Some people find that menopause improves symptoms of hidradenitis suppurativa (HS). But others notice worsening symptoms or no change.

Menopause marks the end of menstruation and officially begins about 12 months after your last period. While many people associate period irregularity and hot flashes with menstruation, these are actually part of perimenopause or menopausal transition.

Perimenopause usually begins between ages 45 and 55 and can last 7–14 years. This phase involves ongoing hormonal shifts that can have various health impacts, such as weight gain or mood shifts.

The hormonal changes that precede menopause may also affect existing skin conditions, including HS. The impacts of menopause on HS aren’t totally clear. Some find their symptoms improve, while others feel it triggers symptom flare-ups.

Here’s a closer look at the potential impact of menopause on HS.

The exact cause of HS remains unclear. While experts once considered it a purely inflammatory condition, some experts now view it as a follicular occlusion disorder. These conditions involve hair follicles getting blocked and eventually rupturing, resulting in skin inflammation.

A 2021 research review noted that hormone dysfunction and estrogen and progesterone fluctuations might affect some cases of HS, but the exact underlying mechanisms are unclear.

The review mentioned several studies reported that 43–63% of women say their HS symptoms are worse around the start of their periods, typically in the week preceding them. But it’s unclear why this happens.

Those with HS can be more likely to have polycystic ovary syndrome (PCOS). While the exact cause of PCOS is also unclear, it links with lower progesterone and higher androgen (male sex hormone) levels.

In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes, and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).

Keep in mind that hormones are part of the story. Other factors that may affect HS include:

  • genetics
  • immune system dysregulation
  • obesity
  • diet
  • smoking
  • changes to your skin’s microbiome

There’s no evidence yet to suggest that menopause can cause or trigger the onset of HS. While a few cases like this 2021 case report involve the postmenopausal onset of HS, this appears to be extremely rare. Plus, the role of menopause in those cases is still unclear.

But menopause may worsen existing HS symptoms for some. A 2020 study reviewed survey responses from 279 people with HS with a pregnancy history. Following menopause, 39.5% of respondents reported worsening symptoms, while 44.2% reported no change.

There’s also evidence that undergoing hormone replacement therapy for menopause symptoms may contribute to worsening symptoms.

In a study from 2014 involving a similar survey with 212 people, 31.5% of respondents reported improved symptoms following menopause, 20.5% reported no change in symptoms, and 8.7% reported worsening symptoms.

Keep in mind that the 2014 and 2020 studies involved fewer than 300 participants, and the authors of both noted the need for more research on the connection between menopause and HS symptoms.

The impact of menopause on HS is unclear. Some people report their symptoms improving, while others notice more severe symptoms or no change. While a few reported cases of HS may appear after menopause, this is extremely rare.

While menopause-related hormone fluctuations might affect HS symptoms, many other factors, like smoking and diet, may play a role, too.

Working with a dermatologist can help you narrow down your triggers for a flare-up and find the most effective strategies for minimizing your symptoms.