Perimenopause can feel like this endless, amorphous time of your life where everything seems like it’s a symptom of your body’s changes: There are early-onset symptoms like sleep issues, anxiety or mood swings, weight gain, irregular periods, perimenopausal rage, belly fat and bloating, and just a general sense of feeling “off.” Then there are the later-in-perimenopause symptoms like hot flashes, night sweats, vaginal dryness – the list goes on.

Well, it’s time to add yet another symptom to that list: skin issues.

Perhaps you’ve noticed that your skin doesn’t have that same youthful glow it once did. Or, no matter how much you moisturize, your skin is the driest it’s ever been.

We get it: The last thing anyone wants is to think about additional perimenopause side effects, but the more we understand the connection between our hormones and our skin, the better equipped we’ll be to treat these concerns.

“Understanding the role that estrogen plays at the level of the skin is important, so you can anticipate and proactively manage the changes that occur during perimenopause and menopause,” says board-certified OB/GYN Caledonia Buckheit, MD.

The bottom line is, we don’t have to accept saggy, dry, dull skin as just an inevitability of getting older. There are even several skincare solutions available courtesy of Alloy Health, designed to target symptoms of perimenopausal skin.

So what’s the connection between our hormones and our skin? Read on for our primer below:

Your hormones and your skin 101

Perimenopause is the transitional period before menopause (when your menstrual cycle stops permanently). During perimenopause, your estrogen levels start decreasing. When your estrogen levels drop, this can have a direct effect on your skin’s health.

Specifically, decreased estrogen levels result in:

  1. Lowered quality of collagen production
  2. The skin’s reduced ability to retain moisture

“There is a strong correlation between declining estrogen levels and decreasing collagen content in the skin,” confirms Dr. Buckheit.

Why is collagen important?

Collagen is an essential protein that provides structure, support, or strength to your skin, as well as many other tissues in the body. Collagen production begins slowing down even before perimenopause, with women replenishing about 1.0% to 1.5% less collagen each year starting in their early 30s. So, as estrogen production decreases further during perimenopause, the skin’s ability to create high-quality collagen is compromised. This results in reduced skin elasticity, which in turn leads to thinner, more delicate skin. “Loss of collagen and elasticity as estrogen levels fall leads to wrinkles, sagging, and dryness that can greatly impact the appearance of the face,” explains Dr. Buckheit.

Reduced moisture production

It’s also important to mention that a decrease in estrogen also affects the skin’s ability to retain moisture and produce oils. This not only leads to drier, itchier skin, but perimenopausal women are now more susceptible to tell-tale aging signs like fine lines and wrinkles.

Perimenopausal skin = estrogen-deficient skin

Another name for perimenopausal skin is estrogen-deficient skin. Due to the decline in estrogen, your skin no longer has the properties that were once responsible for its healthy glow.

Common symptoms of estrogen-deficient skin are:

  • Fine lines and wrinkles
  • Thinner, more delicate skin
  • Dry skin
  • Dull skin (as opposed to glowing skin)

Okay, so I have estrogen-deficient skin. What are my treatment options?

Even though Menopausal Hormone Therapy (MHT) is a popular option for perimenopausal and/or menopausal symptoms, Dr. Buckheit doesn’t recommend it as a skin treatment.

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“Hormone therapy should not be initiated in perimenopause or menopause solely to combat skin changes,” she says. “That being said, if you are otherwise a candidate for HT [hormone therapy], say for management of vasomotor symptoms (like hot flashes and night sweats), or to support bone health, it could also provide some skin benefits.”

But if you’re seeking a treatment that will primarily focus on your skin issues, the good news is, there are several options available.

Hydrating and moisturizing

First and foremost, since photoaging, or sun damage, can increase the risk of wrinkles and loss of skin elasticity, Dr. Buckheit recommends wearing sunscreen and a hat whenever you head outdoors.

Also, since your perimenopausal skin doesn’t hold moisture the way it once did, Dr. Buckheit recommends upping your hydration levels: “Oral intake of water and topical application of moisturizers is of key importance,” she says. In particular, she advises hyaluronic acid-containing moisturizers. “[These are] particularly helpful given their effectiveness at retaining moisture at the level of the skin.”

Alloy Health has a line of estriol-based skincare called M4. Topical estriol is a form of estrogen that, when applied directly to the skin, helps replenish collagen lost to estrogen decline while increasing hydration and elasticity. Alloy’s line includes prescription-strength M4 Face Cream Rx, M4 Eye Cream Rx, and M4 Face Serum Rx. The serum also contains hyaluronic acid and peptides, which help restore firmness and reduce fine lines. Importantly, topical estriol stays on the surface of the skin and doesn’t enter the bloodstream, making it safe for everyday use.

While you should always discuss any new skincare products with your healthcare providers, it’s a good idea to let them in on your perimenopausal skin concerns anyway: “Your OB/GYN and dermatologist may be able to help you develop a personalized plan to protect your skin and target areas of concern,” says Dr. Buckheit.

Ready to elevate your skincare routine? Use code RESCRIPTED20 for $20 off your first purchase, only at myalloy.com.

Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist dedicated to reporting on women's health, parenting, mental health, TV, and pop culture. Her work has appeared in HuffPost, Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.