Let’s be honest, menopause is nobody’s friend. And that sporadic hormonal ebb and flow of estrogen during peri-menopause can be uncomfortable and often very distressing, sneaking into our lives before you can even realize it’s occurring. When the topic is brought up to the healthcare provider, the conversation often trails off into matters surrounding cardiovascular health and cancer risk. But there’s much more at play regarding the physiologic role of estrogen, one of which is how it contributes to skin longevity and facial appearance.
Let’s Dive In!
When thinking about “hormones”, we must respect the profound affects estrogen has on:
✓ Skin scaffolding
✓ Hydration
✓ Bone
✓ Cellular communication
🧪 Angela’s Skin Pharmacist Insight
“There’s much more going on below the surface. Estrogen is like a key, capable of turning on cellular machinery and influencing physiologic systems to function properly.”
Looking in the mirror and something seems off?
Skin is an estrogen-dependent organ, and decline in this biochemical communicator will affect the structural scaffolding of your face and lead to a profound transformation over time. This is due to its activity in producing collagen, elastin, and glycosaminoglycans (aka the natural hydrators). So without estrogen there to stimulate production of these factors, there begins the natural decline in these structurally crucial components. And it all begins with peri-menopause, when estrogen levels start to quietly fluctuate.
Indeed, studies have shown women lose up to 30% of skin collagen during the first five years of menopause, with a subsequent decline of about 2.1% annually thereafter.
And it gets worse… estrogen also influences other physiologic functions that affect facial structure. Fat pads, bone, and blood circulation are all partially controlled by estrogen.
Overall, estrogen decline can change a woman’s appearance over time through:
✓ Declining Collagen Types I & III - causing dermal density to thin and lead to wrinkles, laxity, and a compromised barrier
✓ Elastin Degradation - causing elastin fibers to lose their ability to recoil, ultimately leading to skin sag
✓ Hyaluronic Acid Decline - leading to moisture loss/retention deep in skin and ultimately causing chronic dryness
✓ Atrophy and Shifting of Subcutaneous Fat Pads - visibly appearing as hollowing of temples, under-eye volume loss, and the dreaded nasolabial folds
✓ Bone Remodeling - leading to bone resorption and soft tissue anchor loss. Visible as hollowing around eye sockets, cheekbones, and jawline; may also ultimately affect dental health and lead to tooth loss.
✓ Vascular Starved Cells and Tissues - microvascular blood flow decline, thus reduced delivery of nutrients and oxygen to dermal cells. This slows cell turnover, tissue recovery, and ultimately causes loss of natural radiance.
🧪 Angela’s Skin Pharmacist Insight
“Although peri-menopause/menopause can occur earlier and for various reasons, typically women in their mid to upper 40’s should consider having their hormones checked and discuss with their provider if supplementation is warranted. There is a window of opportunity you don’t want to miss.”
The Role of Bioidentical Hormone Replacement (BHRT)
While high-performance skincare and other non-invasive treatments are essential for skin health and improving/maintaining the skin’s appearance, these interventions work from the outside-in. BHRT works internally to drive biochemical reactions that optimize functional signaling. Maintaining fibroblast function, preserving dermal thickness, protecting moisture retention capacity, and supporting other physiologic systems are all significant modulating characteristics of estrogen.
If you are in your late 30’s or 40’s and noticing changes in skin texture, elasticity, or facial volume, it may not be that your skincare products stopped working - it may be that your cellular signaling has changed because of declining hormones. BHRT works more safely and naturally than “older versions” of hormone replacement thereapy to mitigate the body’s natural decline. Addressing hormonal health early in peri-menopause allows for better facial architecture protection and preservation, before structural loss sets in. I encourage my clients to consider BHRT as part of their skin longevity journey, and seek discussions with their healthcare provider regarding their options for best overall health.
🧪 Angela’s Skin Pharmacist Insight
“As a pharmacist, I view hormone replacement therapy as more than a solution to hot flashes and dry tissues. It’s a matter of public health. It’s a basic bodily requirement for tissues and systems to function properly, giving women their best shot at optimal health despite aging in years.”
What skincare is needed in peri-menopause and menopause?
Many women decide to opt-out of hormonal therapy, and that’s okay; it’s a very personal decision and many prescribers still advise patients against it for a variety of reasons. Regardless, as we age there is a greater need for proper and consistent skincare and treatments. It simply takes more effort, particularly for clients not on BHRT. I typically lean heavier on phytoestrogen-containing topicals and emphasize the importance of homecare products that may have been skipped in younger decades, eye and neck creams in particular.
Leveling up with professional treatments is advisable as well, which includes chemical peels to stimulate collagen production and increase the rate of cell turnover, and unique methods that deeply infuse serums to address the skin’s needs. Many clients also enjoy the results achieved from treatments designed to oxygenate of the skin layers and/or targeted therapies through stimulation with a variety of topical peptides.
And, if you’re in the Memphis or Germantown area and looking for a skin studio to experience the best in facials, advanced skin treatments, or guidance in creating your perfect skincare routine - Explore Glow Lab’s facial treatments and consider becoming a member to maximize all the benefits of your skin journey.
Consult with a qualified healthcare provider or specialized clinical pharmacist to evaluate your hormone levels, discuss all BHRT options, and tailor a protocol built for unique physiology.