Skin care during Menopause

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 40 years after they first begin, and then they’ll either gradually or abruptly stop. Though there is still a great deal of research that needs to be done on all the issues surrounding perimenopause (the time before the onset of menopause), menopause (the actual end of the menstrual cycle), and postmenopause, there is also a lot that is known.

Perimenopause and menopause are brought about by the body’s changes in hormone production.

The sometimes troublesome 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 (androgens). Because the male hormones decline more slowly, there are proportionately more of them once estrogen and progesterone levels plummet, 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; the individual hairs actually become smaller in diameter.

The lessening and eventual loss of estrogen and progesterone also affects skin negatively. Aside from problems caused by sun damage, perimenopausal and menopausal women experience thinner, looser and less elastic skin, reduced production of collagen, cessation of oil gland function, 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 worse, perimenopause and menopause can also cause 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 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..

• Hormone Replacement Therapy: There is no question that Hormone Replacement Therapy (HRT) and Estrogen Replacement Therapy (ERT) are very controversial. Yet, despite the controversy, the research is clear that HRT restores and prevents the loss of skin’s support tissue and elastic quality, as well as its thickness and smooth texture. The American Journal of Clinical Dermatology (2001, volume 2, issue 3, pages 143–150) summed up what all of these reports concluded by stating, "Estrogen appears to aid in the prevention of skin aging in several ways. This reproductive hormone prevents a decrease in skin collagen in postmenopausal women; topical and systemic estrogen therapy can increase the skin collagen content and therefore maintain skin thickness. In addition, estrogen maintains… stratum corneum [skin] barrier function…. Skin wrinkling also may benefit from estrogen as a result of the effects of the hormone on the elastic fibers and collagen…. [I]t has been suggested that estrogen increases cutaneous wound healing…."

Because of the potentially serious risks associated with ERT and HRT regarding their effects on heart disease, osteoporosis, and breast cancer, as well as the possible benefits you may want to consider weighing out the pros and cons with your physician.

• Herbal Alternatives (phytoestrogens, also called plant estrogens): In reality, research about the benefits of plant sources of estrogens such as soy products and red clover extracts is mixed.

It is probably wise for women to get a baseline estrogen count around the age of 40 and then again at 45 to determine what normal is for you. That way you can monitor your hormonal changes and the balancing effect that varying combinations of supplements are having on your body.

Skin Care Options:

We would love to say that there are skin-care products out there that positively affect the changes that occur in perimenopausal and menopausal skin, but there aren’t. There is simply no information suggesting that applying soy extract, black cohosh, wild yam, or evening primrose oil to the 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, which is impressive but not for reversing the effects of menopause.

The truth is 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), considering using Retin-A or Renova, and using gentle skin-care products loaded with antioxidants.

If you have dry skin, use an emollient moisturizer with antioxidants and anti-inflammatory agents (which most products these days contain). The use of hydroquinone or arbutin-based skin-lightening products is another important option if skin discolorations (such as melasma or chloasma) are present. But there is nothing you can apply to skin (other than over-the-counter or prescription-only estrogen creams) that can alter the actual condition of your skin caused by the depletion of hormones.