dryness in perimenopause, everywhere

Dryness in Perimenopause, Everywhere

Perimenopause marks a transitional period leading up to menopause, where a woman’s body undergoes various hormonal changes, particularly in estrogen levels. These changes can manifest in a range of symptoms affecting health and well-being. Among the common indicators of shifting hormone levels in perimenopause is waking up one day and feeling like all of the moisture has been sucked out of your body.

You may experience one or more of these telltale signs of declining estrogen:

While these symptoms may be attributed to aging, it’s often the fluctuations in estrogen that play a crucial role in their development during this phase of a woman’s life.

The Role of Estrogen

As estrogen is integral to maintaining moisture and elasticity in tissues, its wild fluctuations and eventual decline during perimenopause can result in decreased skin hydration, leading to the uncomfortable sensation of dry skin. Similarly, the eyes and hair may lose their usual moisture, creating a feeling of dryness. Vaginal and/or vulvar dryness is another symptom that can significantly affect a woman’s comfort and sexual health. Each of these symptoms can be physically distressing and also emotionally challenging, impacting your quality of life.

Managing these symptoms of perimenopause often involves a holistic approach that can include lifestyle adjustments, targeted treatments, and in some cases, hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT). It’s important for women to pay attention to their bodies and seek guidance from healthcare professionals to alleviate discomfort during this natural, yet complex stage of life. Maintaining open communication about these issues can foster better understanding and more effective management of perimenopausal symptoms.

Common Dryness Issues During Perimenopause

Perimenopause can bring about various changes in a woman’s body, including a decrease in moisture and oil production, leading to dryness in different areas. Here are some simple strategies for managing this dryness.

Dealing With Dry Skin

During perimenopause, dry skin often results from hormonal changes that reduce the skin’s ability to retain moisture and produce natural oils. Moisturizers play a crucial role in rehydrating the epidermis and locking in moisture. For optimal results, select products that contain hyaluronic acid or glycerin, and apply immediately after bathing to retain water content. Drinking plenty of water to stay hydrated will also help to alleviate some of the dryness that can come with perimenopause.

Managing Dry Eyes

Dry eyes in perimenopause can be particularly irritating, frequently caused by hormonal shifts that disrupt the balance of the tear film. To alleviate dry eyes, consider using over-the-counter lubricants, like artificial tear solutions, which help maintain adequate moisture. Your optometrist or pharmacist can help you select the appropriate option or recommend prescription strength products if required. Limiting screen time and staying well-hydrated will also contribute to dry eye relief.

Tips for Dry Hair

Changes in hair texture and dry hair can arise during perimenopause, often due to a decrease in oil production in the scalp. To counter dry hair, use gentle, moisturizing shampoos and conditioners, and minimize heat styling. Deep conditioning treatments and hair oils can help in restoring moisture and shine to the hair. Getting regular hair cuts can also help.

Implementing nutritional changes in your diet can significantly affect hair health. Ensure you’re eating a healthy diet rich in essential vitamins and minerals. Iron and zinc are particularly important for hair strength and growth. Consider incorporating foods rich in biotin, such as nuts, eggs, and avocados, to support your hair.

If your hair-related symptoms are beyond diet changes and your stylist’s product recommendations, see your doctor and perhaps a dermatologist for help.

Vaginal and Vulvar Dryness

Vaginal and vulvar dryness and other genitourinary challenges are common but manageable symptoms of perimenopause. These conditions can lead to discomfort, itching, and irritation. Water-based lubricants or vaginal moisturizers can help provide relief and restore balance. For persistent issues, it’s important to consults a healthcare provider who can prescribe safe and effective treatments.

Hormone Therapy for Vaginal and Vulvar Dryness

Local or vaginal estrogen is considered the gold standard for genitourinary symptoms like vaginal and vulvar dryness. Local means it’s applied directly on the vulvar tissue or into the vagina. It’s effective, and studies show that it’s safe. In 2003, the Food and Drug Administration required that drugs containing estrogen for menopausal women include a label warning that these drugs may slightly increase the risk of heart attacks, strokes, blood clots, and cancer. But local estrogen does not have the same risk profile as systemic estrogen. Systemic estrogen typically contains a higher does of estrogen that is absorbed throughout the body.

Further, the findings in the Women’s Health Initiative (WHI) study, which prompted the warning, are widely acknowledged to have been taken out of context and sensationalized. Experts in the field recognize that the estrogen warning, or ‘class labeling’, on local estrogen is not warranted and unnecessarily frightens women away from this safe and effective treatment for what can become a very serious medical condition.

Systemic estrogen in hormone replacement therapy (HRT) is not as effective for vaginal and vulvar dryness, and other genitourinary symptoms, as local estrogen. HRT is very effective at relieving other menopausal symptoms like hot flashes and night sweats. Some women will find benefit from the systemic estrogen in HRT on their vaginal and/or vulvar dryness when they are prescribed this form of hormone therapy for other symptoms. Some women use both local and systemic hormone therapy to manage their symptoms.

It’s important to understand the benefits and risks of any medication before treatment, including hormone therapy. Always consult with a qualified practitioner who can guide your decision making with current, factual information in the context of your medical profile and history. Should HRT not be suitable, due to your specific health risks and medical history, alternative treatment options include non-hormonal prescription medications.

Hormone Therapy for Skin, Hair, and Eyes?

When it comes to menopausal skin, eyes, and hair, hormone therapy is not indicated. Studies show mixed results when it comes to HRT as well as topical testosterone products for the eyes. Some studies have shown benefits, and others show no change when compared to placebo for both types of medications. HRT and topical testosterone products have also both been shown to make conditions like dry eyes worse. When it comes to hormone therapy and dry perimenopausal skin, eyes, and hair, more research is needed.

Lifestyle Recommendations and Self-Care

Managing the symptoms associated with perimenopause requires a multi-pronged approach. Nutrition and exercise are crucial to supporting your body’s changing needs. As is addressing your mental well-being and developing strong stress management practices.

Nutrition and Exercise

A balanced diet rich in omega-3 fatty acids and vitamin D can help alleviate symptoms of dryness. Foods like salmon, flaxseeds, and egg yolks provide essential nutrients to maintain skin and overall health. Regular exercise promotes blood circulation, which is beneficial for maintaining healthy skin and may help reduce the risk of depression and anxiety associated with perimenopause. Individuals should aim for a mix of cardiovascular, strength, and flexibility routines.

According to the CDC, adults need 150 minutes of moderate-intensity physical activity and 2 days of muscle strengthening activity weekly.

Sleep and Stress Management

The importance of adequate sleep for one’s physical and mental health cannot be overstated, as it allows for the healing and rebalancing of body systems. This can be tough to accomplish in perimenopause as fluctuating hormones can wreak havoc on our ability to sleep. If you’re struggling, learn about good sleep hygiene habits here. Speaking to a menopause specialist about navigating perimenopausal sleep disturbances can also be very helpful.

Mindfulness-based stress reduction techniques are proven to be effective in managing anxiety and enhancing one’s sense of well-being. Practices such as yoga, meditation and breathwork can all be beneficial.

Recognizing Serious Symptoms

If you are experiencing discomfort from dryness, get help. You don’t need to suffer. It’s also important to seek medical advice if your symptoms continue to progress. For instance, dry eyes persistently causing vision problems, or intense skin dryness resulting in pain or infections, signal the need for professional help. Genitourinary symptoms can also become serious and difficult to manage if left untreated.


The intent of this information is to provide the reader with knowledge to support more efficient and effective communication with their medical providers. This information is not intended as medical advice.