Perimenopausethe stage of reproductive change for cisgender women that occurs in the years leading up to full menopause can occur even earlier than expected and, as we now know, in many surprising, confusing ways.
Most women are well aware that one day they’ll have to deal with hot flashes, night sweats and weight gain as their body’s estrogen production declines, but the real shock comes when perimenopausal women, often only in their 30s or early 40s, see these symptoms accompanied by thinning hair and sagging skin before they hit the big 5-0.
If you’re already noticing other perimenopausal changes, such as an irregular menstrual cycle, difficulty falling or staying asleep, or extreme fatigue after a normal day, your mirror may provide further evidence that your body is beginning a so-called “change.”
Hair changes
The scalp and hair are often the first to take a hit in perimenopausal women. Hair loss is the most talked about, but there are several deeper reasons and multiple symptoms you’ve probably never heard of – at least not before middle age, anyway.
Differences in hair texture
During menopause, you will begin to see harbingers of how your hair texture will change as you age through menopause and into your advanced years.
Older ladies don’t run around with frizzy, frizzy or damaged hair because they can’t be bothered to style it. These short-haired, old babies with fine angel hair work with exactly what Mother Nature shows as the clock ticks.
As the body’s estrogen declines, many women see a complete turnaround in hair texture. Women have often described their ‘new’, aging hair as feeling dry and straw-like, or the opposite, with the new growth appearing fine, light and tight. Others have noticed that their formerly straight hair is now growing curly or vice versa.
Significant hair loss
In addition to the lucky winners of the genetic lottery, many women also experience significant to severe hair loss at menopause, and this hair loss often begins in the perimenopausal stage. Women up to 36 – or even younger! – have spoken out about their hair loss struggles and solutions, both online and in salons, proving that you don’t have to be “old” to see your hair begin to seriously thin.
Female Hair Loss is a common diagnosis for perimenopausal women and hair loss is often due to androgen overproduction DHT.
Other types of hair loss may also occur during this time, such as Telogen Effluviuma type of hair loss related to stress or a major, upsetting life event. While TE is usually temporary, Telogen Effluvium can sometimes “unmask” a woman’s predisposition to genetic hair loss, leading to hair loss that becomes permanent without treatment.
Depending on your genetic predisposition to hair loss, as well as your body’s response to different levels of testosterone, progesterone, and estrogen, you can expect to see different types of thinning and hair loss, such as diffuse hair loss, which affects the thickness of hair across the entire scalp. Part enlargement, where the loss is mostly seen where you part your hair. or a receding hairline, with the temples seeing the worst loss.
Micrograph of hair follicles
In addition to seeing more hair fall out in the shower and when you brush, you may also see your hair become thinner again. This is called thinning and occurs when hair follicles shrink, causing fewer hairs to grow from each follicle and individual hairs becoming thinner than before.
Thinning is a symptom of female pattern baldness and will unfortunately contribute to both losing more of your hair on a daily basis and changing texture over time as hair thickness decreases due to smaller follicles.
Skin Changes
You already know that you will eventually end up with wrinkles, but perimenopause can cause many other skin changes that you may have assumed were relegated to your advanced years. Hormonal fluctuations in the years leading up to menopause can cause your skin’s texture, moisture levels and elasticity to change seemingly overnight.
‘Crepey’ Skin
Do you remember looking at your grandmother’s skin and noticing how paper thin it looked, almost like a roll of crepe paper party decorations?
These small, usually horizontal, loose lines on the skin can appear anywhere on your entire body, and although we usually associate this type of skin texture with women over 60, so-called “creamy” skin can start to appear as soon as menopause begins.
Loss of estrogen also results in a loss of collagen and elastin in the skinwhich takes away that rich, hydrated and “replenishing” feeling you once had in your skin’s younger days. Lack of estrogen also makes it harder for your skin to retain moisture, which only accentuates any “creamy” texture you may have.
“Turkey” neck.
Many women notice the first appearance of “singing” skin on the front of their neck, often called “turkey neck” by the ladies in the know because of the way the skin begins to thin, sag and take on an uneven, turkey-like striated texture.
Once your hormones start to weave toward the onset of menopause, you’re likely to see the skin on your neck begin to change shape. “Turkey neck” is a common issue among women over 45, but such skin changes can occur earlier, depending on when you become perimenopausal.
You may see the skin on your neck begin to sag with or without a “crack” texture, which can be similar to the way skin appears after rapid weight loss – sort of like a balloon that has blown up and then deflated, having lost its elasticity.
Enlarged pores, uneven skin texture and acne
As if wrinkles and your skin turned into baby shower decorations weren’t enough, declining estrogen can turn your formerly smooth skin into an acne zone, with enlarged pores and acne scars, tiny bumps and other new, raised textures.
The smoothness of the skin, indeed, is largely due to estrogen, and without it, most of what women consider skin “flaws” can either become more pronounced, such as pores and scars, or seemingly develop overnight. Hormonal fluctuations, as in puberty, can also lead to menopausal acne.
Facial changes
Loss of facial muscle tone, also known as a “Melted Face” or Jowls
Due in part to decreased muscle tone, although largely influenced by loss of skin firmness, many women half-jokingly exclaim that “their face melts into their neck.”
What’s actually happening is that you’re experiencing every woman’s favorite part of aging (and that’s sarcasm, of course): jouleswhich refers to loose, excess skin that makes it look like your cheeks are melting right into your face and neck.
Dimples aren’t bad for your health, but we get it: it can be a confidence killer to go from a tight, defined jawline and cheeks to the type of sagging skin we usually only associate with older people, especially when you’re just approaching your 50s.
Severe dry skin and thin lips
The loss of estrogen, collagen, and elastin can also “deflate” your lips and dry out your skin, leaving you searching for lip balm 24/7 and slathering on lotion to no avail.
Perimenopausal and menopausal women have often described their lips and newly wrinkled skin as beginning to look like a wrinkled, dried raisin, with little benefit from increasing water intake. Dry skin also leads to persistent itchy skin all over the body, a common symptom for women entering menopause. (And surprisingly, one of the most itchy spots for perimenopausal or menopausal women is inside the ears!)
Some women have seen improvement in plump skin and moisture retention while on it Hormone replacement therapy or from use skin creams with estrogenalthough it seems that these treatments do not show results for everyone.
Our conclusion?
Stay in touch with your doctor to maintain a healthy body and mind throughout menopause
We know it sounds obvious, but when it comes to properly monitoring the effects of aging and perimenopause for optimal health, you need an MD. Only doctors with a thorough understanding of how perimenopause and menopause can change a woman’s body and brain will be able to properly address your concerns through exams, blood tests and possibly scalp/skin biopsies and the safest medication based on your medical background and genetics.
Common courses of action often include Hormone replacement therapyor HRT, or regular hormonal methods of contraception, such as the pill or a hormonal IUD, to supplement the hormones the body no longer makes.
None has seeing a doctor or taking medication during the stages of menopause, but if your symptoms are making you feel like your life is falling apart, a doctor specializing in women’s health can help you find a solution.
