Menopause & Acne

Blog by Callie Birtles, RHN in The Clear Skin Solution

Heading into menopause only to find your skin acting like it did when you were a teen? While hot flashes, night sweats, and mood swings are well-known symptoms, many women are surprised to experience breakouts during this phase of life. Below, we’ll explore the key hormonal players, as well as how factors like gut health, liver function, stress, thyroid imbalances, and blood sugar regulation contribute to menopause & acne. Whether you’re dealing with persistent breakouts or noticing new ones, we work with women to identify and address underlying imbalances and take a functional approach to achieving clear, healthy skin.

Key Hormonal Players

Hormonal changes are at the core of many symptoms women experience during menopause and perimenopause, and acne is no exception. As estrogen levels begin to decline, the balance between estrogen and androgens (male hormones like testosterone) shifts. This relative rise in androgens can stimulate the skin’s sebaceous (oil) glands, leading to increased oil production. More oil on the skin means clogged pores, which can result in acne flare-ups, particularly around the jawline and chin—areas that are especially sensitive to hormonal changes.

In addition to the decline in estrogen, progesterone levels also drop during this transition. Progesterone has anti-inflammatory properties, so when levels are low, the body becomes more prone to inflammation, including in the skin. This combination of higher androgen activity and lower anti-inflammatory support can create the perfect storm for breakouts.

Progesterone, often called the “calming hormone,” plays a crucial role in maintaining hormonal balance and keeping inflammation in check. Unfortunately, progesterone is highly sensitive to stress and lifestyle factors, which can lead to insufficient levels even before women enter menopause. Chronic stress causes the body to prioritize cortisol production, the body’s primary stress hormone, over progesterone. This is because both cortisol and progesterone share the same precursor—pregnenolone. When stress is high, the body diverts resources towards making more cortisol, leaving less available to produce progesterone.

Additionally, lifestyle factors like poor sleep, inactivity, and processed foods can worsen progesterone imbalances. Low progesterone in perimenopause or menopause increases inflammation and skin sensitivity, leading to more acne flare-ups.

Gut Health and Its Role in Menopausal Acne

The health of your gut is deeply intertwined with your skin, especially during the hormonal shifts of menopause. The gut-skin axis—a bidirectional relationship between the gut and skin—means that imbalances in your gut microbiome can show up as inflammation, breakouts, and sensitivity on your skin. One common imbalance that impacts both gut and skin health is dysbiosis, where the gut is overrun by harmful bacteria or yeast, leading to inflammation and improper hormone regulation.

In the context of menopause, gut health is particularly relevant to hormone balance, especially when it comes to estrogen. Your gut houses a collection of bacteria known as the estrobolome, which plays a key role in metabolizing estrogen. When the gut is healthy and diverse, this system functions smoothly, allowing excess estrogen to be processed and excreted properly. However, suppose dysbiosis or issues like SIBO are present. In that case, estrogen metabolism becomes disrupted, potentially leading to a condition called estrogen dominance—where estrogen levels are disproportionately high in relation to progesterone. This imbalance can trigger acne by stimulating excess oil production and inflammation in the skin.

SIBO occurs when bacteria from the large intestine migrate to the small intestine, causing dysbiosis. In a recent podcast episode, Dr. William Davis discussed SIBO’s impact on gut and systemic health. SIBO disrupts digestion and nutrient absorption and contributes to toxins that worsen acne. Addressing SIBO can significantly reduce acne by restoring gut balance and lowering inflammation.

During menopause, declining estrogen and progesterone weaken the gut barrier’s integrity, increasing microbial translocation. A weakened gut barrier allows bacteria and toxins into the bloodstream, causing systemic inflammation. This process, “leaky gut,” worsens skin conditions like acne and rosacea. Estrogen helps maintain tight junctions between gut cells, defending against harmful microbes. Lower estrogen compromises this defense, raising inflammation and skin issues related to gut imbalances.

Stress, the Adrenals, and Thyroid: How They Impact Skin Health During Menopause

Stress is unavoidable, but during menopause and perimenopause, it greatly affects hormones and skin health. The adrenal glands control the body’s stress response by producing cortisol, the primary stress hormone. Chronic stress, from emotional, physical, or environmental factors, increases cortisol production. Prolonged stress leads to adrenal fatigue, where the glands become less efficient over time. This inefficiency impacts cortisol production and overall hormonal balance.

Rising cortisol levels disrupt the balance of hormones like progesterone, estrogen, and thyroid hormones. Cortisol and progesterone share the same precursor, pregnenolone. During stress, the body prioritizes cortisol, reducing pregnenolone for progesterone production. Low progesterone increases inflammation and skin sensitivity, leading to more breakouts.

The thyroid, another crucial gland regulating metabolism and energy, is also highly sensitive to stress. Chronic stress can suppress thyroid function, leading to hypothyroidism, which is characterized by low levels of thyroid hormones. Thyroid hormones play an essential role in regulating skin cell turnover, metabolism, and moisture balance. When thyroid function is low, the skin can become dry, dull, and more prone to acne. In particular, low thyroid function can impair the skin’s ability to heal, making breakouts last longer and increasing the likelihood of scarring.

Additionally, the imbalance between cortisol, progesterone, and thyroid hormones can drive androgen dominance. Elevated cortisol levels can increase the production of androgens, which stimulate oil production in the skin, clogging pores and leading to acne, especially around the jawline and chin.

By addressing stress and supporting the adrenal-thyroid connection, we can help clients regain balance in their hormones, reduce inflammation, and ultimately achieve clearer, healthier skin during menopause. For more insights and our top tips for addressing adrenal fatigue, check out our related blog.

The Liver’s Role in Menopausal Acne

The liver regulates hormonal balance, especially during menopause when estrogen and progesterone levels fluctuate. It metabolizes and detoxifies excess hormones, ensuring safe processing and excretion. Compromised liver function from poor diet, toxins, or stress leads to unmetabolized hormone buildup. Elevated estrogen relative to progesterone, known as estrogen dominance, triggers skin issues like oil production, inflammation, and acne.

Moreover, the liver is responsible for filtering and detoxifying inflammatory by-products and external toxins that can further exacerbate skin conditions. When the liver becomes overburdened, these toxins may recirculate through the body, contributing to breakouts, redness, and heightened skin sensitivity. 

In The Clear Skin Solution, we work closely with clients to assess their individual liver function and capacity for detoxification. While supporting liver health is essential for achieving clear skin, we prioritize a gentle, mindful approach to liver cleansing. Forcing the body to eliminate toxins too quickly can overwhelm the system if the liver or other detox pathways are not functioning optimally. By tailoring protocols to each client’s unique needs, we ensure that detoxification is done safely, helping to restore both hormonal balance and skin health during menopause.  If you’re looking to give your liver some gentle TLC, you can read our top tips here, or listen to our podcast on The Detox Organs.

The Importance of Blood Sugar Management During Menopause

Managing blood sugar is another crucial aspect of maintaining healthy skin and overall well-being during menopause. Hormonal fluctuations, particularly in estrogen and progesterone levels, can make it more difficult for your body to regulate blood sugar. This can lead to insulin resistance, where cells become less responsive to insulin, impairing glucose transport for energy. Elevated blood sugar triggers inflammation, leading to skin issues like breakouts, irritation, and premature aging.

Moreover, insulin resistance can also increase androgen production, particularly testosterone, which further stimulates the sebaceous glands to produce excess oil. This can result in clogged pores, acne, and an overall oily skin texture. For women in menopause, this combination of fluctuating hormones and unstable blood sugar levels creates the perfect environment for skin issues to arise.

Balancing your blood sugar can help reduce the hormonal chaos that contributes to acne and inflammation. Incorporating a diet rich in fibre, lean proteins, and healthy fats while reducing refined carbohydrates and sugars is key. Regular meals and snacks that are well-balanced can stabilize blood sugar levels and prevent insulin spikes, which helps in managing both hormonal imbalances and skin health. In The Clear Skin Solution, we emphasize the importance of adopting sustainable, long-term dietary habits that support balanced blood sugar, reduced inflammation, and improved skin clarity during menopause.

By stabilizing blood sugar supports skin health, and hormonal balance, and reduces menopause symptoms like mood swings, fatigue, and cravings.

Balancing Blood Sugar Tips

1. Eat a balance of protein, fat, and fibre at each meal – This combination helps slow down the absorption of sugar, keeping blood sugar levels stable.
2. Avoid going too long between meals – Eating regularly prevents dips and spikes in blood sugar, which can trigger cravings and irritability.
3. Limit high-glycemic foods – Reducing foods like white bread, sugary snacks, and processed carbs helps prevent blood sugar spikes.
4. Incorporate low-glycemic, whole foods – Choose foods like leafy greens, berries, and sweet potatoes to keep blood sugar stable.
5. Stay hydrated – Drinking water regularly helps your body maintain stable blood sugar levels by supporting digestion and metabolism.
6. Include movement after meals – Light exercise like walking can help lower blood sugar by improving insulin sensitivity.

Final Thoughts

Hormonal fluctuations are key to menopause symptoms, but underlying causes must also be considered. Gut health, stress, thyroid function, detox pathways, and blood sugar management impact hormonal regulation. Addressing these factors restores balance, reduces inflammation, and promotes clearer skin during menopause. A holistic, personalized approach is essential for lasting results.