.
The changing hormone levels that are the hallmark of menopause also impact a woman’s mental health. An estimated 70% of women experience some type of mental health impact at the time of menopause. Changes to the skin can be a source of distress, some women find it contributes to a loss of confidence and self-esteem.
Increasing research into the 48 symptoms of menopause is vital to ensure that we have the expertise necessary to support women’s health during this time.