How Does Menopause Affect the Skin?

by Dr Diana Howard

Menopause is an incredibly complicated process that all women endure as they reach middle age. For some, symptoms appear to be a mere end to the monthly cycle. For others, it is a complicated process that can last for a few years and cause a variety of changes. Menopause not only affects the internal body, it affects the skin as well. But before we look at menopause and the effect it has on skin, let’s discuss the changes to a woman’s hormones during menopause.

What Happens to Hormones During Menopause?
Hormonal changes and declines, as well as the slowdown in oestrogen production, cause many of the changes we see associated with menopause. Hormones can cause hot flushes, which are intense feelings of warmth in the skin, particularly of the face, accompanied by profuse sweating. In addition, the adrenal glands and ovaries of postmenopausal women secrete increased androgens. These hormones, in the absence of oestrogens, cause some menopausal symptoms such as the appearance of facial hair.

Menopause and the Skin
So what does this have to do with the skin? A lot. The hormonal changes that occur during and after menopause tend to change the skin’s physiology in new and different ways. We know that the decline in oestrogen during menopause is one of the culprits in the accelerated ageing of the skin. We also know that menopause is mostly caused by age-related changes in the ovaries. This results in lowered oestrogen and progesterone production, which in turn leads to changes in the skin. As a woman gets closer to menopause, the following changes begin to occur in the skin:

Oily Skin
Testosterone reveals itself by stimulating sebaceous glands to secrete more oil, giving the appearance of oily skin (and the tendency toward adult acne in some women).

Facial Hair
Also, due to the unmasking of testosterone, some women may develop facial hair, particularly in the chin area.

Sagging Skin and Wrinkles
Oestrogens stimulate fat deposits over the female body; as oestrogen levels drop during menopause, fat deposits tend to become redistributed and often concentrated over the abdomen and/or on the thighs and buttocks. The result is a loss of supportive fat below the skin of the face, neck, hands and arms; this allows sagging wrinkles to appear, and the skin over these areas is less easily compressed, as it loses its mobility. Also, fat deposits are reduced in the breasts, which causes the breasts to begin to sag and flatten. Lowered oestrogen levels result in less production and repair of collagen and elastin in the skin. UV rays are very destructive to collagen, and if we lose our repair mechanism, then we lose our skin’s resiliency.

Thinning Skin
The growth and maintenance of blood capillaries in the skin are partially under the control of the oestrogens. Thus, blood flow through the capillaries is reduced during menopause, and fewer nutrients and oxygen are available to the deeper layers. This contributes to the thinning of the skin and a slower cell turnover rate.
An interesting note: the cells that make up the surface of the skin are similar in structure to those of the urinary tract and vagina. Often when a woman begins to notice changes in her skin (wrinkling, sagging, dryness, flaking, loss of resiliency, etc.), similar changes are occurring in the lining of the urethra, bladder and vagina. Thus, the skin may be revealing other tell-tale signs of menopause.

More Prone to Sun Damage
As menopause progresses, the number of protective cells degenerate. With less of these, we produce less of the protective melanin, and skin appears lighter. Menopausal skin is, therefore, more prone to sun damage, making it even more important to protect the skin with a sunblock.

Hyperpigmentation/Age Spots
Oestrogens also temper melanin production. In areas of the skin that have been exposed to UV rays over the years, as menopause arrives, melanin synthesis increases. This can result in brown “age spots” appearing on the face, hands, neck, arms and chest of many women.

Hot Flushes
Hot flushes are typically defined by a strong sense of warmth in the skin, (mainly the face), followed by excessive sweating and a rise in body temperature.

Other Symptoms of Menopause
Menopause affects much more than the skin. Some possible internal symptoms can include dizziness, numbness, heart palpitations, insomnia, backaches and dry mouth, among others. About 85% of women have menopausal symptoms both before and after they reach it; the occurrence and intensity of symptoms vary from woman to woman. For most, these symptoms stop within a year, but for some, symptoms can last as much as three years or more.