Why Your Face Changes During Menopause and What Helps
Medically reviewed by
4 independent reviewers
Andrew Conrad Barile, PT, DPT
Doctor of Physical Therapy (DPT) | Licensed Physical Therapist (PT) | CEO and Founder, Xtreem Pulse LLC
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Dr. Andrew Conrad Barile is a Doctor of Physical Therapy and the CEO and Founder of Xtreem Pulse LLC, the engineering company behind PureLift. He earned his Doctorate in Physical Therapy from Daemen College and is a licensed physical therapist.
He brings over two decades of clinical and entrepreneurial experience across physical therapy, craniosacral therapy and medical device innovation, built on a working knowledge of human anatomy and muscle physiology.
For PureLift LAB he reviews how current is delivered across all ten levels, from sub-sensory nanocurrent and skin-level microcurrent to motor-level EMS, and how the Infuse pass fits into the same ten-minute routine.
Bertica M. Rubio, M.D.
Board-Certified Physician, Dartmouth Medical School | Medical Director, Antiaging Regenerative Medicine Clinic
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Dr. Bertica M. Rubio is a board-certified physician and Medical Director of the Antiaging Regenerative Medicine Clinic in Redlands, California. She earned her Doctor of Medicine from Dartmouth Medical School and completed her pediatrics residency at UC Irvine Medical Center.
With decades of clinical experience, she specialises in age management medicine, regenerative medicine, wound healing and growth factor therapies, and her practice integrates evidence-based medical science with advanced aesthetic treatment.
For PureLift LAB she reviews articles for medical accuracy across the whole dial, from the gentle nanocurrent and microcurrent settings through to muscle-level EMS and the Infuse pass.
Daniel Grinberg, MD, FACS
Board-Certified Otolaryngologist | Head and Neck Surgeon | Fellow, American College of Surgeons | Mount Sinai
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Daniel Grinberg, MD, FACS is a board-certified otolaryngologist and head and neck surgeon at ENT and Allergy Associates in West Nyack, New York. He earned his medical degree from Columbia University College of Physicians and Surgeons.
He completed his otolaryngology residency at New York University Medical Center, serves as Assistant Clinical Professor at Mount Sinai School of Medicine, and is a Fellow of both the American College of Surgeons and the American Academy of Otolaryngology.
For PureLift LAB he brings a wider clinical lens, connecting at-home facial stimulation from microcurrent to EMS to the anatomy underneath, with the same rigour we apply to every device specification.
Prof. Dr. med. Ivo Buschmann
Chair of Angiology, Medizinische Hochschule Brandenburg | Clinic Director, University Clinic for Angiology
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Prof. Dr. med. Ivo Buschmann is Chair of Angiology at the Medizinische Hochschule Brandenburg Theodor Fontane and Clinic Director of the University Clinic for Angiology at the Brandenburg University Hospital.
He trained at the University of Hamburg, was a Max Planck Society Fellow at the Max Planck Institute for Heart and Lung Research, and held senior consultant posts at the Charite Universitatsmedizin Berlin before his appointment as Chair in 2016.
One of Europe's leading authorities on arteriogenesis, with over 150 peer-reviewed publications and US and EU patents, he reviews for PureLift LAB how the evidence on electrical stimulation is read and where its limits lie.
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Collagen falls faster in the years around menopause than at any other time, and the changes are mostly in skin and volume rather than in muscle, which is the layer a device reaches.
This article sets out what to check before you start, such as:
- what happens to facial collagen in this window
- why the change feels sudden rather than gradual
- which of the three layers a device reaches
- what helps the skin layer specifically
- what belongs with your doctor rather than a brand
and many more!
This is a stage where the honest answer involves more than one intervention, and a device is one of them rather than the answer.
Key Points:
Research on skin collagen reports a sharp decline in the first years after menopause, considerably faster than the steady loss that precedes it.
The visible changes come from three layers at once, thinner skin with less collagen, shifting and shrinking fat pads, and bone remodeling around the eye socket and jaw.
Muscle is the fourth layer and the one a device reaches, which helps definition rather than skin quality.
Topical estrogen, systemic hormone therapy and prescription retinoids are medical conversations with a doctor or dermatologist.
Nothing in this category heats tissue, so it does not address the skin laxity that most people notice first.
What happens to collagen in this window
Skin collagen declines across adult life at a slow, steady rate, and the years around menopause interrupt that pattern with a much steeper fall.
Published estimates put the loss in the first post-menopausal years at a substantially higher annual rate than the decades before, before settling back toward the slower baseline.
Less collagen means thinner skin, less elastic recoil and less structural support for everything above it.
That is why the change often feels abrupt rather than gradual, and why people describe looking different within a year rather than over a decade.
Three layers changing at once
The skin thins and loses elasticity, so it no longer follows the shape underneath and creases hold where they used to spring back.
The fat pads shrink and shift downward, so the face loses fullness in the upper cheek and gains weight along the jaw.
The bone remodels, with the eye socket widening and the jaw losing height, which removes the scaffolding everything else sits on.
No single intervention addresses all three, which is why advice that promises one is unreliable.
The layer a device reaches
Muscle is the fourth layer and the only one in this list that responds to stimulation.
Kavanagh and colleagues in 2012 reported an 18.6 percent increase in cheek muscle thickness over twelve weeks, measured at the cheek by ultrasound, in a cohort that included women in this age range.
Better muscle tone improves definition along the jaw and gives the tissue above it more support, which is a real contribution to how the face reads.
It is also a maintenance result rather than a permanent one, held while you keep training and lost when you stop, which we set out in our article on stopping.
What helps the skin layer
A retinoid has the strongest human evidence of anything available for dermal collagen, and it is the single most useful addition for most people at this stage.
Daily sunscreen prevents further loss, which matters more when the baseline is falling faster than usual.
Professional resurfacing, whether laser or chemical, addresses texture and tone at a depth no topical reaches.
Radiofrequency and ultrasound are the device categories aimed at laxity specifically, and we make neither, which we say in our comparison.
What belongs with a doctor
Systemic hormone therapy is a medical decision with benefits and risks that have nothing to do with your face, and it is a conversation with your doctor.
Topical estrogen for skin specifically is prescribed in some countries and not others, and a dermatologist is the person to ask.
Prescription-strength retinoids, and whether your skin can tolerate one, are also a dermatologist question.
We are a device company and none of those decisions are ours to advise on, which is why this section exists rather than a paragraph of encouragement.
A realistic plan
Sunscreen daily and a retinoid introduced slowly, which together address the layer changing fastest.
A device four or five times a week, ten minutes with three minutes per side at most, judged at twelve weeks rather than twelve days.
A consultation about volume if hollowing in the upper cheek is what bothers you most, since that is a filler question rather than a toning one.
Expect improvement in definition and in how your face looks the same day, and do not expect the skin itself to behave as it did at forty. The full technology map is in our category overview.
This article sits inside our full map of the category, where we set out all 33 devices we track, what each one carries and what each brand publishes: Nine Technologies on One Dial, What the Rest of the Market Actually Carries.