Does Menopause Cause Sagging Skin?

While we’re probably all very familiar with some of the more common symptoms associated with menopause, including hot flashes and vaginal dryness, you may have noticed a new type of change starting to present on your face and/or body – and that’s a loss of the elasticity in your skin.

While sagging skin is common for both men and women as part of the natural aging process, the drastic hormonal changes experienced during the menopausal transition can play a significant role in the onset and severity. Read on to learn more about when sagging skin can start to occur, what outside elements can contribute to this symptom and what you can do to better support your skin during menopause and beyond.

When Does Skin Start to Sag and Where Does It Show Up First?

Your skin can start to change as early as in your late 30s, with some of the more obvious shifts occurring from ages 35-50. It’s not uncommon to notice your cheekbones becoming more prominent during this time, as the fat under your skin starts to disappear – this also contributes to the more pronounced appearance of fine lines and wrinkles on the face. Additionally, it’s during this time that you’ll likely notice your skin beginning to sag.¹

When referring to the skin on your face, sagging often shows up as fine lines that run from the tip of your nose down past your mouth. Something we once referred to as transient “smile lines”, with age, these wrinkles can become a more permanent fixture on the face. You may also notice that you’ve started to develop areas of sagging skin toward the bottom of your jaw, where these fine lines end. Over time, sagging skin in these areas can cause the jawline to look less defined. Undereye puffiness or “bags” along with a drop of the nose tip are also some initial signs of skin sagging on the face.² But it isn’t just your facial skin that starts to lose elasticity during menopause, so might your thighs and belly.³ So, what exactly is going on to cause these changes to occur?

How Does Menopause Cause Skin Sagging?

Soon after you reach menopause, the signs of aging on your face can really speed up. Your epidermis (or your outer-most layer of skin) thins out, moisture isn’t retained like it once was and you start to lose collagen⁴, an important protein that contributes to skin elasticity.

A loss of collagen is often the main culprit of sagging skin both during and after menopause.  A woman’s skin will lose approximately 30% of its collagen content within the first five years following menopause – but that rate of loss does eventually flatten out. After the initial dramatic loss, collagen will continue to disappear at about 2% every year for the next 20 years, further contributing to a sagging appearance of the skin.⁵

In addition to a drop in collagen, shifts or declines in certain hormones can also have a dramatic impact on your skin’s elasticity. When your body slows down its estrogen production during menopause, the reduced amount of this important hormone slows down the process of skin cell turnover and repair.⁶ Additionally, estrogen is a key component in the skin’s production of collagen and elastin, proteins that contribute to firm skin, so once these start to diminish, sagging can be more pronounced.^7,8

Low estrogen levels also reduce the number of water-loving molecules in the skin, which work to keep the skin adequately hydrated. When your skin loses these important molecules, it can result in less overall water content, which can exacerbate the appearance of skin sagging and wrinkles.⁹

Other Factors that Can Contribute to Sagging Skin

There is another compound naturally produced by our bodies, hyaluronic acid (HA), that attracts water to the skin and can influence elasticity. Like collagen, hyaluronic acid production subsides with age, and due to damage from things like free radicles.¹⁰ Free radicals in the skin can create more of an enzyme called collagenase, which breaks down collagen – as mentioned earlier, you’re already losing significant amounts of this important protein due to the natural aging process – therefore, this additional loss eventually results in visible aging of skin, as well.¹¹

What Outside Factors Cause Skin Sagging?

Outside of the changes caused by shifting hormones and nutrient depletion, perhaps the most widely known skin-aging culprit is excessive sun exposure without wearing appropriate SPF. Photo-aging, or sun damage can impair the skin’s elastin, as UV exposure increases the breakdown of the elastic fibers, contributing to sagging and wrinkles.¹²

Sagging skin can also be caused in part by simple gravity. Year after year, gravity takes its toll by pulling down the skin and underlying muscle – creating more of an inelastic appearance.¹³ It’s also not uncommon to notice when you lose a lot of weight, that left over, loose, stretched skin doesn’t snap back as quickly, as it is less elastic, because collagen and elastin are both damaged in the skin when stretched in this way.¹⁴

How to Reduce Sagging Skin After Menopause

There are many options to address the symptom of sagging skin during menopause, ranging from over-the-counter serums and creams to medical spa treatments or cosmetic surgery. Many women would likely prefer to skip going under the knife, but rest assured there are other, less invasive options that are still effective.

One popular, non-surgical treatment option, which utilizes thermal energy, works to address sagging skin in the face, specifically in the jowls, neck and eyelids. This method, which is done in a physician’s office, utilizes radiofrequency to destroy the skin’s existing dermis and collagen, promoting the effective remodeling of collagen in the deep layers of the skin, helping to perk up sagging areas.¹⁵

Injectable skin fillers, which are often administered by a plastic surgeon, can help fill moderate to deep wrinkles, restore volume, improve symmetry among facial features, and give a more even, smoother appearance to the skin. Typically, the results of these injectables are temporary, however, and do require repeat visits to keep up the results. ¹⁶

Collagen peptides, widely available in dietary supplements or beverages, may help to nourish aging skin by improving and accelerating collagen and hyaluronic acid production in the body. They also can help to significantly increase skin hydration.¹⁷ Taking collagen supplements can also help improve skin moisture and elasticity.¹⁸  

Over-the-counter anti-aging creams and serums are widely available and can be effective for diminishing the appearance of wrinkles, fine lines and skin sagging. Consider looking for products containing ingredients such as Retinol (vitamin A) or tretinoin, which have been shown to help tighten and plump skin to improve its overall appearance. Consistent use of these types of products is key.¹⁹

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Ensuring safe sun exposure is also critical when attempting to address (or avoid) sagging skin, not to mention skin cancer. Higher SPF sunscreens, while effective, should only be part of this routine. Avoiding prolonged exposure to direct sunlight, wearing wide-brimmed hats, and enjoying the day underneath an umbrella, are dermatologist recommended ways to reduce your risk.²⁰

Additionally, simple lifestyle changes, like staying hydrated and quitting smoking can do wonders to help to support your skin’s elasticity and reduce the appearance of sagging during menopause and beyond.

Sagging skin is a natural part of life, especially during and after menopause when many changes are occurring in the body. But that certainly doesn’t mean there’s nothing you can do about it. If you’re not seeing the results you want from over-the-counter options, consider consulting with a dermatologist who can work with you to improve the way your skin behaves, feels and looks.

Resources

1. https://www.medicinenet.com/when_does_skin_begin_to_age/article.htm
2. https://www.aad.org/public/everyday-care/skin-care-secrets/anti-aging/skin-care-during-menopause
3. healthclop.com/sagging-skin-after-menopause-prp/
4. https://pubmed.ncbi.nlm.nih.gov/16198774/
5. https://www.aad.org/public/everyday-care/skin-care-secrets/anti-aging/skin-care-during-menopause
6. https://link.springer.com/article/10.2165/00128071-200304060-00001
7. https://www.sciencedirect.com/topics/medicine-and-dentistry/elastin
8. menopauserx.com/health_center/sym_skin_changes.htm
9. https://link.springer.com/article/10.2165/00128071-200304060-00001
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583886/#R81
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583886/#R81
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047276/
13. https://www.sharecare.com/health/anti-aging-skin-care/what-causes-sagging-skin
14. https://www.healthline.com/health/skin/saggy-skin
15. https://www.sciencedirect.com/science/article/abs/pii/S0094129808001375
16. https://www.americanboardcosmeticsurgery.org/procedure-learning-center/non-surgical/injectable-fillers-guide/
17. https://pubmed.ncbi.nlm.nih.gov/26362110/#:~:text=Collagen%20peptides%20are%20used%20as%20a%20bioactive%20ingredient,acid%2C%20and%20to%20promote%20fibroblast%20growth%20and%20migration
18. https://pubmed.ncbi.nlm.nih.gov/23949208/
19. https://www.healthline.com/health/beauty-skin-care/how-to-tighten-skin-on-face#creams-and-lotions
20. https://www.skincancer.org/blog/ask-the-expert-does-a-high-spf-protect-my-skin-better/