Menopause and Perimenopause Skin Changes

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Perimenopause and menopause are natural stages in a woman’s life that mark the end of reproductive years. These phases and various hormonal changes can significantly impact a woman’s overall health and well-being. One area that often experiences noticeable changes during this time is the skin. Fluctuating hormone levels can affect skin health and appearance, leading to various skin-related concerns. Here, we explore the effects of perimenopause and menopause on the skin and discuss ways to maintain healthy, vibrant skin during this transitional period.

Understanding Perimenopause and Menopause

Perimenopause refers to the transitional phase leading up to menopause when a woman’s body undergoes hormonal fluctuations and prepares to cease menstruation. During this time, the ovaries gradually produce less estrogen, leading to irregular periods and a variety of physical and emotional symptoms. Eventually, a woman enters menopause, officially defined as the absence of menstrual periods for twelve consecutive months.

Impact of Hormonal Changes on the Skin

Estrogen, the primary women’s sex hormone, plays a vital role in maintaining healthy skin. It contributes to the production of collagen and elastin, which provide structure and elasticity to the skin. Additionally, estrogen helps regulate sebum production, keeping the skin moisturized and supple. However, during perimenopause and menopause, estrogen levels decline significantly, causing several changes in the skin.

  1. Dryness and Reduced Elasticity: The skin may become drier with decreased estrogen, resulting in a loss of elasticity. This can lead to increased roughness, fine lines, and wrinkles. Dry skin is also more tending to irritation and itchiness.
  1. Thinning of the Skin: Estrogen deficiency can induce a decline in the production of elastin & collagen, resulting in thinner skin. Thinning of the Skin makes it more susceptible to damage, bruising, and slower wound healing.
  1. Increased Sensitivity: Many women experience heightened skin sensitivity during perimenopause and menopause. The skin may become more reactive to external irritants, leading to redness, rashes, and increased susceptibility to allergies.
  1. Acne and Breakouts: Some women may experience a resurgence of acne or the onset of acne during this phase. Fluctuating hormone levels can increase sebum production, leading to clogged pores and breakouts.
  1. Uneven Skin Tone: Changes in hormone levels can disrupt melanin production, resulting in uneven skin tone and dark spots or patches, commonly known as melasma.

Maintaining Healthy Skin during Perimenopause and Menopause

While the hormonal changes during perimenopause and menopause can affect the skin, there are several strategies women can employ to promote skin health and minimize the impact of these changes.

  1. Establish a Skincare Routine: Adopting a consistent skincare routine is crucial for maintaining healthy skin. Cleanse the skin twice daily, use a moisturizer suitable for your skin type, and apply a broad-spectrum sunscreen with a minimum of SPF 30 daily to protect against UV damage.
  1. Hydration is Key: Combat dryness by staying well-hydrated. Drink adequate water throughout the day to keep the skin hydrated from within. Additionally, use a moisturizer that contains humectants like hyaluronic acid to attract and retain moisture.
  1. Nourish the skin with a Balanced Diet: A healthy diet high in vitamins, minerals, and antioxidants can support skin health. Incorporate plenty of fruits, vegetables, whole grains, and lean proteins. Omega-3 fatty acids seen in fish, nuts, and seeds can help reduce inflammation and maintain skin elasticity.
  1. Protect from the Sun: UV rays can accelerate skin aging and worsen existing skin concerns. Always apply sunscreen with a high SPF, wear protective clothing, and seek shade during peak sun hours.
  1. Avoid Harsh Products and Irritants: Choose skincare and cosmetic products that are gentle and free from harsh chemicals or fragrances. Harsh products can strip the skin of natural oils and disrupt its barrier function, increasing dryness and sensitivity.
  1. Seek Professional Guidance: Consult a dermatologist or skincare specialist who can provide personalized advice and recommend appropriate treatments or skincare products tailored to your skin’s needs.

Perimenopause and menopause bring about significant hormonal changes that can impact the skin in various ways. Dryness, reduced elasticity, increased sensitivity, acne, and uneven skin tone are common concerns during this transitional phase. However, by adopting a consistent skincare routine, staying hydrated, nourishing the skin through a balanced diet, protecting from the sun, avoiding harsh products, and seeking professional guidance, women can maintain healthy, radiant skin throughout perimenopause and menopause. Embracing these strategies will promote skin health and contribute to overall well-being during this transformative period in a woman’s life.

Here we discuss this with Dr. Ginni Mansberg, a physician, to get her thoughts on this topic.

Perimenopausal Skin Health

NourishDoc: Today’s session is going to focus on skin health.

Dr. Ginni: The only patients I see are menopause and perimenopause women and skin issues because I have always had terrible skin. I have been plagued by rosacea; I have acne, I still have adult acne, and I’ve got horrific pigmentation. We know most pigmentation is genetic. I couldn’t find any evidence-based skincare on the market. I couldn’t find those ingredients and formulations in any commercial skincare products. So I made my own. 

Effects of Skin and Hair during Menopause

NourishDoc: What happens to skin and hair when estrogen and progesterone drop?

Dr. Ginni: Menopause doesn’t happen overnight; there’s a long kiss. Goodnight from your ovaries. So the first thing that happens, I’m sure you all know about the straw categories of reproductive health. So you’ve got straw stages. So from minus one, minus two, minus three, all your reproductive periods where you’re still ovulating are fertile. You’re having irregular cycles more or less every 28 days. 

And then you start to go into perimenopause or menopause transition, and the first thing that drops off is your progesterone, a great chill pill. And that’s why there are so many mood and sleep disorders, particularly in what we call straw minus two, the first phase of perimenopause, and you’re more likely to get vaginal symptoms, hot flushes. Estrogen provides moisture by increasing the amount of hyaluronic acid and the number of ceramides in your skin.

These are all part of the building, lots of the scaffolding of the skin, but most important for your skin barrier. The skin barrier keeps good stuff and water inside the skin, keeping it hydrated and bad stuff toxins, bacteria, and funguses out. Many women undergoing Perimenopause experience very itchy, dry, and drier skin. When you lose estrogen, those enzymes that break down collagen, Estrogen also protects you from the effects of UV radiation, the sun’s rays that we know are bad for the skin.

Bioidentical Hormones For Menopause Skin Changes

NourishDoc: Talk a little about the bioidentical hormones

Dr. Ginni: So let’s split this into three parts. The first part is the product. The second part is food and nutrition for menopausal skin. And the third part is bioidentical hormones because that’s a lot to unpack. Anybody who tells you that their products are designed specifically for menopausal skin is trying to sell you rubbish, right? Because there is no such thing as a specific menopausal product. All anti-aging products are designed to increase the amount of collagen, reduce its breakdown, and increase its hydration; that’s all we’re trying to do.

In terms of nutrition. I would caution people who go on fat-free diets or do rapid weight loss that often has quite major impacts on your subcutaneous fat, which is the fat that sits below the skin and can make you look much older. But other than that, eat well. I know eating well is not for your skin but for your health. I urge you to take your diet seriously. Again, everything in skincare is based what we do is based on peer-reviewed journal studies. 

So what we’re talking about is vitamin C, which is L ascorbic acid and is critical for its antioxidant, but it also helps you build collagen. It also helps you battle pigmentation. Vitamin C is stabilized by vitamin E. So vitamin E, also called Alpha-tocopherol it increases vitamin C’s efficacy and shelf life. Vitamin K has evidence for breakouts, anti-aging, wrinkling, and pigmentation. 

The biggest issue is what form of vitamin A you use. Unfortunately, 30 to 50% of people can’t tolerate it because of the stinging, burning, and redness, and it also tends to dry out the skin. Retinol is two steps removed from retinoic acid in the prescription form but still causes a retinal burn. Luckily, there is a step between retinol and retinoic acid; it is equally effective for aging and acne.

Menopausal women lose much of their hyaluronic acid because estrogen builds it into the skin. Low molecular weight hyaluronic acid can penetrate the skin; it can be a little bit irritating; high molecular weight hyaluronic acid is what you have injected, but that’s what you use to sort of build cheekbones, and it’s filler, right? But it doesn’t penetrate the skin. We have created dissolving microneedles; they are point two of a millimeter long, so they don’t cause any pain or get to the skin level layer with the pain fibers. Also, resveratrol gets green tea, which is less evidence-based, but it is released inside the skin as you apply these, and they’re designed for under the eyes, but also this area here. You can even use them on your neck.

Other Options For Skin Health

NourishDoc: Any last thoughts and anything else before we wrap up the session today? 

Dr. Ginni: The reason why the North American menopause society and the International Menopause Society do not recommend bioidentical hormones is that they are not well-regulated. We don’t have good evidence that they are safe. We have had several situations in which people took those with uterine cancer, and I strongly recommend against them. For evidence-based treatments for menopause, not just HRT, incorporate a range of options, including holistic care. So it’s not just about the HRT, but if you are going to do hormone therapy, please. Bioidenticals are, at best. Okay, and at worst, potentially dangerous.


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