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The signs of menopause: changes in the skin
THE SIGNS OF MENOPAUSE: CHANGES IN THE SKIN
‘What I felt wasn't just ordinary itching. I felt as if insects were crawling around on my skin, especially around my abdomen. I would wake up in the night itching like mad, which was another reason I didn't sleep so well.’
‘An unexpected benefit of HRT has been that my skin has looked so much better. It was beginning to get noticeably thinner, and quite dry and flaky, and that in itself made me suddenly feel about 10 years older - but I’m not trying to look like a film star!’
Improved skin texture is a visible — and welcome — result of taking hormone replacement therapy.
Skin consists of two principal parts: a thin outer layer called the epidermis, and a thicker lower layer called the dermis. Within the dermis is a substance called collagen, and this becomes thinner as oestrogen levels fall, causing the skin as a whole to become thinner. This could be because collagen increases the moisture content of the skin and 'fills it out'. Collagen is lost from the dermis most rapidly in the years immediately after the final period, with up to 30 per cent being lost in the first five years, and about 2 per cent a year after that.
As the thickness of the skin depends on its collagen content, skin condition is related more to the number of years since the menopause than to actual age. Once oestrogen is restored, the collagen starts to increase; where conditions such as thin skin, dry flaky skin, and skin that becomes easily bruised are caused by low oestrogen they are almost always reversible within the first six months of taking HRT. This improvement doesn't continue indefinitely, and balances out after about two years of treatment. However, although skin texture improves significantly, there is no evidence that HRT slows the development of wrinkles!
Not only can good skin improve a woman's self-esteem, it can also be an indication of the state her bones are in. Collagen is also present in bone and, if collagen is being lost visibly from the skin, it is also probably being lost invisibly from the bones. Women with transparent skin are much more likely to have osteoporosis than women with opaque skin. If your skin appears to be getting noticeably thinner, it might be a good idea to talk to your doctor about osteoporosis.
A skin condition that quite a few women suffer from during the early days of the menopause is known as formication. The name comes from the Latin formica, meaning 'ant', which aptly describes the feeling you may get of insects crawling just underneath or on top of your skin. It doesn't produce a rash, but the itching can be maddening, and can wake you up in the night. Formication is probably caused by changes in the nerve endings, and the condition can be helped by HRT.
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