Menopause and the skin
Introduction
Strictly speaking, menopause is defined as the day a woman has been diagnosed as not having a menstrual period for 12 consecutive months. This signifies the permanent cessation of menstruation. The period leading up to menopause is described several ways, menopausal transition, peri-menopause or climacteric. During this time, which may precede several years before menopause, fluctuations in menstrual cycles and hormonal changes occur. This is evident from the signs and symptoms that a woman may experience.
| Common peri-menopausal signs and symptoms |
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What effect does menopause have on the skin?
On average menopause occurs as women reach early to mid-50 years. Leading into this time changes in hormone production occur, most notably a decline in oestrogen levels (hypo-oestrogenism).
It has been found that oestrogen affects every organ system of the body including the skin. It appears that oestrogen receptors are most abundant around the genital area, face and lower limbs. Therefore these areas are especially vulnerable to reduced amounts of circulating oestrogen and are the reason for certain skin conditions involving these areas to be more common in peri- and post-menopausal women than in women of other age groups.
| Common skin conditions seen in peri- and post-menopausal women | |
| Atrophic vulvovaginitis |
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| Vulvovaginal candidiasis |
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| Vaginitis |
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| Vulvar lichen sclerosus |
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| Dyaesthetic vulvodynia |
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| Hirsutism (abnormal hair growth in women) |
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| Alopecia (hair loss from areas where it is normally present) |
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| Menopausal flushing |
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| Keratoderma climactericum |
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What treatment is available for menopausal symptoms?
Hormone replacement therapy (HRT) has been shown to have beneficial effects in preventing many of the signs and symptoms experienced in peri- and post-menopause, including urogenital and general skin and hair problems. HRT may consist of oestrogen tablets, patches, vaginal rings, implants or cream (particularly useful for atrophic vulvovaginitis), or a combination of oestrogen and progestogen as patch or tablet. However, HRT is no longer recommended for healthy women without specific problems caused by the menopause.
Other treatments for urogenital problems may include:
- avoidance of soaps and harsh rubbing of the affected area to prevent further irritation of the skin
- topical or oral antibiotics if infection is present
- emollients and bland lubricants to keep the area moist
- antidepressants, particularly if pain is neuropathic.
