7 Keys to Understanding Menopause and Skin Changes

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Reference Lab

MAY 20, 2022

Menopause is known to come with a host of uncomfortable and unwanted symptoms, including negative influences on skin health and appearance. But what are the biological reasons behind these problems and how can you combat skin changes associated with hormone levels during menopause?

What happens during menopause?

Are you wondering “How does menopause affect your skin?” Well, it’s impossible to discuss skin changes that occur during menopause without having a basic knowledge of what happens to hormone levels during this biological transition. And that’s because hormones play a large role in regulating the skin. The observed skin changes during menopause can be primarily attributed to changing levels of two hormones: estrogen and progesterone.

Key 1: Estrogen Levels

In pre-menopausal women, normal estrogen levels are between 30 - 400 pg/mL, coming primarily from hormone production in the ovaries. In post-menopausal women, the amount of estrogen produced by the ovaries dramatically declines, leaving most estrogen to come from the adrenal glands or fat tissue, yielding normal levels between 0 - 30 pg/mL.¹ This hormonal change leads to an estrogen crash that affects many bodily systems, including the following:

The Cardiovascular System: Estrogen promotes HDL, the good cholesterol, and depresses LDL, the bad cholesterol. It also aids with blood clot formation, encouraging speedy healing. Therefore, low estrogen levels can increase an individual’s risk for heart attack and stroke.²
The Nervous System: Intriguingly, there are estrogen receptors in regions of the brain, such as the hypothalamus. This may explain why estrogen levels influence female cognitive function; estrogen decline increases the risk of Alzheimer's disease.³
The Musculoskeletal System: Estrogen is central to blood calcium levels because it induces calcium absorption in the body. Lower estrogen results in loss of bone density and can lead to osteoporosis.⁴
The Integumentary System: Estrogen stimulates the production of several important proteins and molecules, integral to skin health. Lowering estrogen levels weakens skin thickness over time.⁵

Key 2: Progesterone Levels

Progesterone is also critical to several bodily functions. It’s known to lower the risk of anxiety and depression, regulate blood pressure, improve sleep, and promote uterine health. Most estrogen therapies come in conjunction with progesterone to lower the risk of endometrial cancer. ⁶ Progesterone is also involved in skin oil production, to lock in moisture and strengthen the skin barrier.

Hypothalamus-Pituitary Axis

Curious why estrogen and progesterone, specifically, become affected by menopause? That all boils down to a key regulatory pathway, dictated by the hypothalamic-pituitary axis. This regulation pathway starts with the hypothalamus, an area in the brain that secretes hormones to maintain biological equilibrium. With these gonadotropin-releasing hormones (GnRH), the hypothalamus stimulates the anterior pituitary gland, which then releases pituitary hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH).⁷ FSH and LH are responsible for stimulating the ovarian production of estrogen and progesterone. When estrogen and progesterone levels are high, the hypothalamus inhibits the release of pituitary hormones to ensure estrogen and progesterone levels are adequately controlled. When estrogen and progesterone levels lower, the pituitary hormones will no longer be inhibited and the cycle will resume.³ Menopause occurs when this system begins to slip. Eventually, the ovaries start to lose their sensitivity toward FSH and LH hormones, yielding lower estrogen and progesterone levels. ⁸ In pre-menopausal women, the ovaries are the principal source of estrogen and progesterone levels in the body. Hence, these hormone levels significantly and permanently decline during menopause.

What happens to our skin in menopause?

Estrogen and progesterone interact with several crucial levers in skin health. During perimenopause, menopause, and post-menopause, the following factors can be affected.

Key 3: Collagen Production

Collagen is a structural protein that is very relevant to skin health. Using fiber networks, it replenishes dead skin cells to promote skin strength, elasticity, and firmness. Collagen also helps maintain the structural integrity and thickness of the skin; this strengthens the skin barrier, keeping out toxic molecules, pathogens, and external aggressors. It also locks essential molecules in, such as water, to keep the skin hydrated.⁹ Collagen production is closely tied to estrogen levels. Fibroblasts, the skin cells that stimulate collagen production, are activated when exposed to estrogen. When estrogen levels drop, so does fibroblast activation and collagen production, which is where collagen for menopause comes into play.¹⁰ Consequently, around 30% of skin collagen is lost within the first five years following menopause.¹¹

Key 4: Oxidative Defenses

A primary cause of skin aging is exposure to free radicals, or reactive oxygen species (ROSs), which oxidize cellular DNA. Oxidation-induced structural changes lead to genomic instability, and epigenetic alterations - two of the nine hallmarks of aging.¹² Skin fibroblasts are particularly sensitive to oxidative stress, but estrogen can help. Although it’s not quite clear how, estrogen has been observed to have protective, antioxidant capabilities against harmful oxidative agents. ¹³ As estrogen levels drop, this oxidative defense becomes less effective and skin aging accelerates.

Key 5: Sebum Production

Sebum is a substance produced by the body’s oil glands to moisturize and protect the skin. Due to an age-related decline in cell turnover rate, skin oil glands– specifically sebaceous glands– grow larger and less effective. However, these glands seem to respond to estrogen. Higher estrogen levels stimulate sebum production, and vice-versa. ¹⁴

Key 6: Melanin Production

The more melanin you have, the darker the pigment of your skin. Higher melanin levels are also able to protect skin from sun damage. Estrogen increases melanin synthesis and therefore helps protect skin from UV radiation. As estrogen declines, melanin levels lower, and darker skin lightens and becomes more sensitive to sun damage. ¹⁵ So why does menopause tend to exacerbate age spots? One of the primary causes of age spots, or skin hyperpigmentation, are hormone fluctuations and sun damage. That’s why, even though menopause reduces melanin production in the skin, the combination of erratic hormone levels and a weakened skin barrier, can cause or worsen hyperpigmentation.

Key 7: Wound Healing

When your skin is wounded, a class of molecules in the blood, called cytokines, play an important role in the healing process by recruiting inflammatory cells and activating nearby skin cells. Estrogen is involved in regulating levels of cytokines. In fact, topical estrogen can accelerate wound healing in elderly men and women.¹⁶ Post-menopausal women often observe that cuts and skin lesions take longer to heal, which is likely a result of estrogen decline.

What can be expected in terms of changes to skin during and after menopause?

Some of the common skin changes that occur as a result of menopause include:

Loss of firmness: Without collagen’s fibrous networks to cinch everything together, the skin can lose firmness and elasticity.
Weakened barrier: Less collagen leads to a thinner outer layer of skin and a less effective skin barrier.
Dehydration: Estrogen stimulates the production of hyaluronic acid, a substance known for its capacity to hold water, and keep the skin hydrated. Without a strong skin barrier and estrogen-stimulated production of hyaluronic acid, the skin can become dehydrated.¹⁴
Heightened sensitivity: During menopause, the skin’s pH can change, leading to increased sensitivity to chemicals. The weakened skin barrier and loss of estrogen’s antioxidant-like properties also increase sun sensitivity.

What does menopausal skin look like?

Each individual's skin is unique and reacts differently to internal and external factors. The more common manifestations of menopausal skin changes include dry skin, loss of firmness, and an increased presence of wrinkles. Some women also develop acne or rashes, due to the change in skin pH. Lower melanin levels can sometimes result in paler skin, occasionally with age spots due to skin hyperpigmentation.¹⁷

Do these skin changes occur all at once or are they gradual?

These changes are mostly gradual and occur throughout the perimenopausal to postmenopausal periods. Starting on hormone replacement therapies (HRTs) early has been shown to stagger or even prevent the development of some of these issues ¹⁸. Consider having a conversation with your physician about the risks and benefits of hormone replacement therapy (HRT) to avoid perimenopause skin problems from surfacing.

What skin problems does menopause cause?

Menopause is not directly associated with many medical skin conditions, but rather more aesthetic changes, as mentioned previously. Occasionally the hormone changes associated with menopause can lead to skin hyperpigmentation. Skin dryness and sensitivity can also increase the risk of eczemas and allergic rashes. ¹⁹

How can these skin problems be best avoided to extend the longevity of healthy skin?

Fortunately, it is possible to prepare our skin for menopause. Here are some lifestyle and skin care tips you can use to improve skin health, and extend skinspan:

Antioxidants: Eating, or using topical skin care products with antioxidants can reduce oxidative stress and increase collagen levels! In general, topically-applied antioxidants are more effective for skin health.
Sunscreen: Post-menopausal skin is highly sensitive to sun damage. Wearing sunscreen can prevent accelerated skin aging and the development of age spots.
Moisturize: Invest in a peptide moisturizer and hydrating cleanser. This can prevent skin dryness, and reduce the risk of eczema especially if you follow the proper face cleansing steps prior to moisturizer application.
Consider Hormone Replacement Therapies (HRTs): You should consult your physician regarding your options for hormone therapy. Alternatively, topically applied estrogen is effective for increasing skin collagen and reducing skin age.¹⁸
Sleep: Sleeping at consistent times for around 7 - 9 hours daily, can positively influence your hormone cycles and skin health. ²⁰

Are menopausal skin changes more visible on the face than on the body?

Our faces are quite hormone-dense. There is research to suggest that facial appearance can be a direct reflection of estrogen levels in women. Therefore, it might be possible that the decrease in estrogen levels associated with menopause is more visible on our face than on the rest of our skin. ²¹

How does the OS-01 peptide address menopausal skin changes?

Luckily, OneSkin’s OS-01 peptide can help counteract effects caused by the estrogen decline in the skin, by stimulating certain genes. For instance, OS-01 increases the activity of collagen and hyaluronic acid production genes, COL1A1 and HAS2, helping to counteract the decreased levels of collagen and hyaluronic acid caused by menopause. This improves skin structure, strengthens the skin barrier, and keeps the skin hydrated!

Collagen genes activity analysis

OS-01 FACE and OS-01 BODY pair this star peptide with other ingredients such as potent hydrating ingredients and antioxidants. Together, with the OS-01 peptide and supporting ingredients, these formulas improve skin health markers and extend skin span at the molecular level.

Key Takeaways

Estrogen influences several biological systems and functions. Lowered estrogen levels reduce the production of collagen, sebum, melanin, and cytokines.
Menopausal skin is at a higher risk of developing eczemas or skin hyperpigmentation.
Menopausal skin can often be less firm, more wrinkled, dryer, and more sensitive to external pollutants.
To prevent menopause-associated skin changes, use antioxidants, apply sunscreen, moisturize, and get sufficient sleep. You should consult your physician regarding your options with HRTs.
OneSkin’s OS-01 peptide increases the activity of collagen and hyaluronic acid production genes, COL1A1 and HAS2, helping to counteract the decreased levels of collagen and hyaluronic acid caused by menopause. This improves skin structure, strengthens the skin barrier, and keeps the skin hydrated.

By Kiran Kumar: Kiran is studying Biotechnology Engineering at UC San Diego. She is highly enthusiastic about longevity sciences, specifically reproductive aging! You can find more on her at thisiskirank.com.