Menopause, Aging Skin, and “What’s a Girl to Do?”

Because the skin is our “visible” part, it gets more than its share of notice as we age, from others and from ourselves. What many may not realize is that, on top of changes that are directly due to aging, hormonal changes cause additional problems. The skin ageing process increases rapidly after age 50, especially in women.

As if the effects of intrinsic aging, photo-aging, and environmental aging weren’t enough, onset of menopause accelerates changes through reductions in the production of estrogen.

Key Role of Estrogen

Estrogen is very involved in the normal function of the skin, It influences several skin functions including elasticity, water holding capacity, pigmentation and vascularity It also has direct effects on key cells such as fibroblasts (produces collagen and elastin), keratinocytes (closely involved in skin protection) and melanocytes (involved in evenness of skin color, etc.).  It helps regulate hair follicle function (hair production) as well as sebaceous gland activity (producing skin oils). It influences skin thickness,

Cells in the skin have specific receptors that respond to the signals estrogen provides. When estrogen begins to disappear, these messages become less powerful.

 

Reduced estrogen levels are believed to be at least partially responsible for:

  • Increased loss of collagen –the support structure in the skin
  • Decrease in the glycosaminoglycans (GAG’s) that provide ‘plumpness’ to skin
  • Decrease in dermal thickness
  • Decrease in skin elasticity
  • Dry skin
  • Fine wrinkling
  • Poor healing, increased susceptibility to trauma
  • Increase in unwanted facial hair
  • Decrease in scalp hair
  • Decrease in skin strength

What If the Estrogen is Replaced? 

If you suspect that replacing the body’s lost estrogen would limit these effects, you are correct.  Multiple studies confirm that hormone therapy (HT) can reverse these effects to a large degree.  For example, Korean women using HT were shown to have a significantly lower risk for the development of facial wrinkling.

However, the issue of HT is a complex one and dermatologists do not recommend their use ONLY to treat just the skin. They are cautiously optimistic that research currently being done on selective estrogen receptor modulators may provide a solution by targeting effects on the skin, but this research is still ongoing. Topical application of estrogen-containing cream (estradiol) has been shown to significantly increase the amount of collagen in the treated skin.

 

Effects of Topical Application of Estrogen (Estradiol) Gel on Skin Collagen

A study published in Obstetrics and Gynecology looked at the effects of topical estrogen gel on sixteen postmenopausal women who had never received hormone replacement. Skin biopsies of the abdomen and thigh at 3, 6, 9 and 12 months demonstrated significant increase in collagen content but found response also related to the original amount present. A leveling off effect suggests that the effect was present until and “optimum” skin collagen level had been reached.

 

What about Other Topical Therapies?

A study in Climacteric in 2007 found that preliminary data on the topical use of phytoestrogens and selective estrogen receptor modulators showed efficacy in benefiting aging skin in postmenopausal women but that additional study was necessary before conclusive recommendations could be made.

Phystoestrogens are plant derived compounds that mimic estrogen effects and are common in oil seeds, nuts, soy, flax and other botanical sources. One class of phytoestrogens are the isoflavones which are derived from soy beans. Soy isoflavones have demonstrated efficacy in replacing estrogenic effect in skin when applied topically with beneficial effect on stimulation of fibroblast proliferation, reduction of collagen breakdown, and inhibition of 5α-reductase. The prevalent isoflavone in soy is the glycoside genistin. Its aglycone (the molecular form without sugar residues), genistein, is a well-known inhibitor of protein tyrosine kinase, critical enzymes involved in the molecular mechanisms that link UV exposure to photoaging. Soy derived isoflavones are helpful organic and natural topical “replacements” for declining estrogen levels.

Concerns about Skin Cancer Risks with Hormone Replacement Therapy      

A large placebo controlled study published in the Journal of the National Cancer Institute looked at the incidence of non-melanoma and melanoma skin cancer in postmenopausal women aged 50 to 79 who received either oral estrogen only, estrogen plus progesterone or placebo. No difference was noted over a period of up to 7 years indicating the incidence of skin cancers is not affected by oral hormone replacement therapy.

Never Give Up the Race

Beating the clock of aging is a life-long battle that pays dividends in the short, medium, and long term. Looking and feeling one’s best starts with healthy lifestyles based on nutrition, physical activity and the steps one takes to minimize risks and damage.  The payoff is improved quality of life over the long haul.

A great deal of looking and feeling “old” is thinking old. As we age, we all change. We have to but “beauty” can last a lifetime with a little effort. There’s nothing wrong with aging beautifully and trying to be your best along the journey.Consider the alternative.

5 Comments

  1. Jina says:

    Hi Dr John, I like this topic. I have been applying sesame oil on my skin this winter which has been fine so far. I hope this is what my peri menopausal skin needs as moisturizer until your product is available. When do you think this will be possible? Are there any special diets I could look into to help my skin look healthier? Would applying soy oil help?
    Regards

  2. Jill says:

    I have been using estrogen cream on my face for a year. It does help but only somewhat. What really helps is increasing your estrogen blood levels. The standard dose of HRT the doctors give out today are to low.By increasing that dosage you will see results in weeks.

    • drjohn says:

      HRT remains controversial, it’s not for everyone. Requires careful sifting through individual history, etc, testing, etc, to arrive at a decision (with your doctor). What interests us is that you can get a lot of the skin benefits without the systemic risks by using bioequivalents applied topically. Soy isoflavones have a lot of good evidence…natural, safe, effective for skin benefits. Even men can use it (proven not to feminize or affect testosterone levels). Needs to be delivered in liposomes for best response.

  3. Sam says:

    Hello,
    I have a question about soy isoflavone creams in men. If they act like estrogens then will they not enter the body through the skin and then cause hormonal issues? I read that for men xenoestrogens are a danger and that they should avoid them. Has this been tested? Do we know wether men can use creams which are usually targetted for women?

    • drgeorge says:

      Reasonable question, Sam, but nothing to worry about. First, the purpose of topical application of soy isoflavones in skin products is to provide estrogenic effect. Generally speaking, women’s skin is soft, supple, and well hydrated – characteristics that are associated with youthful looking skin. We men are rough creatures who could use a little softening…in our skin.

      Which brings us to the theoretical issue that is of concern i.e. negative effects on erectile function, spermatogenesis, and semen quality. First of all, the doses in a topical product are low since the sought after effect is local and in the organ where the product is applied. The transdermal absorption into the systemic circulation is negligible, certainly minuscule enough to not anticipate systemic effect. But what about nutritional supplements containing soy isoflavones? That is another question because doses and absorption may be enough to effect male physiology. There is no proof of that being an issue in humans.

      There are rodent studies that demonstrate negative effect but the doses of soy isoflavones administered to the test animals were relatively much, much higher than what any nutritional supplement product contains. A number of studies have looked at the real world and the effect of nutritional supplements on human males. the study below is a “meta study”, where the review looks at a number of studies and consolidates their findings. It speaks for itself.

      Fertil Steril. 2010 May 1;93(7):2095-104. doi: 10.1016/j.fertnstert.2010.03.002. Epub 2010 Apr 8.
      Soybean isoflavone exposure does not have feminizing effects on men: a critical examination of the clinical evidence.
      Messina M.
      Author information
      • Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, California 92350,USA. markm@olympus.net
      Abstract
      OBJECTIVE:
      To critically evaluate the clinical evidence, and when not available, the animal data, most relevant to concerns that isoflavone exposure in the form of supplements or soy foods has feminizing effects on men.
      DESIGN:
      Medline literature review and cross-reference of published data.
      RESULT(S):
      In contrast to the results of some rodent studies, findings from a recently published metaanalysis and subsequently published studies show that neither isoflavone supplements nor isoflavone-rich soy affect total or free testosterone (T) levels. Similarly, there is essentially no evidence from the nine identified clinical studies that isoflavone exposure affects circulating estrogen levels in men. Clinical evidence also indicates that isoflavones have no effect on sperm or semen parameters, although only three intervention studies were identified and none were longer than 3 months in duration. Finally, findings from animal studies suggesting that isoflavones increase the risk of erectile dysfunction are not applicable to men, because of differences in isoflavone metabolism between rodents and humans and the excessively high amount of isoflavones to which the animals were exposed.
      CONCLUSION(S):
      The intervention data indicate that isoflavones do not exert feminizing effects on men at intake levels equal to and even considerably higher than are typical for Asian males.

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