Creepy crawling on my skin during menopause, should I be worried? Here's the tea on formication

Picture this: You're binge-watching your favorite show, snuggled up on the couch with a cup of tea, when suddenly you feel it… a phantom itch creeping across your arm. Or maybe it's the unmistakable sensation of tiny ants having a parade on your legs. You jump up, swatting at nothing, looking around like you're starring in your own personal horror movie. You check for bugs. Nothing. You check again. Still nothing.

Then comes the spiral: Am I developing some weird allergy? Is this a skin condition? Oh god, what if I'm losing my mind?!

Here's the tea, bestie: You're not going crazy, and you definitely don't need to worry. If you've been experiencing a "creepy-crawly" sensation on your skin, that bizarre feeling like something is crawling under your skin during perimenopause or menopause, you're experiencing what doctors call formication. Yes, it's a real thing. Yes, it's super annoying. And yes, it's a symptom of perimenopause and menopause that basically no one warns you about.

Welcome to one of the most bizarre (and embarrassing) hormone imbalance symptoms that women whisper about in doctor's offices but rarely discuss openly. Well, we're about to normalize the heck out of it and explain exactly why your body is staging this creepy production.

What causes formication in menopause?

Let's spill the real tea on why does my skin feel like something is crawling on it. Spoiler alert: Your hormones are throwing a farewell party, and your nerve endings got the memo.

Hormones regulate nearly every function in your body. From your mood and metabolism to your nervous system and skin health. So when your hormones fall out of balance (especially during perimenopause), the effects naturally ripple through your sensory receptors like a hormonal game of telephone gone wrong.

1. The estrogen-skin connection (AKA why your nerves are acting extra)

Estrogen isn't just the hormone that manages your reproductive system, it's also your skin's best friend. Think of estrogen as the "hydration and collagen" hormone. It supports your skin health, helps maintain the protective barrier of your skin, and keeps those nerve endings chill.

The decline: During perimenopause, your estradiol levels typically range from 30-400 pg/mL. Not too shabby, right? But as you transition into menopause, these levels can plummet to under 15 pg/mL. That's a reduction of more than 90 percent. Ninety. Percent. That's not a gentle decline, that's your hormones basically ghosting you.

The glitch: This sharp drop in estrogen affects the nerve endings just beneath your skin. When estrogen is low, these nerves become hyper-reactive drama queens, sending false alarm signals to your brain that register as itching, tingling, or that skin crawling sensation during menopause. Your nerves are literally making stuff up because they're understimulated. It's like they're bored and decided to entertain themselves by pranking you.

This is one of those sensory symptoms perimenopause loves to throw at you when you least expect it, usually right when you're trying to relax or fall asleep (because of course).

2. The collagen crash (when your skin gets clingy)

Still thirsty? Here's some more tea: Estrogen is also essential for collagen production. As your hormone levels drop, your skin becomes thinner, drier, and more sensitive. We're talking about a serious hormone imbalance symptom that affects your largest organ.

When your skin loses moisture and elasticity, those already-sensitive nerve endings become even MORE reactive to environmental stimuli (like the air touching your skin, your clothes brushing against you, or even just existing). Everything feels more intense, which amplifies that crawling, tingling sensation.

It's like your skin suddenly decided to become high-maintenance without asking your permission first.

3. The nerve sensitivity menopause special

Is skin crawling a symptom of perimenopause? Absolutely yes. And it's not just about estrogen. It's about how your entire nervous system adapts (or struggles to adapt) to hormonal shifts.

When your hormones are fluctuating wildly during perimenopause, your nervous system can become dysregulated. This can manifest as:

• Increased nerve sensitivity
• Phantom sensations (like bugs crawling)
• Heightened awareness of normal body sensations
• Tingling skin that hormones can't quite regulate properly

Think of it as your nervous system being stuck on "high alert" mode because it doesn't have the hormonal backup it's used to.

We will actually listen (because your doctor might not get it)

Let's be real for a second: Many women are hesitant to bring up itchy skin menopause symptoms or menopause skin crawling to their doctors because it sounds absolutely bonkers. We get it. Saying "I feel like bugs are crawling under my skin" out loud sounds like you're auditioning for a psychological thriller.

But here at HHWL, we understand the BHRTea, we know that your symptoms are REAL, valid, and can be addressed. Understanding what your body needs is the first step toward feeling better. You shouldn't have to accept this as your "new normal" just because you're close to, or over, 40. The tea is hot, and we're serving it with zero judgment.

How to stop formication naturally (and actually feel human again)

So, how to stop formication naturally? We believe in treating the root cause of these sensory glitches by restoring your hormonal balance, not just slapping a band-aid on the symptoms and calling it a day.

Stop the guesswork: get tested

We start with our Total Hormone Blueprint Assessment. This isn't your standard "let's check your thyroid and call it good" lab work. This is targeted testing that measures your current hormone levels, including estradiol, progesterone, testosterone, and more to identify exactly where the imbalances exist.

Because here's the thing, you can't fix what you don't measure. And guessing about your hormone levels is about as effective as trying to bake a cake without measuring ingredients. Sure, you might get lucky, but probably not.

Consistent restoration: pellet therapy style

We believe in Pellet Therapy because it provides a steady, 24/7 release of bioidentical hormones directly into your bloodstream. No peaks and valleys. No forgetting to take your pill. No variability in cream absorption because you applied it to slightly damp skin instead of bone-dry skin (yes, that matters).

Pellets ensure your nerve endings get a consistent "dose" of the estrogen and other hormones they desperately need to calm the heck down and stop sending phantom crawling signals.

This is hormone replacement therapy for skin that focuses on addressing the underlying issue instead of just numbing the symptoms.

Targeted nutrition: feed your hormones

We often recommend supporting your skin from the inside out with:

• Vitamin D3: Essential for hormone production and immune function
• Omega-3s: Critical for skin barrier health and reducing inflammation
• Collagen supplements: Help rebuild what estrogen loss has depleted
• B vitamins: Support your nervous system function

Think of it as giving your body the building blocks it needs to address the damage and prevent future hormonal chaos.

What to expect on your journey 

Results vary individually and BHRT does not guarantee results. This part of the hormone journey absolutely needs to be guided by licensed providers and treatment is appropriately determined by provider discretion.

Is it really just hormones? (other skin changes after 40)

While formication is most commonly a hormone-related issue, it's worth noting that other skin changes after 40 can include:

• Increased dryness and thinning
• More visible veins and age spots
• Slower wound healing
• Changes in skin texture and elasticity
• Increased sensitivity to products

If you're also experiencing severe itching WITH rashes, blisters, or other visible skin changes, definitely get those checked out by a dermatologist to rule out actual skin conditions. But if it's just that maddening phantom crawling sensation? Yeah, that's probably your hormones being dramatic.

Ready to address the ich?

You don't have to live with a nervous system that's constantly on edge, sending you false signals like an overzealous security system. Let's find out if your hormones are the real culprit behind your creepy-crawly skin.