Skin Changes After Menopause

Fluctuations in hormones impact the body and skin

As all of us age, we expect certain things to happen with our bodies. Our skin forms more wrinkles, we have more aches and pains, our hair changes color and becomes thinner and sparser. Usually, between the ages of 45 and 50, women start to go through a physiological transition called menopause. This happens when the ovaries stop producing the same amount of hormones that they did when they were younger. This natural decline in reproductive hormones leads to changes throughout the body. Reduced estrogen is associated with hot flashes, dryness of the skin and vagina, fine skin wrinkles, tissue atrophy, and poor wound healing.[1,2]


Reproductive System 

Technically, menopause is the absence of a menstrual cycle for 12 months. After menopause, a woman can develop thinning of the vaginal tissue. When the tissue becomes dry and thin, it can become more fragile and susceptible to tearing, bleeding, and injury, especially during intercourse. This can be painful with any vaginal penetration, and the discomfort can become great enough for women to choose to completely avoid sexual contact. For some, it is possible that this could lead to emotional stress, a burden on relationships, or even self-confidence issues. 



Hair loss is commonly reported after menopause, and the hormonal changes can significantly influence different qualities of hair including growth rate, texture, changes to the hair growth cycle, and how hair is distributed on the head.[3,4] Unfortunately, women with a preexisting hair condition such as androgenetic or androgenic alopecia may have worsened symptoms following menopausal changes.[5]



Estrogen is a stimulator of bone growth, and when this hormone decreases in the body after menopause, the bones begin to decline in structure and function. Specifically, some of the joints in the low back can become arthritic at a faster rate.[6] In larger bones such as the tibia, the bone density can decrease[7] leading to a greater risk for osteoporosis and fractures.



A review of the literature examining the skin changes seen in post-menopausal women and the effect of hormonal replacement therapy on slowing the skin aging process showed that decreased estrogen can slow down the synthesis of collagen and reduce how quickly the cells of the skin divide of the basal layer of the epidermis, leading to thinning of the skin.[8] A study of Dutch women showed that around one-third of women experience increased skin sensitivity after menopause.[9]


What Is the Verdict?

Hormonal fluctuations during menopause can cause significant changes in the body. In addition to many other parts of the body, the skin, bones, hair, and reproductive system can all undergo shifts with menopause. Hormonal therapy may be considered to manage some of these symptoms during menopause but need to be carefully discussed with a licensed health care provider.

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  1. Hall G, Phillips TJ. Estrogen and skin: the effects of estrogen, menopause, and hormone replacement therapy on the skin. J Am Acad Dermatol.2005;53(4):555-568; quiz 569-572; PMID: 16198774.
  2. Thornton MJ. Estrogens and aging skin. Dermatoendocrinol.2013;5(2):264-270; PMID: 24194966.
  3. Mirmirani P. Hormonal changes in menopause: do they contribute to a 'midlife hair crisis' in women? Br J Dermatol.2011;165 Suppl 3:7-11; PMID: 22171679.
  4. Mirmirani P. Managing hair loss in midlife women. Maturitas.2013;74(2):119-122; PMID: 23182767.
  5. Chen W, Yang CC, Todorova A, et al. Hair loss in elderly women. Eur J Dermatol.2010;20(2):145-151; PMID: 20172841.
  6. Chen H, Zhu H, Zhang K, et al. Estrogen deficiency accelerates lumbar facet joints arthritis. Sci Rep.2017;7(1):1379; PMID: 28469263.
  7. Alvarenga JC, Fuller H, Pasoto SG, et al. Age-related reference curves of volumetric bone density, structure, and biomechanical parameters adjusted for weight and height in a population of healthy women: an HR-pQCT study. Osteoporos Int.2017;28(4):1335-1346; PMID: 27981337.
  8. Bensaleh H, Belgnaoui FZ, Douira L, et al. [Skin and menopause]. Ann Endocrinol (Paris).2006;67(6):575-580; PMID: 17194967.
  9. Falcone D, Richters RJ, Uzunbajakava NE, et al. Sensitive skin and the influence of female hormone fluctuations: results from a cross-sectional digital survey in the Dutch population. Eur J Dermatol.2017;27(1):42-48; PMID: 27873738.