Skin care tips – Solutions for Perimenopause & Menopause
There are no special cosmetic skin-care products that can affect skin that is experiencing perimenopausal or menopausal symptoms, so you need to follow the skin-care routine for your skin type or special concerns. Consider talking to your physician about hormone replacement therapy, a topical hormone cream or lotion, or alternative hormone replacement therapy.
Note:The issue of hormone loss is an extremely complex and controversial medical issue it is essential to discuss treatment options with your physician. There is no panacea, either natural or otherwise, and the pros and cons of any treatments need to be evaluated rationally.
Do not be misled by headlines or Web sites that present one-sided information, because the research about all the potential treatments is not conclusive in any way. Each one has its negatives and positives that must be personally evaluated before a decision is made. The information below will give you a cursory overview so you can begin the process of evaluating whether to incorporate this into an overall anti-aging program, or decide if you want to consider a particular option as a skin-improvement approach.
When your body makes less estrogen
It has been said that menopause starts the day you get your first menstrual cycle. I don’t know if that’s a hopeful comment or a depressing one, but any way you slice it a woman will have periods for about 30 to 40 years after they first begin, and then they’ll stop. There is still a great deal of research that needs to be done on all the issues surrounding perimenopause (referring to the symptoms taking place in the years before the onset of menopause as estrogen production begins to fall off ), menopause (the actual cessation of the menstrual cycle), and postmenopause (the years after your period has stopped). What is known for certain is that when the body has less estrogen available changes in the appearance of skin, hair, bone, and other physical manifestations begin to take place.
Perimenopause and menopause are brought about by the body’s changes in hormone production. The irksome side effects of menopause are caused primarily by the imbalance between a woman’s female hormones (estrogen and progesterone, which become depleted) and her male hormones (like androgens such as testosterone). Because the male hormones decline more slowly, there are proportionately more of them, so they have a stronger impact. This imbalance, for example, can affect hair growth.
When estrogen levels decrease, many women experience an increase in androgen production, resulting in varying amounts of dark hair growth on the face—particularly around the chin and moustache area above the lip. Ironically, while the hair on your face may get darker, the hair on your head will have reduced growth and you may experience some balding; even the individual hairs actually become smaller in diameter.
The diminishing levels and eventual loss of estrogen and progesterone also affect skin negatively. Aside from experiencing problems caused by sun damage, perimenopausal and menopausal women will have thinner, looser, and less elastic skin, reduced production of collagen, cessation of oil gland function, impeded wound healing, and dry skin. Other parts of the body are also influenced by the diminishing amount of female hormones; the vaginal lining becomes thin and can burn and itch, and the breasts’ mammary tissue is replaced with more fat tissue, which can cause sagging.
To make matters even more frustrating, perimenopause and menopause can also bring hot flashes, flushes, night sweats and/or cold flashes, a clammy feeling, intermittent rapid heartbeat, irritability, mood swings, trouble sleeping, heavier periods, flooding, loss of libido, itchy skin, and more brittle nails, just to name a few.
As complex and multifaceted as this all sounds, there are actually some fairly exciting options for addressing the side effects of perimenopause and menopause, and these include both alternative herbal options and conventional Western medical choices. For the purpose of this section I’m going to highlight a few of the current options as they affect skin, but it is also important to find a doctor or medical expert who is practiced and proficient on the complexities of this topic.
Warning: Please avoid the Web sites, companies, alternative health practitioners, or physicians who do not offer a balanced approach to this issue. Medical options are not evil or dangerous, as many alternative-based professionals or companies assert, and herbal alternatives are not as ineffective or as unproven as many medical doctors assert. Both approaches play a role in mitigating some of the more annoying (as well as intolerable) symptoms of perimenopause and menopause, and both have their pitfalls.
(Sources:Journal of the European Menopause and Andropause Society, November 2008, pages 227–232, and July 2001, pages 43–55; Epidemiology Biomarkers & Prevention16, December 2007, pages 2524–2525; Journal of Biomaterials and Science Polymer Edition, 2008; volume 19, issue 8, pages 1097–1099; Endocrine Pathophysiology, author C. B. Niewoehner, published by Hayes Barton Press, 2004; and Journal of Clinical Dermatology, 2001, volume 2, issue 3, pages 143–150.)
Hormones for wrinkles and healing
Estrogen appears to aid in the prevention of the skin’s aging in several ways. Topical and systemic estrogen therapy can increase the skin collagen content and therefore maintain skin thickness. In addition, estrogen maintains skin moisture by increasing ceramides and hyaluronic acid in the skin and by maintaining the stratum corneum’s barrier function. Sebum levels are higher in postmenopausal women receiving hormone replacement therapy. The wrinkling of skin may also be lessened with estrogen as a result of the effects of the hormone on the elastic fibers and collagen. And aside from of its influence on skin aging, it has been suggested that estrogen increases wound healing by regulating the levels of cytokines, proteins that generate an immune response. In fact, topical estrogen has been found to accelerate and improve wound healing in elderly men and women.
Benefits from taking hormones are dose dependent and are also affected by whether you start taking the hormones during perimenopause or postmenopause. There are compelling reasons to consider hormonal treatment as part of a battle plan for wrinkles. It is a multifaceted, controversial issue, with possible risks you need to consider. The following information will provide an overview to help you create a dialogue with your physician to evaluate all the options available to you.
(Sources: Journal of the American Academy of Dermatology, September 2008, pages 391–404; British Medical Journal, May 2008, pages 1227–1231; Clinical Interventions in Aging, 2007, volume 2, issue 3, pages 283–297; and International Journal of Cosmetic Science, October 2006, pages 335–341.)
Hormone replacement therapy
Hormone Replacement Therapy (HRT) or Estrogen Replacement Therapy (ERT) describes prescription-only treatments that give your body estrogen and/or progesterone. HRT, taken in pills or via skin patches, has been shown to restore some amount of the skin’s support tissue and elastic quality. A number of studies have demonstrated that ERT and HRT can increase the thickness and elasticity of skin as well as lessen the appearance of skin’s “aging.” Estrogen appears to aid in the prevention of skin aging in several ways, including an increase in collagen production, improving barrier function, and creating healthy skin cells; it can also increase wound healing, and improve skin elasticity.
(Sources: Skin Research and Technology, May 2001, page 95; Maturitas European Menopause and Andropause Society, May 2000, pages 107–117; and American Journal of Clinical Dermatology, 2001, volume 2, issue 3, pages 143–150.)
There are serious risks associated with ERT and HRT and there are controversies regarding their effects on heart disease, osteoporosis, and breast cancer. But there seems to be little opposition to the notion that they ease hot flashes, night sweats, mood swings, and vaginal thinning while improving the appearance of skin experiencing perimenopause. It is essential to weigh the pros and cons of ERT and HRT to decide if they are the right direction for you.
Around the age of 40 you can consider getting a baseline estrogen count to determine what normal is for you. That way you can monitor the changes and balancing effect that varying combinations of supplements are having on your body.
(Sources: Climateric Journal of the International Menopause Society, August 2007, pages 289–297; and Experimental Dermatology, February 2006, pages 83–94.)
Topical application of Progesterone and Estrogen
There are a lot of believers in “natural estrogen” and “natural progesterone” creams and lotions. Particularly for progesterone, the Internet is replete with advocates and believers who are convincing in their rhetoric, describing it as the fountain of youth. It’s important to point out that while natural progesterone applied to the skin is absolutely an option for perimenopausal and menopausal symptoms and improvement in the appearance of skin, the versions you buy at health food stores or over the Internet are not regulated in any way by the FDA, and so they are, in actuality, merely cosmetics. That means any cosmetics company can put progesterone or estrogen into whatever products they want to and make outrageous claims for them.
Having said that, there is research showing that topical application of 2% progesterone creams can have benefit for improving the appearance of skin, reducing wrinkles, and increasing elasticity. The same is true for topical application of estrogen. For both estrogen and progesterone, applying patches or creams with these actives appears to greatly reduce the risk associated with oral medications. Objective research about topically applied estrogen and progesterone is limited and should be discussed with your physician before you consider this route.
(Sources: Maturitas European Menopause and Andropause Society, May 2007, pages 77–80; British Journal of Dermatology, September 2005, pages 626–632; Journal of Clinical Pharmacology, June 2005, pages 614–619; Menopause, March 2005, pages 232–237; and Drugs in Aging, 2004, volume 21, issue 13, pages 865–883.)
I would love to say that there are traditional or state-of-the-art skin-care products out there that positively address the changes that occur in perimenopausal and menopausal skin, but there aren’t. There is simply no information available to suggest that applying soy extract, black cohosh, or evening primrose oil to skin can mitigate any of the changes taking place in the epidermis and dermis, and definitely not in comparison to taking those substances orally. None of those substances are a problem if they show up in skin-care products, but their benefits are most likely not any different from those of other anti-inflammatory and antioxidant cosmetic ingredients.
The truth is that the real basics for skin care continue to apply to perimenopausal and menopausal women alike: sun protection, treating the skin type you have (not all menopausal women have dry skin, wrinkles, skin discolorations, or skin disorders), considering using Retin-A or Renova, and using gentle skin-care products. If you have dry skin, use an emollient moisturizer laden with antioxidants, skin-identical ingredients, and cell-communicating ingredients. The use of hydroquinone or arbutin-based skin-lightening products is another important option. But there are no cosmetics you can apply to skin that can alter the actual condition of your skin caused by the depletion of hormones.
Pharmaceutical options, such as over-the-counter products containing USP progesterone or prescription-only estrogen creams, can be applied topically and there is some research showing they can have benefit for skin. But here again you need to discuss this with your physician because these products are not without warnings and potential risks.
Ahas and Bha for Postmenopausal Women
What about the use of effective AHAs and BHA for menopausal women? Does exfoliating help all skin types? For the most part the answer to this question is yes. Removing built-up layers of dead skin cells gently and without abrading skin (as can happen with scrubs) can be incredibly effective for all ages. How often to exfoliate depends more on the condition of your skin than anything else, including how old you are.
Once you’re past age of 70 skin can become so thin it can literally tear when gently scratched or rubbed. This thinning is a result of many factors but primarily it is brought about by a combination of estrogen loss, genetic aging, and sun damage. All of these things cause the skin cells to produce “less skin” as well as less healthy skin. In terms of genetic aging, skin cells seem to have a preprogrammed mechanism that slows down skin-cell turnover, and sun damage causes a buildup of dead skin cells on the surface of skin.
AHAs and BHA help the outer layer of skin to shed more normally by removing built-up dead skin cells. For some women in their 70s, 80s, and 90s with extremely fragile skin that may be problematic (they may indeed need the dead skin cells to stick around on the surface for as long as possible). It would thus be important to experiment with frequency to see how the skin responds. Perhaps instead of using the AHA or BHA product every day you should only use it every other day or every few days to get the best results. If AHAs and BHA can be tolerated in some fashion there is a great deal of benefit to be achieved in removing dead skin cells at the surface, as that absolutely helps improve the appearance of skin and allows healthier skin cells to come to the surface. It has also been shown that AHAs and BHA can stimulate the production of collagen, which also has benefit.
Supplements for hormonal changes
The following information is from www.drweil.com. Dr. Andrew Weil is the author of many books on alternative and medical remedies and treatments for an immense range of health concerns. These are his suggestions for oral supplements or dietary additions to treat perimenopausal or menopausal symptoms.
Soy foods.The isoflavones in soy foods help balance hormone levels and have some estrogenic activity. There is ongoing research about the safety and efficacy of isolated soy isoflavone supplements. Although the initial results look promising, many physicians currently recommend using natural soy foods rather than supplements. Choose from tofu, soy milk, roasted soy nuts, or tempeh.
Flaxseed.Substances called lignins in flaxseed are important modulators of hormone metabolism. Grind flaxseed daily in a coffee grinder at home and use 1 to 2 tablespoons a day.
Dong quai.Dong quai (Angelica sinensis)is known both in China and the West for its ability to support and maintain the natural balance of female hormones. It does not have estrogenic activity. This is one of the herbs for menopause that should not be taken if a woman is experiencing heavy bleeding.
Black cohosh (Cumicifuga racemosa). One of the best-studied traditional herbs for menopause, black cohosh is used to help alleviate some symptoms of menopause, including hot flashes. Black cohosh seems to work by supporting and maintaining hormonal levels, which may lessen the severity of hot flashes. Many women report that the herb works well but it isn’t effective for everyone. While any therapy that influences hormonal actions should be a concern, black cohosh does not appear to have estrogenic activity and thus may be safe for women with a personal or family history of breast cancer.
Vitamin E.A daily dose of 400 IUs of natural vitamin E (as mixed tocopherols and tocotrienols) can help alleviate symptoms of hot flashes in some menopausal women.
B vitamins.This group of water-soluble vitamins may help women deal with the stress of menopausal symptoms.
Evening primrose oil or black currant oil.These are sources of gamma-linolenic acid (GLA), an essential fatty acid that can help influence prostaglandin synthesis and help moderate menopausal symptoms.