Understanding Hair, Skin, and Body Changes During Menopause
- Dr. Susan Reed, a board-certified obstetrician-gynecologist and Professor Emeritus at UW Medicine, says menopause involves more than hot flashes, with many women also experiencing hair loss tied to hormonal shifts, low iron, or other underlying conditions.
- She notes that treatments for hair loss can include topical or oral minoxidil, but patients should discuss options with their provider to see what might work best for them.
- Dr. Reed also explains that menopause can bring broader skin and body changes, including collagen loss, reduced estrogen levels, muscle loss, and a slower metabolism, which can lead to fat gain.
Menopause is often associated with hot flashes, but Dr. Susan Reed, a board-certified obstetrician-gynecologist and Professor Emeritus at UW Medicine, says the transition involves much more — including hair loss, which is more common than many women realize and can be tied to hormonal changes, nutrient deficiencies, and other underlying health issues that shouldn’t be overlooked.
It is true that hot flashes and night sweats are the most commonly reported symptoms of the menopause transition, and The Menopause Society explains, “They are characterized by a sudden, intense sensation of heat in the upper body — particularly the face, neck, and chest. Night sweats are hot flashes that occur during sleep.” Read MoreWhy Does Hair Loss Occur?
Understanding why hair loss occurs during this stage in a woman’s life, Dr. Reed explains, “You get hair loss due to low ferritin [indicating reduced iron levels], secondary to types of anemia [a condition in which the body lacks healthy red blood cells to carry oxygen effectively].
“You can get hair loss from hypothyroidism, or low thyroid [when the thyroid gland does not make sufficient thyroid hormones], and some other conditions, so it should not be ignored.”
She continues, “I think too often patients see a provider and the provider said, ‘Oh, you’re getting older. This is normal. It is normal to have less hair as we age. That’s normal.’
“But there are some things that people can do if it’s bothersome for them.”
Dr. Reed Advises: Talk To Your Doctor
Since the exact cause of hair loss isn’t always clear, Dr. Reed recommends speaking with your doctor, as factors such as low iron levels may be contributing to the problem.
She explains, “So it’s something that if a patient is noticing a significant loss of hair, they should check in with their primary care provider and ask for a referral to a dermatologist.”
Understanding Skin & Body Changes
As for skin changes, Dr. Reed notes that this is “mainly due to aging and is accelerated by loss of estrogen.”
“Some people take a hormone, what we call systemic hormone and feel they have some improvement. What we do know from studies is that people who have lived in California or Florida or Texas have had significant skin damage from sun, and that does not repair with hormone therapy,” she says, further advising that a dermatologist be seen for skin and hair changes.
Referring to how a woman’s skin will wrinkle, bruise easily, and become more elastic, Dr. Reed says, “The skin will do that because the collagen has lost all of its cross-links.
“Collagen makes a little web that makes your skin look plump and moist and wonderful, and all of that gets lost as we age, but also with lower estrogen.”
As for the body changes that come alongside menopause, Dr. Reed says most patients will think of weight gain as something normal, seeing more fat around the abdomen.
“That is a metabolic change and hormones, but it’s more than hormones. There’s a big change at midlife for both men and women,” Dr. Reed explains. “You lose muscle mass and you get increased ratio of fat to muscle. That’s from hormones, but it’s also from metabolic changes that can be associated with things like diabetes and some other, we call them endocrine or hormonal.
RELATED: What’s the Difference Between Menopause and Perimenopause? A Leading OB/GYN Explains
“And again, metabolism. We use that ‘change’ word, meaning how you process your foods, how that’s with your exercise and the energy that is expended,” she adds.
She adds that as people age, especially during menopause, they may gain body fat while losing muscle mass. And this type of muscle loss can slow metabolism, making weight gain more likely even without major changes in diet.
Understanding The Signs
Dr. Stephanie McNally, Medical Director for Katz Institute of Health at Northwell Health, previously explained to SurvivorNet that menopause is the point at which a woman has gone 12 months without a period, while perimenopause is the transition leading up to it.
Early and common perimenopause symptoms, according to Dr. McNally may include:
- Breast tenderness
- Headaches
- Menstrual cycle changes
- Mood changes
Other physical, metabolic, and weight-related changes women may experience:
- Skin changes and itchiness (including itchy ears)
- Hair changes
- Changes in breast density
- Slower metabolism
- Belly weight gain despite healthy habits (diet, supplements, hydration, fiber, protein)
As for pelvic and urinary changes, as well as broader body effects, these may include:
- Urinary leakage
- Incontinence
- Vaginal dryness
- General pelvic health changes
- Joint discomfort
“All of the things from head to toe, front to back joints included, can be affected,” Dr. McNally emphasizes. “Any body part can be affected because based on our biology, there’s an estrogen receptor everywhere in a female body. So as these hormones are changing, it can affect us all differently. And no body part is off limits.”
Dr. McNally emphasizes that it’s hard to accurately forecast what someone will experience during perimenopause or menopause, since symptoms and changes vary widely based on individual factors like biology, ethnicity, and medications.
She concludes, “The menopausal state is really a depletion of our sex hormones, the estrogen, progesterone, and a portion of our testosterone, because testosterone is made not only in the ovaries, but in the adrenal glands.”
“So there are other sources of testosterone in our body, but essentially we’re talking about those main sex steroid hormones that are gone at any significant levels in that menopausal transition. That’s the difference, erratic and then absent in the menopausal state.”
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