Skin & Menopause: Understanding the Link

Menopause was once taboo but is now increasingly discussed, albeit surrounded by a significant amount of misinformation. Various approaches to managing menopause—such as supplements, dietary changes, skincare products, and exercise routines—are available. As skin therapists, it is essential to act as guides and trusted advisors during this challenging time for clients.

What is Menopause?

Menopause is the stage in a woman’s life when her menstrual cycle comes to an end, resulting in the inability to conceive. It is important to note that menopause varies for each individual, similar to pregnancy experiences. Menopause typically occurs between the ages of 45 and 55

Source: North American Menopause Society. (2020). The Menopause Guide.

Statistics on Menopause

According to statistics from Over The Bloody Moon:

• 67% of women reported a negative impact on their feelings and mood.
• 59% experienced a lack of self-confidence.

Here are some additional statistics on menopause:

• The average age of natural menopause is 51 years.
• Approximately 5% of women experience menopause before the age of 40 (premature menopause).
• Up to 75% of women experience hot flashes during menopause.
• About 80% of women report sleep disturbances during perimenopause and menopause.
• Approximately 50% of women notice changes in their skin, such as increased dryness and sensitivity, during menopause.
• 30% to 50% of women experience weight gain during menopause, with some studies suggesting an average weight gain of about 5-10 pounds.
• About 50% of menopausal women invest more in skincare products as they notice changes in their skin.
• After menopause, women can lose up to 20% of their bone density in the first 5-7 years, increasing the risk of osteoporosis.
• The risk of cardiovascular disease increases significantly after menopause, with studies indicating a 50% higher risk compared to premenopausal women.

 Stages of Menopause

1. Perimenopause

• This is the transitional phase leading up to menopause, often starting between ages 35-45. It can last anywhere from 4-10 years.
• Estrogen levels begin to decline significantly, leading to various symptoms and fluctuations in hormone levels.
• Estrogen plays a critical role in skin hydration, collagen production, and elasticity. As estrogen levels drop, the skin may begin to show signs of dryness, fine lines, and decreased firmness.
• Factors such as genetics, diet, and lifestyle influence the duration and severity of this stage.
• Common symptoms include mood swings, hot flashes, and sleep disturbances.
• Skin becomes thinner, and some women experience acne breakouts due to hormonal imbalances. Estrogen declines while androgens (male hormones like testosterone) remain stable, sometimes leading to oilier skin and breakouts similar to adolescent acne.
• Increased skin sensitivity and flushing can also occur, and some women develop rosacea or experience worsening of pre-existing conditions due to blood vessel dilation.

2. Menopause

• Defined as the cessation of menstrual periods for 12 consecutive months, typically occurring between ages 45-51.
• It marks the point when the ovaries stop releasing eggs, and estrogen levels significantly decrease.
• The production of estrogen by the ovaries significantly reduces, and the skin loses collagen—a key protein that maintains skin structure and firmness. This loss leads to sagging, fine lines, and wrinkles.
• Dry skin becomes a common complaint due to decreased sebum (oil) production and the reduction in glycosaminoglycans (GAGs), which help the skin retain moisture. This leads to itchiness and rough texture.
• A decrease in estrogen also affects the production of melanin, sometimes leading to age spots or hyperpigmentation, particularly in sun-exposed areas.

3. Postmenopause

• This stage follows menopause and encompasses the rest of a woman’s life.
• Changes initiated during menopause continue to progress, including further skin aging and other symptoms.
• Collagen levels continue to decrease, potentially resulting in a loss of up to 30% of skin collagen in the first five years after menopause.
• Skin elasticity declines significantly, leading to sagging, especially around the jawline and neck.
• Wound healing becomes slower, and the skin’s barrier function may be impaired, leading to irritation and increased risk of infections or conditions like eczema.
• Facial hair may increase in certain areas (like the chin and upper lip) due to the relative increase in androgens compared to estrogen.

Source: Haskin, M. H., & Robinson, T. J The impact of menopause on the skin: a review. Journal of Cosmetic Dermatology

Early & Premature Menopause

Early menopause occurs before age 45, and premature menopause occurs before age 40.

• Causes may include surgical removal of ovaries, autoimmune disorders, cancer treatments, and hormonal therapies.
• Medically induced menopause can also occur due to these factors.

Symptoms of Menopause

There are 34 different symptoms associated with menopause, including:

• Dry skin
• Sleep disturbances
• Brain fog
• Hot flashes
• Thinning hair
• Itchy skin
• Aching joints
• Rosacea flare-ups
• Mood swings
• Anxiety
• Weight gain
• Dietary changes
• Loss of confidence
• Bone loss
• Decreased muscle strength

Women often describe feeling “like a different person” during this time.

Hormonal Changes During Menopause

Endocrine System

• The endocrine system comprises various glands producing hormones that regulate bodily processes.
• Ovaries produce sex hormones, and during pregnancy, the placenta acts as a temporary endocrine organ.
• The skin is sensitive to hormonal fluctuations and can produce hormones, making it part of the endocrine system.

Key Hormones

1. Estrogen

• Estrogen is essential for skin hydration, collagen production, sebum and hyaluronic acid synthesis, and wound healing.
• As estrogen levels drop, skin sensitivity increases, and inflammation may trigger skin disorders.

2. Progesterone

This hormone declines during menopause and works in conjunction with estrogen, impacting skin health and other bodily processes.

3. Testosterone (Androgens)

These male hormones don’t drop as significantly, so they become more dominant during menopause, leading to oilier skin and increased facial hair growth.

4. Thyroid Hormones

Many women experience thyroid dysfunction during menopause, leading to slower metabolism, dryness, weight gain, and delayed healing.

5. Cortisol: Levels of this stress hormone can increase during menopause due to sleep disturbances and hot flashes, potentially leading to collagen breakdown and inflammation in the skin.

Source: Wentzell, C. L., & Adigun, C. G. (2018). Hormonal Changes and Effects on the Skin During Menopause. American Journal of Clinical Dermatology, 19(6), 877-886.

Skin Changes During Menopause

During Perimenopause

Common Issues

• Ageing skin
• Breakouts (recommended ingredients: niacinamide)
• Pigmentation and sensitivity
• Dehydration
• Hot flashes (cooling mists can provide relief)

Skincare Recommendations

• Simplify skincare routines to basics.
• Incorporate Vitamin C for its antioxidant effects and benefits for collagen, skin tone, and pigmentation.

During Menopause (Post)

Common Issues

• Uneven skin tone
• Increased pigmentation
• Wrinkles and loss of firmness
• Dryness and poor wound healing

Skin Ageing

• Collagen loss accelerates, with a reduction of 2% per year post-menopause.

Strategies for Managing Menopausal Skin

Home Care Routine

• Integrate cell renewal ingredients like lactic acid and enzymes.
• Use active ingredients like retinol to promote collagen production.
• Opt for a progressive, not aggressive, approach to skincare.

Treatment Options for Menopausal Skin

• Increase exfoliation to improve skin texture.
• Promote collagen induction and tissue repair mechanisms.
• Enhance the infusion of active ingredients into the skin.
• Maintain overall skin integrity.

 Health and Wellness Tips for Clients

• Medication: Consult healthcare providers for suitable options.
• Sleep: Prioritize quality sleep for overall well-being.
• Exercise: Engage in regular physical activity, especially strength training.
• Nutrition: Focus on a balanced diet rich in essential nutrients.
• Mental Health: Encourage mindfulness practices and stress management techniques.
• Expert Advice: Seek guidance from healthcare professionals.
• Self-Care: Encourage clients to prioritize self-care routines.

Empowerment Through Education

Providing education on menopause enables clients to feel empowered during this transition. Resources such as Zoe Health offer valuable podcasts, and masterclasses can provide additional insights and support for women navigating menopause.

Further Reading

• North American Menopause Society. (2020). The Menopause Guide.
• Haskin, M. H., & Robinson, T. J. (2019). The impact of menopause on the skin: a review. Journal of Cosmetic Dermatology
• Wentzell, C. L., & Adigun, C. G. (2018). Hormonal Changes and Effects on the Skin During Menopause. American Journal of Clinical Dermatology
• Zoe Health: Available for insightful podcasts on menopause topics.