Easy bruising

A purple thumbprint on your forearm that you can't trace to a knock. A bruise from carrying a tote that stays for two weeks. Skin that tears on the corner of a drawer. Easy bruising in perimenopause, menopause and postmenopause is a real, largely benign, well-described pattern — but it can also flag things worth ruling out.

A stack of small changes plus a short medical list worth checking.

Thinner skin and less padding. Collagen and dermal fat both drop with estrogen loss. Capillaries lose the cushion around them, so ordinary bumps that used to be invisible now show as bruises.

Fragile capillary walls. Estrogen influences vessel wall elasticity. Post-menopause, the same amount of pressure ruptures a capillary more easily — which is why bruises are also more likely on the backs of hands, forearms and shins.

Common medications thin the blood. Daily aspirin, ibuprofen or naproxen, fish oil at high doses, SSRIs and — obviously — anticoagulants all raise bruising. Any new bruising pattern should include a full medication and supplement review, not a stop-taking-it decision.

Low vitamin C, low vitamin K, low protein. All three matter for vessel and skin integrity. Perimenopause diets often drift lower in protein and vegetables without anyone noticing. Fixing this alone is often enough.

Boring, cheap, effective. Give it a fortnight before judging.

Protein at every meal, and colourful plants. Adequate nutrition matters, but dietary changes don't diagnose or reliably resolve unexplained bruising. Ask about assessment rather than treating the pattern with food or supplements alone.

Review supplements and painkillers with your doctor. Chronic ibuprofen, high-dose fish oil, and daily aspirin add up. A five-minute medication conversation often changes the picture. Don't stop prescribed medications without your doctor.

Protect the high-traffic areas. Long sleeves in the garden. A wheelie bag instead of a tote. A folded towel under the forearm when working at a hard desk edge. Small changes to friction and impact matter more than any cream.

Topical estrogen or MHT restores some of the skin picture. Systemic and topical estrogen both increase dermal collagen and skin thickness in trials. Not a first-line for bruising alone, but a real side benefit worth naming if MHT is already on the table.

Gentle care after a known knock. A wrapped cold pack may ease discomfort after a knock. Don't assume arnica or a cream will treat unexplained bruising; the underlying pattern still needs assessment.