Is Menopause Making My Skin Crawl? Why Your Skin and Legs are Staging a Menopause Protest
There you are. It's 2:15 AM. You've finally managed to quiet the "to-do list" loop in your brain, the duvet is at the perfect temperature and you are on the precipice of actual, restorative sleep.
And then it starts.
A phantom itch on your left shoulder. Then a sensation like a tiny, invisible ant is trekking across your shin. You scratch. It moves. Then, just as you settle again, your legs develop a mind of their own- an electric, jittery urge to move that makes staying still feel like a form of low-grade torture.
If you've found yourself kicking the sheets or moisturising at 3:00 AM, you aren't losing your mind. You're experiencing two of menopause's most irritating "hidden" symptoms: Pruritus and/or Formication (the itchy skin sensations) and Restless Legs Syndrome (RLS).
The Great Oestrogen Drying-Out
We talk a lot about hot flushes but we don't talk enough about the fact that oestrogen is essentially the "WD-40" of the human body. It keeps things moving, hydrated and cushioned.
When oestrogen levels take a dive, so does your skin's ability to hold onto moisture. Your body stops producing as much collagen and natural oils (sebum). The skin barrier becomes "leaky," leading to that classic menopausal dryness. But it's deeper than just "dry skin."
The "ants crawling" sensation- formication- is actually a neurological glitch. Your nerve endings are reacting to the hormonal shift, misfiring and sending "itch" signals to your brain when there is absolutely nothing there. It's the biological equivalent of a practical joke and it's not particularly funny when you're exhausted.
The "Jimmy Legs" Mystery
Then there's the Restless Legs. It's a pulling, throbbing, "must-move" sensation that affects up to 20% of women during the transition. Why now?
Dopamine Discord: Oestrogen helps regulate dopamine, the chemical that controls smooth muscle movement. When oestrogen drops, dopamine can fluctuate, leading to those jerky, restless movements.
The Iron Trap: Many women in perimenopause suffer from heavy periods, leading to low iron (ferritin) levels. Low iron is a primary trigger for RLS.
Magnesium Depletion: Stress and hormonal changes can deplete our magnesium stores- the very mineral our muscles need to relax.
Exploring Your Options
You don't have to just "put up with it." There are several evidence-based approaches that women find helpful during this transition. These might be worth discussing with your healthcare provider:
Skin hydration approaches: Research suggests that skincare containing ingredients like ceramides and hyaluronic acid may help restore the skin barrier. Some women find that applying moisturiser to damp skin after a lukewarm shower helps "lock in" moisture.
Understanding your iron levels: For Restless Legs Syndrome, many specialists recommend checking ferritin (stored iron) levels. Current evidence suggests that ferritin levels on the higher end of the normal range- ideally above 75 µg/L- may be more beneficial for managing RLS symptoms.
The magnesium connection: Out of my scope but some women explore magnesium supplementation, with magnesium glycinate being a commonly discussed form. A relaxing magnesium-rich bath before bed is another option some find helpful for both skin and muscle relaxation.
Medical options: Menopause Hormone Therapy (MHT/HRT), prescribed by your GP, is an option that many women find transformative. For some, restoring oestrogen levels can address both the nerve misfiring causing formication and help restore the skin barrier. This is definitely worth an informed conversation with your doctor to understand whether it might be suitable for your individual circumstances.
The Bottom Line
Your body isn't "misfiring" because it's failing; it's reacting to a massive chemical recalibration. But you shouldn't have to dread the duvet. Whether it's the itch or the "jimmy legs," these symptoms are a signal that your body is going through significant hormonal changes.
Ready to Feel Supported Through This Transition?
If the midnight creepy-crawlies are leaving you exhausted and frustrated, I'm here to support you in navigating this phase. Together, we can:
Explore what your symptoms might be telling you about your body's needs
Help you prepare questions and information for confident conversations with your GP about treatment options like MHT/HRT
Look at lifestyle factors- nutrition, sleep hygiene, stress management - that might support your wellbeing during this transition
Create a personalised action plan that feels manageable and sustainable for your life
As your health coach, I'll partner with you to explore evidence-based information, help you clarify your goals and support you in implementing any recommendations from your healthcare team.
Book Your 1:1 Menopause Support Consultation or Lets Chat
References
Skin & Oestrogen: Lephart, E. D., & Naftolin, F. (2021). "Menopause and the Skin: Old Favorites and New Innovations in Cosmeceuticals." Dermatology and Therapy. PMID: 33242128
Fang, Y. et al (2024). Mapping global prevalence of menopausal symptoms among middle-aged women: a systemic review and meta-analysis. PMID: 38956480
Restless Legs & Iron: Allen, R. P., et al. (2018). "Evidence-based and consensus-based recommendations for the iron treatment of restless legs syndrome." PMID: 29425576
Dopamine & Hormones: Barth, C., et al. (2015). "Estradiol and the reward system in humans." Frontiers in Human Neuroscience.
