What is the menopause and the perimenopause?
The menopause is the time in a woman’s life when her periods stop because her body has stopped producing reproductive hormones like oestrogen. It’s roughly around the age of 51, and ‘menopause’ is defined as the point when a woman hasn’t had a period for 12 months. This drop-off in hormones levels doesn’t happen overnight (unless you’ve had a hysterectomy), and the previous years, while hormone levels are declining, is called the perimenopause.
Why is oestrogen loss to blame for ‘menopause face’?
Hormone levels have a big impact on the skin. During the perimenopause, the amount of oestrogen created in the body dwindles, and when we hit actual menopause, our oestrogen levels tank.
What does having less oestrogen mean for the skin?
• It’s not so firm – less oestrogen means that our skin can’t create as much collagen as it used to.
• It’s not so bouncy – without oestrogen, making elastin, the protein that gives skin its spring, becomes harder.
• It’s drier – because our skin makes less of its own hyaluronic acid and loses its ability to hold onto moisture.
• It’s thinner – losing the collagen and elastin means skin becomes flatter.
• Wrinkles show up more – because of all the above.
• It looks dull – because dry, thinner skin doesn’t reflect the light in the way that hydrated, plumped up, firmer skin does.
• It’s more fragile – and doesn’t heal as quickly as younger skin.
This is all very normal, all very natural, but it’s not great to watch this happening in your own face.
Can hormone supplements improve the skin?
Yes. Replacing the hormones in which you have become deficient will do more than any cream or serum to keep your skin in good nick. Seriously. If I could choose only one thing to help my skin, I would pick hormone replacement before any fancy cream or tweakment.
Body identical vs bio identical hormones – what does this mean?
The hormones provided by the NHS and specialist menopause doctors are described as ‘body identical’ hormones’. These are made to standard doses by pharmaceutical companies and users are advised how much to use for the most appropriate dose.
BHRT uses ‘bio-identical’ hormones that are identical in structure to your natural hormones. It is customised for each patient and provided by private doctors, rather than the NHS, so it’s expensive. HRT advocates criticise BRHT for ‘not being regulated’, though as BHRT practitioners will point out, you can’t regulate a product when it is being made in bespoke measures for each patient to whom it’s prescribed.
Doctors will argue the merits of body-identical vs bio-identical but in my experience, patients on any form of hormone replacement are usually delighted with it, though everyone says it takes a bit of tweaking to get the doses right, and these doses may need adjusting over time.
Are there any natural alternatives to HRT/BHRT?
Many people who can’t or don’t want to take HRT swear by alternatives including evening primrose oil, black cohosh, and red clover, all of which contain plant oestrogens or plant oestrogens.
Do I need special ‘menopause’ skincare?
I’d suggest starting with the sort of effective, hardworking products that address any skin issues such as dryness or dullness and which work at any age. Yes, there are many new skincare ranges specifically aimed at menopausal skin. That is a triumph in itself, given that, until very recently, menopause was such a taboo subject that retailers would shy away from anything aimed at ‘women of a certain age’ and would never have dreamed of putting anything labelled ‘for menopause’ on their shelves or website.
Read my menopause e-book for more detail, but I think that if, for example, your skin barrier needs a bit of help, then use a ceramide-rich moisturiser. You don’t have to seek out a ceramide-rich moisturiser labelled ‘for menopausal skin’ unless it can convince you that it has other, relevant, ingredients or benefits to offer you.
What’s the best tweakment for a menopausal face?
At the risk of being irritating – it completely depends on your face and what is bothering you (and yes, that’s the same answer I give to people who ask for advice on the best tweakment for 30-year-old, or 40/50/60-year-old faces). First, you need to ask yourself, what is your main concern, or concerns, about your face?
However, here are my suggestions for cosmetic procedures for the typical symptoms of menopausal skin:
• Injectable moisture treatments and medically certified LED red and infrared light treatments for thinner, drier skin
• Lasers, radiofrequency microneedling and ultrasound for sagging skin
• Fat-dissolving injections, fat freezing and dermal fillers for jowls or double chin
• Dermal fillers, fat injections or fat grafting for a hollow or gaunt face
• Wrinkle-relaxing injections for an ‘angry’ or ‘tired’ face
• Skin peels, laser, IPL and broadband light for treating pigmentation, sun damage and age spots.
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