Menopause is tough enough without adding an unbearable urge to scratch to the list of symptoms. Yet up to 64 percent of women in perimenopause and menopause experience it. So why is no one talking about it (1)?
“Itching is just not one of the symptoms women tend to talk about at the water cooler,” says menopause specialist Sherry Ross, M.D. Most women don’t even connect itching to menopause, she notes—until they mention it to their doctor.
Don’t ignore the scratchy struggle. Left untreated, menopause itching (known as pruritus) can dampen your quality of life, Ross adds. “Persistent itching, particularly vaginal itching, can lead to burning and pain.” It’s not just uncomfortable. The irritation can mess with your physical and emotional well-being and make it hard to enjoy activities you love.
About the Experts
Kecia Gaither, M.D., M.P.H., FACOG, is double board certified in obstetrics-gynecology and maternal-fetal medicine. She is currently the director of perinatal services at NYC Health + Hospitals/Lincoln in the Bronx, New York.
Sherry A. Ross, M.D., FACOG, is a board-certified obstetrics-gynecologist at Providence Saint John’s Health Center in Santa Monica, California. She’s also the author of She-ology and The She-quel.
Leslie Greenberg, M.D., M.S.C.P, is a physician at the women-led online hormone clinic, Pandia Health, where she helps people navigate menopause.
What Causes Itchy Skin in Menopause?
You’re more likely to hop aboard the itchy skin train during perimenopause than menopause (2). During perimenopause, your ovaries slow their estrogen output before shuttering business forever in menopause, Ross explains. Without estrogen to kick off your period each month, it just stops.
Regulating your monthly bleed isn’t estrogen’s only job. The hormone also supports your heart, brain, and skin during all stages of your life (3). When estrogen levels are high, your skin churns out collagen and oil, two natural skin moisturizers, explains OB-GYN Kecia Gaither, M.D. “This drop in estrogen can decrease natural oil and collagen production, which leads to drier skin,” she says.
Collagen and natural oils don’t just make skin supple and glowy—they’re also protective shields against potential irritants. When your skin becomes so dry that it cracks, using fragrant detergents, soaps, and body lotions can irritate your skin and send you into a scratching tizzy.
Without estrogen, your skin also becomes duller, less elastic, and more fragile, says menopause specialist Leslie Greenberg, M.D. Scratch your tissue-paper-like skin and it can tear, letting bacteria and germs to seep inside and cause infection. The result? Even more itching (4).
It doesn’t stop there. Low estrogen levels can also slow wound healing, Gaither notes. That’s because estrogen blocks the production of an inflammatory protein that slows healing (5). When estrogen levels bottom out, skin cracks take longer to heal, giving infectious pathogens a longer runway to wreak havoc—and drive you mad with the itch.
Where you’ll itch
Of all the body parts your skin blankets, the ones that regularly rub against irritants—the face, neck, chest, arms, and legs—are the most vulnerable, Ross says. But, it’s not unusual for you to feel the need to scratch your breasts, abdomen, back, underarms, arms, and thighs, too, she says.
For example, scented shaving cream can irritate your armpits and cause you to scratch, creating microscopic cuts in the skin and setting you up for further irritation. That fragrant deodorant you love? Consider it your new enemy. Also, if you use a potent detergent, the parts of your body that come into contact with your shorts and shirts could become susceptible to scratches.
Ross says switching to unscented deodorants, moisturizers, and detergents can all help prevent irritation.
We hate to be the bearer of bad news, but menopause itchiness isn’t limited to your arms and inner thighs. “The vagina can also fall victim,” Ross says.
Specifically, the walls of your vagina, the skin of your vulva and perineum (the area between the vagina and rectum) may all itch. That’s because natural vaginal lubrication nosedives during perimenopause. Before menopause, estrogen keeps vaginal cells plump and hydrated, Greenberg explains. When estrogen drops, those cells become thinner and drier, she adds.
Estrogen doesn’t just help with moisture. It also supports blood vessel function and blood flow, which is crucial for arousal and lubrication, Greenberg says (6). Less efficient blood vessel function results in dryness, itchiness, and a higher chance of getting microtears from everyday activities like sex or wiping after using the bathroom. These tiny tears can make you more susceptible to sexually transmitted infections (STIs), which can ramp up the itch factor even more (7).
Menopause itching at night
Going to bed early may be your go-to solution for headaches and fatigue, but it won’t spare you from menopause itching. In fact, the night sweats that plague an estimated 80 percent of women during this transition can heighten the need to scratch (8).
Estrogen fluctuations mess with your brain’s thermostat (the hypothalamus), causing profuse sweating, Greenberg says (9). “The sweat the body produces during a hot flash or night sweat dries quickly on the skin,” Ross says. Salt from sweat can further dry out your skin, leading to more irritation, she adds.
Your move: Turn on the air conditioner, open windows, and blast fans to keep your sleeping space cool. Outfit your mattress with cooling sheets and wear pajamas made with breathable, quick-drying fabrics like bamboo.
What Treatments Can Help Menopause Itching?
Menopause itching treatments are as varied as the badasses navigating the skin-clawing condition.
HRT
Hormone replacement therapy (HRT) helps stabilize hormones, which reduces the urge to scratch. “For most people, HRT will safely reverse or improve vaginal dryness and itchiness, as well as night sweats,” Ross says.
There are several forms of HRT available, including estrogen patches and pills, as well as topical estrogen and gels. “A healthcare provider who specializes in menopause will give you a personalized HRT suggestion based on your symptoms and overall health,” Ross says.
If your main issue is genital itching, a localized estrogen suppository may be recommended. But if you’re scratching from head to toe, then you’re probably a good candidate for a more systemic option (like an estrogen pill or patch), Greenberg explains.
Topical medications
For general body itching, over-the-counter hydrocortisone cream or prescription corticosteroids can provide relief, Gaither says. An OTC cream, like Cortizone-10, should do the job for mild itching. For more stubborn irritation, you may need a steroid-based cream (10).
For intense pain, your doctor may prescribe a local anesthetic cream. If an infectious pathogen has cozied up in the cracks of your skin, a prescription antifungal or antibacterial ointment is the correct antidote (11).
Vaginal moisturizers
“A vulva-specific moisturizer can help hydrate and moisturize the skin of this delicate area, while an internal vaginal moisturizer can provide daily comfort to the vaginal tissues,” Ross says. You can rub most of these moisturizers onto your vulva (or insert the appropriate ones into the vagina) after showering, similar to how you’d apply lotion to other parts of your body, Greenberg adds.
For added comfort and moisture during sex, use a water-based lubricant, adds Ross.
Home remedies
“An oatmeal or coconut oil bath with warm, but not hot, water for 10 to 20 minutes each day can soothe dry and irritated skin,” Ross says. When you get out, lather yourself in unscented moisturizer like a baker icing a cake.
You could also try applying cooling agents, such as calamine lotion (12). Pro tip: Place your go-to, free-of-additives moisturizer in the fridge for extra relief when you apply it.
How to Prevent Menopause Itching
It might sound trite, but as far as menopause itching is concerned, prevention is the best medicine. Preventing itching is much easier than chasing it away, Ross says.
Moisturize your skin daily with a reputable, fragrance-free moisturizer or coconut oil. Staying hydrated, avoiding hot showers, and managing stress can also help you avoid clawing your skin, she says.
When Does Itchy Menopause Skin Go Away?
For most women menopause itching begins with perimenopause, as estrogen levels boomerang up and down in the four to eight years before menopause (13). Once menopause makes her grand debut, estrogen levels stabilize, and your body begins to adjust to its new norm. It takes about a year for your body to get used to this steady, reduced level of estrogen. After that, perimenopause symptoms, including itching and night sweats, usually ease up (14).
The Bottom Line
Menopause itching affects millions of women in perimenopause and often affects the arms, inner thighs, and face. Ping-ponging estrogen levels reduce collagen and natural oil production necessary for healthy skin. Perimenopause symptoms such as night sweats can further dry out your skin, making you susceptible to irritation and infection. Several medicinal and holistic treatments are available to offset the incessant itch, including HRT, oatmeal baths, and fragrance-free moisturizers.
