Dermatologic Manifestations of Perimenopause and Menopause: Structural, Functional, and Therapeutic Considerations
Résumé
Perimenopause and menopause represent major endocrine transitions across a female’s life course. In Canada, over 10 million women are aged 40 years or older, meaning a substantial proportion of the population is within the perimenopausal, menopausal, or post-menopausal stages. The average age of natural menopause in Canadian women is approximately 51 years, although the menopausal transition may begin several years earlier.
Perimenopause is defined as the interval preceding menopause during which ovarian function becomes irregular, leading to fluctuating estrogen and progesterone levels, irregular menstrual cycles, and the onset of vasomotor and somatic symptoms. Menopause is diagnosed retrospectively after 12 consecutive months of amenorrhea and reflects permanent cessation of ovarian follicular activity. The hypoestrogenic state that follows menopause has systemic effects on multiple organ systems, including the cardiovascular system, skeletal system, and the skin.
Skin and hair are estrogen-responsive tissues, with estrogen receptors expressed in keratinocytes, fibroblasts, sebocytes, melanocytes, endothelial cells, and hair follicles. As a result, declining estrogen levels during perimenopause and menopause contribute to structural, functional, and aesthetic changes. These changes may prompt consultation requests to Dermatology services and as such, our specialty should be prepared.
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