Perimenopause | Skin Signs

During perimenopause, there is a decrease in the amount of estrogen and progesterone produced by the ovaries.  To understand what is happening to your skin, it helps to learn more about which hormones are released from where and what they do. Read more...

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Topics

• What is perimenopause?

• What hormonal changes signal the onset of perimenopause?

• Are there any blood tests to determine perimenopause?

• What kinds of symptoms do women experience during perimenopause?

• Are there skincare tips to consider recognizing that hormones are changing and impacting the skin during perimenopause?

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Photo: Wix

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What is perimenopause?

Perimenopause is broadly defined as the window of time that precedes menopause.  This can range from about 2 to 8 years before menopause with the median age of menopause at 51 years of age. The age of menopause varies and is affected by genetics, hormones, lifestyle, stress, smoking, alcohol, UV, and even sleep deprivation. 

What hormonal changes signal the onset of perimenopause?

During perimenopause, there is a decrease in the amount of estrogen and progesterone produced by the ovaries.  To understand what is happening, it helps to learn more about which hormones are released from where and what they do.

The onset of menses marks the beginning of the menstrual cycle.  The first week of the cycle there is shedding of the lining of the uterus since estrogen and progesterone levels are at their lowest.  

The low estrogen levels trigger the brain to release a hormone called FSH, follicle-stimulating hormone, and LH, luteinizing hormone, from the pituitary gland.  FSH acts on the ovaries to release estrogen and LH acts on the ovaries to produce both estrogen and progesterone.  As levels of these hormones rise, they act to drop the FSH and LH levels.  When LH reaches its peak, ovulation occurs halfway through the cycle.  

Estrogen peaks around 2 weeks into the menstrual cycle and progesterone peaks around 3 weeks into the cycle.  

Are there any blood tests to determine perimenopause?

The changes hormonally speaking during perimenopause may not be as obvious on blood tests during the cycle.  The main change noted as perimenopause progresses into menopause would be gradual increases in the amount of FSH released since there is less estrogen to feedback to reduce FSH release.  A diagnosis of menopause is generally marked by high FSH levels and a lack of a menstrual cycle for 12 months. 

What kinds of symptoms do women experience during perimenopause?

The classic findings of menopause that people reference such as hot flashes may not be as prevalent during perimenopause.  There is very little written and researched on this window of time to give women guidance on expectations and how to manage this window of time.  

I have been in practice for almost 2 decades and have seen thousands of women experiencing perimenopause, including myself.  There are some classic findings I have come across that are worthy of note.  

The most common perimenopausal skin complaints I have come across are:

• Increase in breakouts

• Excess dryness of skin

• Change in the texture of hair, wispier

• Widened hair part 

• Chin hair

• Thinning eyebrows and eyelashes

• Discoloration from photodamage and melasma

Are there skincare tips to consider recognizing that hormones are changing and impacting the skin during perimenopause?

With the changes noted above, most of my patients' challenges are understanding how products work and why they may not address their particular skincare needs.

The most important thing to learn about choosing skincare is to recognize the links between these symptoms.  The breakouts and dry skin are related as a manifestation of an adult form of acne called rosacea.  These are breakouts that are not true acne but more of a sensitivity of the skin that results in redness, pimples, dryness, and sensitivity.

The changes with regards to increased hair growth on the chin and decreased on the scalp are due to gradual decreases in estrogen overall leading to unopposed androgen effects on the hair.  

The discoloration of the skin is a result of hormones and photo sources interacting and prior sun damage that catches up with our skin.

To truly address these aspects of our skin, recognizing the role of photoprotection and anti-inflammatory benefits is essential.