Some women experience skin crawling sensations only at night during menopause primarily due to the decline in estrogen levels, which affects skin health and nerve function. This hormonal change leads to dry, thin, and sensitive skin, impaired nerve endings, and increased histamine responses, all contributing to the unsettling sensation often described as bugs crawling on or under the skin, medically known as formication.
During menopause, estrogen, a hormone crucial for maintaining skin moisture, thickness, and collagen production, significantly decreases. Collagen is essential for skin strength and elasticity, and its reduction causes the skin to become thinner and more fragile. This thinning makes nerve endings more exposed and sensitive, which can trigger abnormal nerve signals perceived as crawling or tingling sensations. Additionally, estrogen deficiency can lead to neuropathic itch, a type of itch caused by nerve dysfunction rather than skin irritation itself.
The sensation tends to worsen at night for several reasons. At night, there are fewer distractions, so women become more aware of subtle sensations that might be ignored during the day. Also, the body’s natural circadian rhythms can influence nerve sensitivity and histamine release, potentially amplifying itchiness and the crawling feeling. Dry skin, which is common during menopause due to reduced oil production and moisture retention, can also become more irritating when the skin cools down at night, further intensifying the sensation.
Moreover, the increased histamine response linked to estrogen loss can heighten itchiness. Histamine is a chemical involved in allergic reactions and itching, and its elevated levels can make the skin feel more irritated and crawl-like sensations more pronounced. Stress and anxiety, which often accompany menopause, can exacerbate these sensations, creating a cycle of discomfort that disrupts sleep.
Women describe this crawling sensation as pins and needles, tingling, or the feeling of insects moving on or beneath the skin. This symptom, formication, is a recognized but often misunderstood part of menopause. It can be distressing and interfere with restful sleep, adding to the overall challenges of menopausal transition.
In summary, the skin crawling sensation at night during menopause is a complex interplay of hormonal changes leading to skin dryness, thinning, nerve sensitivity, and increased histamine activity, all of which are intensified by nighttime physiological and psychological factors. Addressing these symptoms often involves managing skin hydration, reducing irritation, and sometimes medical interventions targeting hormonal balance or nerve function.
