medically reviewed by Patricia Shelton, MD
Itching, body itching and vulva itching are a common symptom in perimenopause. This is because estrogen plays an important role in maintaining the health of the skin, as well as the membranes of the vagina. When estrogen levels drop during perimenopause, women commonly experience symptoms related to skin dryness and thinning, including itching. Vulva itching and dryness is also very common around this time, and is also related to the drop in estrogen. Itching can be uncomfortable and frustrating, and can greatly affect a person’s quality of life.
If you’re experiencing itching related to perimenopause or menopause, you’re likely looking for a way to get relief. One option that many women turn to is to use a moisturizing cream. How can you go about choosing the right cream for itch relief in perimenopause? What should you look for when evaluating the many different options out there?
Restoring the skin barrier
The main goal of a skin moisturizer is to restore the outer barrier of the skin, and to increase hydration in the skin tissues. You can look for certain ingredients that may help with this. Ceramides are waxy substances that the skin naturally makes in order to create the outer barrier. Hyaluronic acid is a natural molecule that acts like a molecular sponge to hold water in tissues. Skin care products that contain one or both of these ingredients may be more effective at moisturizing.
Some “moisturizers” don’t last very long, and can actually lead to the skin becoming dryer. Emulsifiers, like sodium lauryl sulfate (SLS), cetearyl alcohol, or stearic acid, cause skin dryness. On the other hand, petrolatum-based products have been shown to restore the skin’s barrier function quickly. Vaseline is one example, but there are others that are less heavy and greasy.
One option that may help is a product containing oatmeal. The specific starches in oats help to hold water in the tissues. In fact, studies have found that chemicals in oats actually influence skin cells to create more oils and bind together more closely. This may explain why skin products containing oatmeal are so effective at restoring the skin barrier and relieving itching.
It’s best to put on your moisturizer just after you get out of the shower or bath. This helps to lock in the moisture from the water, which helps to keep your skin hydrated. If you put on moisturizer when your skin is already very dry, it may be less effective, and could even lock water out rather than in.
Avoid fragrances and other added chemicals
During and after the menopausal transition, the skin is generally more sensitive to irritation. Because the skin is producing less oil, it’s more permeable, and chemicals can get through and cause itching or a rash. Because of this, it’s generally best to avoid unnecessary chemicals in your skin products.
Fragrances are particularly likely to cause skin irritation, because the molecules of a fragrance are very small. (This is what makes it so easy for them to move through the air and be smelled.) These tiny molecules can easily make it through even a tiny break in the skin’s barrier, causing irritation. Other chemicals, like dyes, can also cause irritation.
If a skin product causes irritation of your skin, stop using it, but keep the bottle. If you experience irritation again with another product, this will make it easier for you to compare the ingredients to help you figure out which one is causing the reaction, so you can avoid it in the future.
Related: The Perry Menopause Journal – The No.1 perimenopause handbook & journal
Can you use estrogen-containing skin cream?
Because the drop in estrogen causes many of the skin-related symptoms during perimenopause, it’s natural to wonder whether you can simply use a cream containing estrogen to help restore the skin. However, estrogen is actually absorbed very well through the skin. If you apply estrogen-containing cream to your whole body, the levels of estrogen in your blood would skyrocket. This isn’t a safe option.
However, there’s a newer option known as methyl estradiolpropanoate, or MEP. This is a chemical that stimulates estrogen receptors, so it mimics estrogen in the skin. However, it’s broken down into an inactive chemical within the body, so it won’t raise your estrogen levels. Products containing MEP are more expensive, but this is an option you can try if you’d like to get the benefits of estrogen for your skin.
You can also deliver estrogen to your skin by taking systemic hormone replacement therapy (HRT), which is aimed at restoring levels of estrogen in your bloodstream. The skin will receive this estrogen, and will stay thicker and more hydrated as a result. This may be delivered through a patch or cream, but it won’t just affect the skin where you put the product – it will be absorbed and will affect the skin all over your body.
Solutions for vulva itching
If you’re experiencing vulva itching, then you have a few different options. You can use vaginal estrogen, which helps to address the thinning of the tissues that’s causing itching. Studies have shown that only a small amount of estrogen is absorbed through the vagina, so your blood estrogen levels won’t rise too much.
If you prefer to avoid hormones, another good option is a vaginal insert containing hyaluronic acid, which will help to hold water in the tissues and keep them hydrated. Some studies have shown that hyaluronic acid vaginal inserts are just as effective as vaginal estrogen treatment.
The perry community has collaborated with Sweet Spot Labs and their ultra-rich vulva balm – The Rescue Balm. (when you use the code PERRY15 you will get off 15% of your first order)
For very dry, itchy vulvar skin.
Check in with your doctor
Although itchy skin is a common symptom of perimenopause, it can also be a sign of a more serious medical condition, like diabetes, thyroid disease, liver disease, or kidney disease. If your itchy skin is very intense, or if it persists or gets worse despite your efforts to stay moisturized, then it’s a good idea to talk to your doctor about this. They may recommend blood tests to check for these medical issues.
For vulva itching, this can be a sign of an infection, such as candidiasis (a yeast infection) or bacterial vaginosis. It’s a good idea to check with your doctor if vaginal itching develops suddenly, or if it’s associated with other symptoms (like increased vaginal discharge or a change in odor).
Sources
Rzepecki AK, Murase JE, Juran R, et al. Estrogen-deficient skin: The role of topical therapy. Int J Womens Dermatol. 2019 Mar 15;5(2):85-90. doi: 10.1016/j.ijwd.2019.01.001
Lephart ED, Naftolin F. Factors Influencing Skin Aging and the Important Role of Estrogens and Selective Estrogen Receptor Modulators (SERMs). Clin Cosmet Investig Dermatol. 2022 Aug 19;15:1695-1709. doi: 10.2147/CCID.S333663
Loden M. Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders. Am J Clin Dermatol. 2003;4(11):771-88. doi: 10.2165/00128071-200304110-00005.
Cohen JL. Evaluation of Efficacy of a Skin Care Regimen Containing Methyl Estradiolpropanoate (MEP) for Treating Estrogen Deficient Skin. J Drugs Dermatol. 2019 Dec 1;18(12):1226-1230.
Ilnytska O, Kaur S, Chon S, et al. Colloidal Oatmeal (Avena Sativa) Improves Skin Barrier Through Multi-Therapy Activity. J Drugs Dermatol. 2016 Jun 1;15(6):684-90.
Santin RJ, Mirkin S, et al. Systemic estradiol levels with low-dose vaginal estrogens. Menopause. 2020 Mar; 27(3): 361–370. doi: 10.1097/GME.0000000000001463.
Dos Santos CCM, Uggioni MLR, et al. Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review. J Sex Med. 2021 Jan;18(1):156-166. doi: 10.1016/j.jsxm.2020.10.016.
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