What is Facial Bone Resorption or Menopause Face?

What Is 'Menopause Face'? Understanding Facial Bone Resorption

As you’ve scrolled on social media, or maybe just in casual conversation, you may have stumbled across the term “menopause face.” Like most catch-all phrases, it hints at something real but can also feel reductive or even a little confusing. Not to worry — we’re here to clear things up and focus on the info that actually matters.

The gist: “Menopause face” describes a range of changes that can happen during this life transition, and how those changes may show up in your face. While things like wrinkles and dryness tend to get the most attention, there’s another biological process at play called facial bone resorption.

That’s a science-y way of describing the gradual decrease in bone density and volume in the face. It’s a normal, age-related process that can accelerate during menopause thanks to hormonal shifts, particularly lower estrogen levels. As time goes on, it can lead to visible changes like more sagging and differences in your face shape.

So, let’s dig into what’s happening and what it means for how these changes show up over time.

How Hormonal Changes During Menopause Affect Your Face

Some women describe menopause as a kind of second puberty. 

Just like during the tweenage years, shifting hormones can bring changes in mood, appearance, and just how the body functions in general. That’s because estrogen is a very important hormone. Beyond reproductive health, it’s also involved in maintaining skin and bone density and volume, including in the face.

During perimenopause and menopause, as estrogen levels decline, bone and muscle strength can decrease, and skin can also get more fragile. These can make visible signs of aging more noticeable over time. 

Let’s take a closer look at estrogen’s relationship to these systems: 

• Estrogen and bone health. Estrogen helps keep the process of bone breakdown and formation in balance during the reproductive years. After menopause, as estrogen levels drop, some women also experience bone loss, especially in the years right after menopause. In the face, this may show up as changes in overall structure, like hollowing out or shifts in shape.

• Estrogen and collagen. As estrogen declines, the skin can become thinner, drier, and more reactive. This may show up as a loss of plumpness and smoothness.

• Estrogen and skin elasticity. Collagen and elastin work in tandem to keep skin firm and supple. When the body isn’t producing as much, the skin can gradually lose some of its structure. So that also contributes to the sagging or less defined contours you might notice. 

While estrogen is a huge player here, other hormones are doing some behind-the-scenes work, too. For example, androgens (another type of sex hormone) impact skin thickness, how much oil you produce, and hair growth patterns. 

Hair, Acne, and Other Facial Changes: Beyond Bone and Skin

Beyond the bone and skin changes, lower estrogen and shifting androgens during and after menopause can lead to things like: 

• Thinning hair on your scalp

• Increased facial hair 

• More acne, especially around the jawline and chin

Many of the treatments we’ll discuss ahead can help with these symptoms, and addressing them can absolutely help you feel more confident instead of frustrated. 

Visible Signs of Menopause Face: What to Expect

By now, you might be wondering what these deeper changes actually look like in the mirror. It’s different for everyone, but there are some patterns that tend to show up:

• Sagging cheeks

• Hollowing under the eyes

• Deepening nasolabial folds (aka smile lines, which, frankly, can be a bit of a badge of honor)

• Thinning lips

• Drier, thinner skin

• More noticeable wrinkles

• Changes in facial fat distribution

To some extent, many of these examples are just signs of the natural aging process. But the hormonal shifts that happen during menopause can change the rate and way these developments unfold. 

That distinction matters, not because these face changes need to be “fixed,” but because understanding what’s driving them can help you feel better equipped to make decisions around how (or if) you want to respond.

The Science of Collagen, Skin, and Soft Tissue Changes

We touched on this earlier, but it’s worth taking a deeper look at how menopause interacts with collagen, skin, and soft tissues.

First, let’s define collagen. It’s the most abundant protein in the body and works like a building block for our nails, hair, and, of course, skin. In the skin, it forms a supportive framework within the dermis (the middle layer), helping maintain firmness, elasticity, and hydration. When collagen levels are higher, skin tends to feel smoother, more resilient, and more even in texture.

Over time, collagen production naturally declines. While factors like UV exposure, genetics, certain habits (like smoking and drinking), and aging itself all affect how much collagen your body produces, menopause is also a contributing factor. That’s mostly thanks to estrogen. 

Basically, estrogen sends signals to cells in your skin to produce collagen and elastin and supports cellular turnover. It also counteracts certain enzymes that break down existing collagen. When there’s less estrogen during menopause, those protective and regenerative qualities are diminished. 

In fact, research shows that women lose up to 30 percent of their collagen within the first five years post-menopause. That link between estrogen and collagen is hard to ignore.

At the same time, changes in soft tissue (like shifts in fat distribution and volume) can further affect how the face looks. So these more surface-level changes often reflect the deeper collagen and bone changes happening. 

Lifestyle and Nutrition: Supporting Facial Bone and Skin Health

Seeing as menopause can impact your whole body, it makes sense that holistic approaches are often the most meaningful. And lifestyle changes can be a big part of that —  which is important, since habits are within your control (to a certain extent).

In other words, small, consistent choices around exercise and eating habits can help support healthier bone structure and skin over time.

“Many women are surprised to learn how much lifestyle impacts facial aging during menopause. In practice, we see that consistent habits like strength training, proper nutrition, and hydration can significantly support both bone density and skin quality over time.” - Dr. Judith Barreiro

Nutrition

Eating a balanced diet built around whole, unprocessed foods is a good foundation during menopause (and any life stage). More specifically, nutrients like calcium, vitamin D, and protein support bone health, while antioxidants and healthy fats are crucial for skin health. 

Are a starting point, here are some foods to add to your grocery cart:

• Leafy greens

• Broccoli

• Carrots 

• Beans

• Tofu

• Yogurt 

• Cheese 

• Fatty fish 

• Eggs

• Chicken 

• Mushrooms 

• Whole grains 

• Nuts and seeds 

• Berries 

• Avocado 

• Sweet potatoes 

This isn’t an exhaustive list, but it’s a good starting point.  

Other Lifestyle Factors and Habits  

First and foremost, getting enough movement can go a long way in supporting many facets of health. And certain exercises are more beneficial as you age and go through menopause. 

Weight-bearing activities are extra beneficial during midlife, as they help support bone and muscle strength while also improving mobility. 

And some habits can work against skin and bone health. Two big ones are smoking and drinking alcohol. The former is associated with lower bone density and premature skin aging, while the latter is linked with an increased risk of fractures and changes in skin quality. 

If you can, limit or avoid smoking and drinking to support your health, including your facial skin and bones. 

Last but not least, make sure to hydrate with plenty of water. 

Medical and Skincare Treatments for Menopause Face

There’s no shortage of options when it comes to addressing the facial changes that can accompany menopause. The right approach can depend on your goals, preferences, comfort zone, and medical history, but it can be helpful to know what’s out there.

Let’s break them down by type:

• Topical estrogen. Topical estriol and other estrogen-based creams may help improve skin elasticity, hydration, and collagen production, particularly in estrogen-deficient skin.

• Prescription retinoids. You may have heard of tretinoin, one of the more widely used prescription retinoids. These support cell turnover and can help reduce the appearance of fine lines and wrinkles. Like topical estrogen, they’re usually applied as a cream and can be folded into your regular skincare routine.

• Minimally invasive aesthetic treatments. Options like laser therapies and certain resurfacing treatments can help improve skin quality by stimulating collagen production. Though it works in a different way, Botox also falls into this category. It works by temporarily relaxing certain facial muscles. This can then soften existing lines and help prevent new ones from forming.

• Menopause hormone therapy (MHT). MHT can slow down bone loss after menopause by helping restore estrogen levels. It may also help support skin by improving collagen production, thickness, and hydration. While it’s not prescribed solely for skin concerns, it may be a good treatment for anyone looking to manage other menopause symptoms, like hot flashes and mood changes.

Surgical Menopause and Accelerated Facial Changes

While natural menopause can bring many changes, surgical menopause (which happens when the ovaries are removed) often brings them on more abruptly.

It leads to a sudden loss of estrogen, which can trigger faster changes in bone and skin (among other effects). Because estrogen levels fall rapidly and all at once, the symptoms of low estrogen can be more sudden and intense. 

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One of the symptoms some women notice is faster facial aging, including the effects of more bone resorption and collagen loss we’ve been talking about. 

In these situations, early treatment and individualized care are especially important, given how quickly these changes can unfold.

Talking to Your Healthcare Provider About Facial Aging in Menopause

If you notice these changes and find them bothersome, one of the most helpful things you can do is start a conversation with a healthcare provider. You don’t have to just throw up your hands. There are ways to support your skin and bone health so you can feel more like yourself.

Going into that conversation, be ready to talk through your symptoms, medical history, and goals. From there, your provider will likely walk through potential treatment options. And if they don’t cover everything, be sure to speak up and ask about options like hormone therapy, topical treatments, or anything else you’ve been wondering about.

It’s also a good time to ask about targeted lifestyle changes that could support your skin and bone health. A personalized approach matters here, and you deserve one. 

If you’re looking for support around any of these changes, you can connect with a menopause-trained clinician through Alloy today. 

Frequently Asked Questions

What is facial bone resorption and how does it relate to menopause?

Facial bone resorption is the biological process where bone density and volume in the face gradually decrease. During menopause, this process often accelerates due to falling estrogen levels. Since estrogen helps balance bone breakdown and formation, its decline can lead to a loss of structural support. Visually, this often manifests as hollowing under the eyes, sagging cheeks, and changes in the overall shape or contour of the face.

How does the loss of estrogen specifically impact skin collagen and elasticity?

Estrogen is a primary signal for the body to produce collagen and elastin, the proteins responsible for keeping skin firm and hydrated. Research indicates that women can lose up to 30% of their skin's collagen within the first five years following menopause. Without the protective and regenerative influence of estrogen, the skin becomes thinner, drier, and less resilient, which contributes to the development of deeper wrinkles and more noticeable sagging.

What treatments are available to address facial changes during menopause?

There are several medical and topical options to manage these changes, ranging from prescription skincare to systemic therapy. Topical estrogen creams can improve skin hydration and collagen production, while prescription retinoids like tretinoin support cellular turnover. Menopause hormone therapy (MHT) may also help by slowing systemic bone loss and improving skin thickness. Additionally, lifestyle habits such as weight-bearing exercise and a diet rich in calcium and protein provide a foundational layer of support for bone and skin health.