Some of the most common symptoms associated with menopause, such as hot flashes and vaginal dryness, are probably familiar to many women over 50. But you may have noticed a new kind of change in your face and/or body - and that is the loss of elasticity in your skin.
While sagging skin is common in both men and women as part of the natural ageing process, the drastic hormonal changes that occur during menopause may play a significant role in its development and extent.
Read on to learn more about when sagging skin may occur, what external factors may exacerbate this skin concern, and what you can do to better support your skin during menopause and beyond.
When Does Skin Start to Sag?
Your skin can start to change as early as your late 30s, with some of the most noticeable changes occurring between the ages of 35-50.
It's not uncommon for your cheekbones to become more prominent during this time as the fat under your skin begins to recede - this also contributes to a more pronounced appearance of fine lines and wrinkles on your face. You will also likely notice that your skin starts to sag during this time.
When it comes to facial skin, sagging often shows up as fine lines that run from the tip of your nose to your mouth. These lines are commonly referred to as laugh lines or nasolabial folds and as we age, they can become a permanent part of the face. You may also notice that sagging skin has developed on the underside of your jaw where these fine lines end.
Over time, sagging skin in these areas can cause the jawline to look less defined. Puffiness or "bags" under the eyes and drooping of the tip of the nose are also early signs of sagging facial skin.
But it's not just the facial skin that begins to lose elasticity during menopause; your thighs and abdomen do, too.
How Does Menopause Cause Skin Sagging?
Shortly after menopause, the signs of ageing on your face can accelerate. Your epidermis (or your outermost layer of skin) becomes thinner, moisture is not retained as well as it used to be, and you begin to lose collagen. This critical protein is a significant contributor to skin elasticity.
Loss of collagen is often the leading cause of sagging skin during and after menopause. A woman's skin loses about 30% of its collagen content in the first five years after menopause.
After the initial dramatic loss, collagen continues to disappear at about 2% per year for the next 20 years, further contributing to sagging skin appearance.
The difference between estrogen-rich versus estrogen-depleted tissue is quite dramatic - with cells growing in estrogen-rich tissue being much more compacted and inter-connected than those bound by estrogen-depleted tissue.
In addition to the decline in collagen, changes or reductions in certain hormones can also significantly affect your skin's elasticity. When your body slows down its production of estrogen during menopause, the decreased amount of this vital hormone slows down the process of cell turnover and skin repair.
In addition, estrogen is a crucial component in the production of collagen and elastin in the skin, proteins that contribute to skin firmness. The collagen layer under the skin firms up as it binds water and protein together.
Estrogen withdrawal causes cell water to seep through osmosis and makes forming new collagen threads impossible as they are much looser and less able to bind together effectively. Once these proteins decrease, skin sagging can become more noticeable.
Low estrogen also decreases the number of water-loving molecules in the skin that ensure the skin is adequately hydrated. When your skin loses these crucial molecules, it can lead to lower overall water content, which can worsen the appearance of skin sagging and wrinkles.
Other Factors Which Contribute to Sagging Skin
Another compound produced naturally in the body, hyaluronic acid (HA), stores water in the skin and can affect skin elasticity. Like collagen, hyaluronic acid production decreases with age due to free radical damage.
Free radicals can increase the skin's production of an enzyme called collagenase, which breaks down collagen. As mentioned earlier, you already lose significant amounts of this vital protein due to the decline in estrogen levels during menopause - so this additional loss ultimately leads to more visible skin ageing and sagging.
Aside from the changes caused by hormonal changes and nutrient deficiencies, perhaps the most well-known culprit for skin ageing is excessive sun exposure without proper SPF. Photoaging or sun damage can affect the skin's elastin, as UV exposure increases the breakdown of elastic fibres, contributing to sagging and wrinkling.
Sagging skin can also be caused in part by gravity. Year after year, gravity takes its toll by pulling the skin and underlying muscles downward - resulting in a more inelastic appearance.
It's also not uncommon after a large weight loss for the loose, stretched skin to not bounce back as quickly because it's less elastic, as both collagen and elastin in the skin can be damaged when stretched by weight gain.
How to Reduce Sagging Skin After Menopause
There are many ways to combat the symptoms of sagging skin during menopause, from over-the-counter serums and creams to medical spa treatments or cosmetic surgery. Many women would rather not go under the knife, but rest assured that other, less invasive options are also effective.
One popular non-surgical treatment option is the use of radiofrequency energy to treat sagging facial skin, particularly around the cheeks and neck.
This method, performed at our medical aesthetics clinic, uses radiofrequency to stimulate the formation of new collagen in the deep layers of the skin, resulting in the improvement of sagging areas. You can learn more about radio frequency skin tightening here.
Injectable dermal fillers can help fill moderate to deep wrinkles, restore volume, improve the symmetry of facial features, and give the skin a more even, smooth appearance. However, results from these injectables are usually temporary and require repeated treatments to maintain results.
Collagen peptides, available in dietary supplements or beverages, can help nourish ageing skin by enhancing and accelerating the body's production of collagen and hyaluronic acid. They can also help to significantly increase the moisture content of the skin. Taking collagen supplements can also help improve skin hydration and elasticity.
Medical-grade anti-ageing creams and serums are widely available and can effectively reduce the appearance of wrinkles, fine lines and sagging skin. Look for products with ingredients like retinol (vitamin A) or tretinoin, which have been shown to help tighten and plump the skin to improve its overall appearance. Consistent use of these products is crucial.
Avoid prolonged direct sun exposure and wear wide-brimmed hats. This is crucial if you want to combat (or avoid) sagging skin, not to mention skin cancer. High-quality sunscreens with a high SPF play a big part in protecting your skin from sun damage.
In addition, simple lifestyle changes, such as drinking enough water and quitting smoking, can do wonders for maintaining your skin's elasticity and reducing the appearance of wrinkles during menopause and beyond.
Sagging skin is a natural part of life, especially during and after menopause when the body changes in many ways. But that does not mean there's nothing you can do about it.
If over-the-counter remedies are not giving you the results you want, visit Dr Aesthetica to learn how you can improve the way your skin behaves, feels and looks.