Updated: Aug 31, 2019
With life expectancy nearly doubling in the last century and still continuing to rise; coupled with women outliving men on average, there is now a whole new older female generation. Dare I say it, a post-menopausal generation, with a third of their life expectancy still to live. As female hormones deplete, the skin encounters catastrophic ageing. Here we will look at how the menopause causes this ageing and what we can do to help prevent it.
Menopause is clinically diagnosed as the day a woman has not had a menstrual flow for a full year. Before this happens though, a woman will experience changes in her menstrual cycle, such as infrequency of cycles, heavier or lighter bleeds, hot flashes, night sweats, mood swings and vaginal dryness. This is termed the peri-menopausal stage, which can either pass by symptomless for some or last up to a few years. The natural transition into post-menopause is a journey which every woman will encounter at some point in the years that follow her 50th birthday.
Oestrogen affects every organ system of the body, not just the skin. However, the most plentiful oestrogen receptors are in areas such as the face, lower limbs and genitals. This is why most skin problems exacerbated by the menopause tend to occur within these areas in particular.
As the ovaries start to produce very low levels of oestrogen in menopausal women, a growing cascade of effects begin to show on her skin; a much speedier ageing than she had experienced previously. This is because oestrogen is partly responsible for dermal thickness and hydration of the skin. Oestrogen increases the skins hyaluronic acid levels, which are the skins number one hydrators. Hyaluronic acid loves water and will attract molecules of water equal to a thousand times its own weight. This contributes to that youthful plump appearance in younger adults. When hyaluronic acid depletes the skin becomes much drier, and wrinkles are more likely to develop.
Oestrogen also helps to increase collagen synthesis within the dermis. Collagen supports the skins deeper layers, keeping them tightly packed together like a supportive mesh. As oestrogen levels decline, collagen quality and density diminish within the skin. Lack of collagen causes the epidermis to become thinner and wrinkles to increase.
Oestrogens have fantastic anti-inflammatory properties, so when these hormones decrease in our body it is not surprising that symptoms such as hot flashes and night sweats are experienced. If the patient suffers from any inflammatory conditions, such as rosacea for example, it is not uncommon for these conditions to flare up before, during or after the menopause. Extra care and consideration should be given to all women with inflammatory diseases who are going through the menopause.
Another skin issue exacerbated by the menopause is sun damage. As oestrogens regulate melanocyte activity (our colour forming cells); the numbers of melanocytes in the skin reduce. This means we have less ultra violet protection from melanin and skin colour becomes paler. On the flip side, hyperpigmentation and age spots can also occur on more sun exposed areas such as the face hands and décolleté. Again this is due to oestrogens not being present to regulate melanin production. It’s very important therefore to use a high factor broad-spectrum sun protection every day, regardless of what the weather is doing.
Female pattern alopecia, or baldness, is also common during the menopause. As oestrogen levels decline, the oestrogen–androgen ratio becomes unbalanced resulting in seemingly higher androgen levels, such as testosterone. Higher testosterone levels in the body can cause hair loss in women, increase sebum production causing adult acne and cause unsightly facial hair.
Increased mucosal dryness is yet another symptom of the menopause, many women reporting vaginal dryness and discomfort during intercourse. There are oestrogen creams which can improve this symptom, or simple KY jelly can also help.
As you can see, there are a lot of symptoms women going through the menopause can experience. Not everyone will experience all of them, and some may not have any symptoms at all. Luckily nowadays, if ageing is a concern, there are plenty of professional treatments which will boost collagen and elastin production as well as increase glycoaminoglycans such as hyaluronic acid, in the skin. As with all anti-ageing treatments though, the earlier you start treating the skin the better the result will be.
If the skin has become dry, avoid using skin-drying soaps and shower gels. Anything that foams up is likely to dry your skin further. A moisturising wash which is soap free such as Dermol 500 would be a much better option.
To increase the collagen and elastin production on the face, neck, décolleté and back of hands, Fraxel laser is a very effective anti-ageing solution at the moment. Visit your dermatologist for a consultation. Dramatic results are seen from the very first treatment. It works by creating microscopic puncture holes into the dermis which causes regenerating effects, improving aged skin as well as scar tissue.
Exfoliation is another key step in rejuvenating ageing skin. Professional treatments such as microdermabrasion help to speed up a slower cell turnover, and improve the texture of the skins surface resulting in a more translucent complexion.
Retinoids, including Retinol, are part of the Vitamin A family. These increase cell proliferation and fibroblast activity such as the synthesis of new collagen and elastin proteins. Thus, retinoids help prevent thinning of the skin as we age which leads to fine lines and wrinkle formation. There are many different products out there claiming to contain retinol; for best results you should choose a 0.5% tretenoin cream and use once to twice a week nightly to start, with the aim of using every night once tolerance has improved. This is a prescription only medication so you will need to visit your dermatologist to buy.
In the daytime, a hyaluronic acid serum applied to clean skin would improve hydration each morning. If you are experiencing hot flashes or have inflammation then try using a non-steroidal anti inflammatory cream which contains ingredients such as camomile, green tea or liquorice.
Vitamin C is also another ingredient which should be mentioned. This antioxidant has fantastic brightening effects on the skin and has been shown to boost collagen production too.
The menopause can accelerate a lot of symptoms, but as I’ve mentioned already, there are many solutions available. Better understanding of the menopause will help women understand the changes they experience and hopefully create a smoother happier transition.