How can menopausal women manage dry, itchy skin. What are the hormonal and other causes of dry skin during menopause. Tips to soothe dry, flaky skin and hair.

Hormonal Changes and Dry Skin During Menopause

Menopause brings about significant hormonal changes, which can have a direct impact on the health and appearance of the skin. As estrogen levels decline, the skin’s oil glands shrink and produce less sebum, leading to dryness, flakiness, and even itchiness. This is because estrogen helps keep the skin hydrated and plump, giving it a youthful appearance.

According to the North American Menopause Society, collagen loss begins early but is most rapid in the first few years of menopause, further contributing to the skin’s loss of elasticity and moisture. This can result in an increase in wrinkles and a more aged appearance.

Other Causes of Dry Skin During Menopause

Hormonal changes are not the only culprit behind menopausal dry skin. Other factors can also play a role, including:

Thyroid Dysfunction

Levels of thyroid hormone can decrease in menopausal women, which can also contribute to dry skin and hair. Women experiencing dryness should consult their doctor to have their thyroid function tested, as hypothyroidism (low thyroid hormone) can be a potential cause.

Nutrient Deficiencies

Inadequate intake of vitamins and minerals, such as vitamins A, C, and E, can hinder the skin’s ability to maintain its moisture and elasticity. Ensuring a well-balanced diet and potentially incorporating supplements (with your doctor’s approval) may help address this issue.

Environmental Factors

Exposure to harsh weather conditions, such as cold, dry air in the winter or excessive sun exposure in the summer, can strip the skin of its natural oils and lead to dryness and irritation. Protecting the skin with appropriate clothing, moisturizers, and sun protection can help mitigate these environmental stressors.

Soothing Dry, Itchy Menopausal Skin

There are several steps menopausal women can take to alleviate the discomfort of dry, itchy skin:

Avoid Hot Showers

Very hot water can strip the skin of its natural oils, exacerbating dryness. Opt for warm water instead, and limit shower or bath time to no more than 5-10 minutes.

Wear Gloves

The hands are particularly vulnerable to dryness, as they are frequently exposed to environmental factors and harsh chemicals. Wearing gloves, especially in the winter, can help protect the skin on the hands.

Moisturize Regularly

Incorporating moisturizers containing ingredients like vitamins A and C, collagen, lactic acid, or urea can help replenish the skin’s moisture and improve its overall appearance. It’s important to look for products that are specifically formulated for dry, mature skin.

Soothe the Scalp

Dry scalp can lead to flaky, itchy hair. Using a shampoo containing zinc or selenium, and applying a deep conditioner, can help alleviate these issues. Limiting the use of heat styling tools can also prevent further dryness.

Addressing Underlying Causes

While topical treatments can provide relief, it’s important to address any underlying causes of menopausal dry skin. This may involve:

Thyroid Evaluation

If dry skin and hair are persistent, it’s recommended to have your thyroid function tested to rule out any thyroid-related issues that may be contributing to the problem.

Nutrient-Rich Diet

Ensuring a well-balanced diet that is rich in vitamins, minerals, and antioxidants can help support the skin’s natural moisture and health. Supplementation may also be beneficial, but should be discussed with your healthcare provider.

Stress Management

Stress can negatively impact hormone levels, including estrogen and thyroid hormones, which can exacerbate dry skin and hair. Incorporating stress-reducing activities, such as yoga, tai chi, or simply taking time to relax, may help alleviate these symptoms.

Staying Hydrated

One of the simplest yet most effective ways to combat dry skin during menopause is to stay hydrated. Drinking plenty of water throughout the day can help replenish the skin’s moisture levels from the inside out.

Conclusion

Menopause-related dry skin and hair can be a frustrating experience, but there are numerous strategies and solutions available to help manage these symptoms. By addressing the underlying hormonal and other factors, incorporating targeted skincare and hair care routines, and making lifestyle adjustments, menopausal women can help restore the health and appearance of their skin and hair.

8 Quick Beauty Boosts for Dry Skin and Hair – Menopause Center

You may know to be prepared for hot flashes and night sweats when they hit menopause, but you may not know that falling estrogen levels can also affect the health of your skin and hair. According to the North American Menopause Society, collagen loss begins early but is most rapid in the first few years of menopause, leading to dry, flaky skin and lackluster locks.

“Estrogen helps keep things hydrated and plump and youthful-looking,” says Alicia Stanton, MD, an obstetrician-gynecologist in Hartford, Conn., and the author of Hormone Harmony. “When estrogen levels drop during menopause, the skin gets more wrinkled and dry, and in some women, it can even be itchy.” This is because oil glands in the skin shrink after menopause, and less is secreted.

911 for Dry Skin and Hair

Nourishing your skin and hair from the inside and protecting them on the outside will go a long way toward easing these menopause symptoms.

Have your thyroid checked. Levels of thyroid hormone can decrease in menopausal women, which can also contribute to dry skin and hair. In fact, Dr. Stanton says, women who begin developing dryness should consult their doctor about having their thyroid function tested. Dry skin is a symptom of hypothyroidism, a potentially dangerous condition caused by low levels of thyroid hormone in the body.

Boost your intake of vitamins and minerals. Once medical causes for dry hair and skin have been ruled out, a few simple changes can often help relieve the dryness. Getting adequate levels of nutrients through a well-balanced diet and a multivitamin (or supplements that are approved by your doctor) may just give your body the boost it needs to get your hair and skin back on track.

Ban the tobacco. Tobacco use also reduces estrogen levels in a woman’s body, so quitting smoking may have a positive effect. “If you need another reason to stop smoking, that could be a good one,” Stanton says.

Baby your complexion. Topical treatments for dry skin and hair abound, but you don’t have to splurge on expensive brands. The key is to look for certain ingredients on the label. Skin products containing vitamins A and C, for example, can improve skin due to their antioxidant effects, while creams with collagen (a naturally-occurring substance that keeps skin firm) may help keep skin youthful-looking. For severely dry skin, seek out moisturizers with lactic acid or urea. “You don’t have to spend a ton of money,” Stanton says. “Many of my patients do fine with over-the-counter treatments.”

Soothe your scalp. If dry scalp is a problem, consider using a shampoo that contains zinc or selenium, ingredients that reduce dandruff for some people. Dry hair may also get a boost from a deep conditioner. Be sure to limit how often you shampoo and use your blow dryer and other damaging heat appliances. Whenever you’ll be spending a lot of time outdoors, treat your hair to a protective leave-in conditioner with zinc oxide and wear a hat; both will help your hair retain moisture.

Protect your hands. If you plan to be outside in cold weather, make sure you wear gloves — dry winter air can rob your hands of even more moisture. In the summertime, wear sunscreen with a sun protection factor (SPF) of 30 or higher — overexposure to the sun can make you more prone to dry skin, not to mention wrinkles and age spots.

Relax. If you really want to go the extra mile to combat dry skin and hair, try relaxing. Stress can lower your body’s levels of estrogen and thyroid hormone, Stanton says. Take time out of every day to unwind, and you may just be rewarded with a better complexion and healthier-looking hair. “Yoga and tai chi can relieve stress, and that can help your estrogen and thyroid levels,” Stanton says. “Things that allow you to decompress a little can provide some benefit.”

Hydrate from the inside. Finally, drink more water. Your skin can’t get hydrated if the rest of you isn’t. It’s an easy enough thing to do, but something that many women neglect during their busy day.

Menopause and Dry Skin | Unilever Vaseline®

How to Soothe Dry, Itchy Menopausal Skin
You don’t have to suffer from skin changes during menopause forever. There are different methods to soothe your dry, itchy skin and restore the moisture your skin craves.

• Avoid Hot Showers – Very hot water will strip your skin of moisture. Instead, shower or bathe in warm water for a short amount of time (five or ten minutes) to keep your skin nourished and moisturized.

• Wear Gloves – Your hands get drier than the rest of your body, as they are more exposed to the environment. To ease dry skin on your hands, wear gloves outside in the winter to protect from the cold weather. The chemicals from cleaning products or hot water in the skin will dry out your hands, so wear rubber gloves.

• Wear Sunscreen – It doesn’t matter the season, sunscreen should always be part of your skincare routine. The winter sun will still damage your skin. To combat this, wear a daily moisturizing lotion with SPF or – if you’re planning to be in the sun – add a broad spectrum sunscreen with SPF between 30 and 50. Put your sunscreen on 30 minutes before heading outdoors.

• Moisturize Damp Skin – To keep the moisture locked in, apply lotions and creams when your skin is damp. When you get out of the shower, gently towel dry your skin (leaving it slightly wet). Then apply your face and body moisturizer, locking in moisture.

• Use Oatmeal – For centuries, oatmeal has been used to combat dry skin. Oats contain chemicals called avenanthramides that may reduce the redness and help the inflammation caused by overly dry skin. Add ground up oats to your bath and soak for 15 minutes.

• Vaseline® Mature Skin Rejuvenation – Vaseline® Mature Skin Rejuvenation Healing Moisture Lotion is designed to moisturize to soothe and calm dry, itchy skin associated with menopause. Containing micro-droplets of Vaseline® Jelly, the unique formulation moisturizes to relieve dry, itching skin associated with menopause. Vaseline® Mature Skin Rejuvenation is designed to cater to the skincare needs of mature women.

Vaseline® Mature Skin Rejuvenation has long lasting, effects; your skin will feel softer and smoother.

Prevent Dry Skin Problems During Menopause
One of the main causes of dry skin is hormonal change that occurs during menopause. These changes can’t be reversed, therefore completely avoiding dry skin throughout your menopause may prove difficult. However, you can help to prevent deep cracks and ease the itching.

• Switch to a Gentle Cleanser – Ordinary soaps with strong perfume can be harsh and dry out your skin. Instead, opt for a cleanser that is gentle on your skin.

• Invest in a Humidifier – A humidifier will add moisture to the air. During the winter months this will keep your skin fresher and dewier.

• Opt for Natural Fibers – Clothes made from cotton and breathable fabrics may also really help your skin. Heavier materials such as wool, or synthetic material (polyester) can scratch at your skin, increasing the itching.

Dry Itchy Skin and Menopause | Best Los Angeles OBGYN

Dry and Itchy Skin in Menopause: its causes and treatment options

Most women approaching menopause know about hot flashes and night sweats, but other side effects of menopause are not often discussed, such as dry and itchy skin after menopause. Hormonal changes during menopause can cause a range of skin complaints, including hot flashes, sweating, and itchiness.

Dry skin actually results from the decreasing estrogen levels in the bloodstream at the onset of menopause. Estrogen stimulates the body’s production of collagen and oils, which keep the skin naturally moisturized through most of a woman’s life. Once your estrogen levels begin to decline, your body’s ability to produce oil slows down, leaving your skin dry and itchy.

One of many menopause symptoms, you might start to notice your skin drying out on the elbows and the T-zone – the area of your face covered by a capital T, which includes the forehead, nose, and chin. However, dry patches can appear anywhere, including your chest and back, arms, legs, and even genitals.

What Can I Do to Treat Dry and Itchy Skin after Menopause?

Unfortunately, dry skin can start early in perimenopause and remain a problem for the rest of your life, but this menopause symptom is easily managed with some simple, at-home skincare practices.

Eat and drink smart

Getting enough omega-3 fatty acids in your diet will help your skin to produce the protective oils it needs to keep itself hydrated. Look for essential fatty acids, such as omega-3s in eggs, salmon, sardines, soy, walnuts, flax, and many other foods. Of course, drinking lots of water is also essential to staying hydrated improving skin condition.

Get moving

Exercise is a great way to circulate oxygen and nutrients to all parts of your body, including your skin. Exercise can also increase collagen, one of your skin’s natural moisturizers.

Apply sunscreen

Use SPF 15 or higher for the most effective protection. You should apply sunscreen even on cold or cloudy days; UV rays can easily penetrate clouds and cause damage to your skin.

Take cooler showers

Take shorter showers in warm water rather than long hot showers or baths. Hot, steamy showers and baths feel great at the time, but they can really dry out your skin. Hot water actually strips the skin of its natural oils. Turn down the temperature and spend less time in the shower to protect your skin.

Use mild soap

Fancy scented or antibacterial soaps can actually work too well, stripping healthy oils off your skin and drying it out. Stick to unscented, gentle soaps formulated for dry or delicate skin. Exfoliate with a loofah to slough off the itchy, dead layers of skin.

To ease itchiness, you can take a lukewarm bath with colloidal oatmeal, a fine powdered form of oatmeal that helps soothe the skin. Colloidal oatmeal can be purchased in any pharmacy.

Moisturize

Lotion up right after you shower. You don’t need anything special here: it turns out that expensive lotions moisturize just as well as the ones you pick up at a corner store. Even petroleum jelly can work just fine – it can go on pretty thick, so use a towel to dab off the excess.

Avoid alcohol and nicotine

These harmful chemicals can also dry out your skin.

Hormone replacement therapy

Hormone therapy, taking supplemental estrogen and progesterone can almost instantly end the flashes and improve mood swings. Estrogen is a vital hormone that helps a woman’s body function in a healthy state. The treatment with estrogen, also known as Hormone Replacement Therapy (HRT), has been proven to minimize the unwelcome side effects of menopause, such as dry and itchy skin conditions. in some studies, postmenopausal women on hormone therapy appear to have skin that holds onto water better than women not on hormones.

Medications

Try an anti-itch cream. Anti-itch creams help moisturize and soothe itchy skin. You can try over-the-counter topical anti-itch creams or antihistamine tablets if these don’t work, ask your women’s health care doctor to give you a prescription for something stronger. This is a short term solution to relieve discomfort for your skin condition.

If you’ve been taking good care of yourself by following the steps above and are still suffering from dry and itchy skin after menopause, you are welcome to make an appointment to discuss your concerns. Some skin problems indicate a more serious condition, like hypothyroidism, vitamin deficiencies, or fungal infections. You may need to seek the help of a dermatologist.

As always, when you make your appointment, come prepared with specific concerns and questions. It might be helpful to keep a diary of symptoms or create a list of questions you have for me.

If you are experiencing dry and itchy skin after menopause and our home treatments are not working, please talk to your doctor

We also invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863- 6700.

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Highly-trained and honored by the medical community, Dr. Thais Aliabadi is certified by the American Board of Obstetrics and Gynecology and a Diplomat of the American College of Obstetrics and Gynecology. She implements the most advanced, state-of-the-art technology and treatment options. Dr. Aliabadi specializes in up-to-date, minimally invasive surgical techniques, promising her patients shorter recovery times, reduced pain, and the least interruption to their daily lives.

Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.

Latest posts by Dr. Thaïs Aliabadi (see all)

Here’s How Menopause Affects Your Skin and Hair – Cleveland Clinic

They don’t call menopause “the change” for nothing. This time of life, which begins 12 months after a woman’s last period, triggers changes throughout her body. You may welcome some of these changes — no more PMS! — but others may not be as enjoyable.

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Take, for instance, the way skin and hair may change after menopause. Dermatologist Kiyanna Williams, MD, discusses how your skin and hair might look different after your periods are done — and what you can do about it.

How estrogen affects hair and skin

If you’re seeing changes in your hair and skin post-menopause, you can usually blame rapidly declining levels of the hormone estrogen.

“Estrogen promotes water retention and plumpness in the skin,” Dr. Williams says. “When estrogen drops, you lose some of the molecules that help keep the skin moisturized. Estrogen also contributes to hair growth and fullness. Without it, your hair may become thinner. ”

Common menopause skin and hair changes

These are the most common changes people can expect in their skin and hair post-menopause.

Sagging and loss of plumpness

Collagen is a protein that holds the body’s tissues together. And when estrogen drops, your skin’s collagen production decreases, too. Loss of collagen means the skin loses its youthful volume and tightness.

To combat this problem, many people take collagen supplements or eat high-collagen foods like bone broth. But the jury is still out on this strategy. “We don’t have enough controlled studies to prove that consuming collagen will help post-menopausal skin,” Dr. Williams says.

Don’t give up, though. You can help fight collagen loss at home with a simple facial massage. Dr. Williams recommends taking your favorite moisturizer or facial oil and giving yourself a facial rubdown each night. “The massaging motion stimulates your skin’s collagen production,” she says.

Dryness, flakiness and itching

You can usually manage post-menopause skin dryness with a good home care routine. Dr. Williams recommends:

• Cleanse skin gently: Even if your skin is dry, cleanse your skin each day to remove makeup and daily grime. But don’t use a foaming cleanser unless your face is oily. “Use a non-foaming, gentle cleanser designed for sensitive skin,” says Dr. Williams.
• Moisturize daily: After menopause, many women need to up their moisture game. “Moisturizers that contain hyaluronic acid help hold in water, keeping skin supple,” Dr. Williams says. Serums and creams with antioxidants may also help. “Antioxidants like vitamin C fight off free radicals that contribute to aging.”
• Avoid irritating ingredients: You don’t want to make skin troubles worse with ingredients that aggravate your skin. Avoid products with fragrance, colors and alcohol (usually listed as SD alcohol or denatured alcohol). “If it smells or looks pretty, it’s probably not good for sensitive skin,” says Dr. Williams. “Go for bland, colorless products with little to no scent. ”
• Take warm, not hot, showers: Keep showers short and not too hot. Hot showers strip your skin of its natural oils, leaving it parched. And moisturize immediately after you towel off. Skin can absorb ingredients better when it’s still damp.

If you see redness or rashes, see your doctor. A dermatologist can rule out issues like eczema, rosacea or allergic reactions and help you find a solution.

Dark spots

Those pesky dark marks, sometimes called age spots, often appear after menopause and they’re hard to treat at home.

“Dark spots may not always respond to over-the-counter creams,” says Dr. Williams. “There are several prescription creams that can help such as tretinoin which is a prescription-strength retinoid. If that’s not enough, in-office facial peels or laser treatments can fade individual spots and enhance the overall brightness and youthful appearance of the skin. Ask your dermatologist about these options.”

Unwanted facial hair

As hormones shift, you may notice hair on the upper lip or chin. If you want it gone, the tried-and-true methods of tweezing, waxing, hair removal creams and threading will get rid of it — until it grows back.

Electrolysis is a permanent hair removal solution. It destroys the growth cells in hair follicles, so they can’t grow back. Most people need several appointments to get results. If you decide to go this route, choose a licensed electrologist or ask your doctor for a recommendation.

Laser hair removal can get rid of unwanted facial hair — but there’s a caveat. “The laser targets melanin, which gives hair and skin its color,” says Dr. Williams. “Laser treatment only works on dark hair. If your unwanted hair is light, the laser won’t work.”

Post-menopause acne breakouts

Unfortunately, menopause doesn’t mean the end of pimples. Some women get acne throughout their lives while others get more acne when estrogen levels drop after menopause.

If you notice post-menopause breakouts, don’t slam them with the strongest acne product you can find. Many of the acne products on store shelves are too harsh and drying for adults. Try a gentle cleanser that contains salicylic acid. If over-the-counter products aren’t working, see your dermatologist for a prescription solution.

Hair loss and thinning

Estrogen promotes hair growth, density and fullness. During menopause, people may notice their hair is thinning, less full or shedding more.

“Treat your scalp like fertilizer that you want to optimize for hair growth,” says Dr. Williams. “If your scalp is dry, use gentle, moisturizing shampoos and wash it less frequently. If your scalp is oily, however, you may want to shampoo every day. This varies from person to person.”

And older adults are more likely to experience androgenic alopecia, often called male or female-pattern baldness. It can cause overall thinning or bald spots. Over-the-counter products with the ingredient minoxidil can help.

Finally, if you notice any of these signs, see your dermatologist:

• Distinct circle-shaped bald spots on the scalp.
• Hair loss that occurs with itching, burning or pain.
• Pimple-like bumps on the hairline.
• Hair coming out in clumps.
• Rash.

Sun protection is a must

No matter what your skin challenges are, sunscreen is your friend. Slather it on every day, all year round. Sun protection can ward off signs of aging and prevent skin cancer.

Use a broad-spectrum sunscreen that’s SPF 30 or higher. Choose one you like so you’ll be more likely to apply it every morning. If you’re going to be outside, reapply every two hours or after swimming, sweating or toweling off.

“The sun’s rays age your skin and increase the risk of skin cancer,” Dr. Williams says. “Even in the winter, UV rays penetrate the clouds.”

Take care of you

We may not like what time and hormone changes do to our skin and hair. But you have the power to maximize your well-being. Eat a healthy diet, get regular exercise, don’t smoke and see your doctor regularly. If you make good health a priority, you’ll feel — and look — your best.

Skin changes during menopause: A top dermatologist’s guide

Dr. Graf is a Board Certified, Clinical and Research Dermatologist and Assistant Clinical Professor of Dermatology at Mount Sinai Medical Center in New York, NY. She is widely respected for her expertise and objectivity.

Many of our lovely customers come to us for help with skin care challenges related to perimenopause and menopause: Estrogen levels that fall while androgens stay constant can lead to a variety of unwelcome changes, ranging from acne that’s reminiscent of the teen years to wrinkles that seem to have settled in overnight. We thought a guide to some of the most common menopause-related skin changes, and the best approaches to their treatment, was long overdue. We approached top dermatologist Jeannette Graf, MD, for expert advice on the topic.

(And when you’re done reading, check out this interview with Tamara Neuhaus, MD – a popular Bay Area OB/GYN who specializes in menopause — to dig deeper into all things peri/menopause-related, and watch this video Q&A with Dr. Neuhaus and our founder, Dara.)

Ayla: Generally speaking, when do you find that women begin to experience skin changes related to menopause?

DR. GRAF: Well, it begins with perimenopause, which often starts sometime in your mid-forties and lasts for 3-4 years. Perimenopause is very different from menopause: Periods might become irregular at this point, but you still have estrogen. During perimenopause, you’re getting hot flashes, so you might find that your skin gets red. You might also have breakouts, and skin that was previously balanced might start to get dry or oily patches. Sometimes women experience rosacea at this point, too.

Once women reach menopause, things change again. If you go on estrogen therapy (which is typically not considered until you’ve lost your period for 6 months), you won’t experience a lot of skin-related shifts. If you don’t go on estrogen therapy, your skin will get quite dry. Skin also becomes thinner in menopause, since there’s a relationship between collagen production, skin thickness, and lack of estrogen. The natural slowdown of cell turnover and decrease in humectants in the skin exacerbates the dryness, too.

Ayla: Are these shifts gradual, or do they occur all at once?

DR. GRAF: It’s an ongoing change. Some people will notice it overnight, others more gradually. But it happens. The problem is that hormone replacement therapy — which would alleviate many of these issues — works very nicely, but a lot of times, transdermal estrogen is administered as a treatment for menopause, and not everyone is a candidate. In the future, perhaps we’ll have the ability to use estrogen on skin without fear of worsening cancer risks.

Ayla: What do you most often recommend to address skin changes during perimenopause and menopause?

DR. GRAF: For acne, I often put women on spironolactone, especially during perimenopause. It’s a fabulous androgen blocker — in this case, acne often occurs because estrogen levels are starting to decrease while androgens stay constant.   I also recommend taking high amounts of flaxseed oil, which is a great anti-inflammatory (and acne is an inflammatory condition).
As far as other acne treatment products are concerned, you want to be as gentle as you can. Take care to use non-drying products, because most acne products can be drying. Salicylic acid cleansers are good. However, the kinds of breakouts you often get at this point are not necessarily best treated with topical products. Sometimes they’re under cysts, and that’s when spironolactone helps.
Ayla recommendations: Check out Marie Veronique’s Treatment Cleanser, Treatment Mist, Treatment Serum, and Treatment Oil, all designed to address acne prone skin without drying it out. We carry Marie Veronique’s acne book, too!

Once menopause arrives, there are three things I usually recommend:

Retinoids. Whether you use retinol, retinaldehyde, or tretinoin, once any form of vitamin A gets into the skin, it interacts with an enzyme that creates transretinoic acid, which then binds with about 52-57 different types of DNA, repairing skin and stimulating collagen production. It’s safe, and as long as the treatment you choose doesn’t dry you out, it’s fine to use it for an extended period of time.
Ayla recommendations: Marie Veronique’s Gentle Retinol Night Serum is one of our best sellers. It boasts a whopping 7% microencapsulated retinol along with anti-inflammatories for great results without irritation.

Peptides. These will also stimulate collagen production and boost skin’s elasticity, which is important as skin becomes thinner and starts to sag. I think peptides are great as you age and suggest them for anyone over 50.
Ayla recommendation: We love Luzern’s Firming Collagen Booster serum, which is rich in peptides as well as hyaluronic acid and glycerin (which Dr. Graf mentions next).

A really good, rich moisturizer. Something with hyaluronic acid or glycerin will be particularly helpful at easing the dryness that many women experience with menopause.
Ayla recommendation: One of our best sellers is the super hydrating but non-comedogenic BioRecept LycOconfort de Peau, which is rich in hyaluronic acid and a variety of other great anti-aging ingredients.

It’s also not a bad idea to do a gentle at-home peel twice a week to remove dead skin cells, brighten, and allow products to more easily penetrate the skin.
Ayla recommendation: We think Marie Veronique’s Probiotic Exfoliation Mask and The Organic Pharmacy’s Enzyme Peel Mask are delightful.

Ayla: What other specific concerns are often raised during menopause?

DR. GRAF: In addition to acne, dryness, and the thinness, sagging, and wrinkling that’s related to the loss of collagen, I often see the following:

-Flushing can occur due to rosacea or skin reactivity. Some of it is related to vasodilation. There are a lot of good anti-redness products on the market that work well, and I typically treat rosacea symptomatically.

-Increased sensitivity happens as we age and the natural lipids in our skin diminish. Studies show that, after the age of 50, the pH level of our skin gets higher. There’s a certain level (5. 4) where the pH of our skin allows for optimal operation of our microflora and defensive cells. As the pH level climbs, those cells are less able to help defend the skin and we’re more prone to rashes, sensitivity, and dermatitis. It becomes important to repair the skin’s moisture barrier with good, effective emollients.

-Scraggly facial hair can start to appear due to the imbalance of estrogen and testosterone. Electrolysis is the best treatment for this.

-Hyperpigmentation can sometimes be more of an issue because skin is thinner, and you’ve had more chronic sun exposure at this point. You might have had lots of tans or burns in the past, so you have a lot of melanin in your skin and get darker more easily. Retinoids can help with this, too.

Ayla: Is it true that menopausal skin changes are more visible on the face than on the body?

DR. GRAF: Possibly, and facial skin is very hormone-rich. But we also dry out on our bodies way before menopause. For the body, I love extra-virgin coconut oil as a moisturizer. There’s tons of literature about it. It’s solid at room temperature and melts on the skin, and it’s very nutritious when ingested, too. Although it’s a saturated fat, its lauric acid content seems to cause it to have an opposite effect in heart disease.

Ayla: Speaking of nutrition, what do you recommend in terms of dietary changes?

DR. GRAF: The healthiest diet is a colorful, Mediterranean diet with lots of water with lemon, few processed foods, and very little sugar. I’m also not a big fan of dairy. A lot of cows are treated with hormones; there’s also a lot of allergy associated with milk, and it’s mucous-y. I’d substitute coconut milk.
I generally advise supplementation through food, but I think vitamin D3 is the most important supplement and we often underdose it. I think a minimum of 5000 IUD is important for keeping skin firm, supporting its repair mechanisms, and activating its anti-microbial systems.

Ayla: What about vitamin E, which is often suggested for menopausal women?

DR. GRAF: It’s good, but I’d say vitamin D is the more important supplement. And I don’t suggest taking vitamin E out of a capsule and putting it on the skin, since that can cause contact dermatitis. However, you can do that with evening primrose oil, which is great for the skin.

Ayla: What else do you wish more 50+ women knew about skincare?

DR. GRAF: I’d reiterate the ones I mentioned earlier — at night, you need to use a retinoid to keep skin firm (I often hear complaints that their pores are too large, which is due to lack of firmness) you should use a peptide product to boost collagen. And you need to keep skin moisturized.
Aside from that, you need to wear sunscreen every single day, including during the wintertime.
And other products that stimulate the skin are wonderful. Products with lactic acid are great, and I love antioxidant serums for daytime, under moisturizer and sunblock. That’s a great companion regimen to a nighttime routine of retinol or peptides under a good moisturizer.

Ayla product recommendations:
Marie Veronique Treatment Cleanser, a wonderfully refreshing, creamy cleanser for acne-prone skin
Marie Veronique Gentle Retinol Night Serum, a serum with 7% microencapsulated retinol
Luzern Labs Firming Collagen Booster Serum, a peptide-rich wonder serum
Luzern Labs La Defense SPF 30, our favorite sunscreen
Marie Veronique + Kristina Holey Intensive Repair Serum, which contains lactic acid
MyHavtorn Organic Face Oil, which is rich in antioxidants and great for rosacea-prone skin
Ayla + MyHavtorn Guldkorn Cream, a nourishing customer favorite that’s also antioxidant-rich
Luzern Labs Force de Vie Crème Luxe and Crème Intensive, multi-benefit anti-aging creams that our customers adore
37 Extreme Actives Extra Rich, which features peptides, antioxidants, and humectants, all in one jar

Ayla: Will starting an anti-aging regimen early prevent some of these problems?

DR. GRAF: It can prevent a lot of them and slow a lot of them down. So will having a diet that is healthy, and taking care to keep skin moisturized. But at end of the day, estrogen is estrogen!

**
Looking for more information about menopause, perimenopause, and skin? You’ll find these additional resources on our blog: 

– Learn from another favorite dermatologist, Dr. Macrene Alexiades, about skin care during perimenopause and menopause here. You can also learn from this brilliant expert on skin firmness and elasticity here; she has also shared her thoughts on collagen in topical and ingestible skincare with us here.

– Find additional skin-specific suggestions and recommendations from skincare specialist Kristina Holey and star formulator Marie Veronique here.

– Watch a recording of our virtual Q&A with Dr. Tamara Neuhaus, OB/GYN, and our founder, Dara, here.

– Read our interview about skin and body symptoms during Perimenopause and Menopause with Dr. Neuhaus here.

– To learn how Traditional Chinese Medicine can address perimenopausal and menopausal symptoms, read our interview with Dr. Anna Gold here.

About Dr. Graf: Jeannette Graf, MD is an Assistant Clinical Professor of Dermatology at Mount Sinai Medical Center in New York, NY and a Board Certified, Clinical and Research Dermatologist with a private practice in Great Neck, New York. While at the NIH, Dr. Graf was one of the first doctors to work with peptides, earning a NIH patent in 1987. She continues to research innovative technologies and has been published in several scientific journals. Widely respected for her expertise and objectivity, she is regularly called upon to forecast on dermatology and cosmetic trends, and she’s a frequent guest on TV programs like The Dr. Oz Show, The View, Good Morning America and The Early Show on CBS. Dr. Graf is also the author of the best-seller Stop Aging, Start Living. 

Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.

From Oily To Dry Skin And Back: Welcome To Menopause

My cosmetic bag was once filled with foundations for oily skin and all type of oil control skin care products. As we say in my native country, Venezuela, it looked like a pastelito bag, when a greasy fried empanada soaks its brown paper bag with oil.

That all changed when I started to experience menopause symptoms. Suddenly, my skin was flaky and irritated. Even my dermatologist said my skin was really dry and sensitive. I’ve always bought T-zone control creams. What was I going to do with all the oil control products? And more importantly, how was this even possible?

“Blame the hormones and the calendar,” my dermatologist said. Many perimenopausal women (I belonged to this group in my mid-30s) experience some skin changes, such as age spots, wrinkles, itching, and, yes, even dry skin, faster than their peers. These changes often are associated with estrogen deprivation, which leads to decreased skin elasticity and blood supply, according to an article published in The Journal of the American Pharmacists Association.

Erin Palinski, R.D., CDE, LDN, CPT, author of the book Belly Fat Diet for Dummies, wrote “the reduction of estrogen causes the body to slow production of body oils, as well as reduces the body’s ability to maintain moisture.”

Kitchen Beauty Counter

Before running out to buy the latest $200 miracle moisturizer, first look in your kitchen. Feeding your skin certain foods that are rich in specific vitamins and minerals can keep your complexion glossy and healthy.

The same way that hundreds of crunches will do little to shred the extra pounds, slathering on expensive cream won’t help if you fill you plate with simple carbohydrates and other foods that damage your skin tissue from within.

Plus, most of the food that can help bring your skin back to life will also help you fight other perimenopause and menopause symptoms, including hot flashes, vaginal dryness, and weight gain. They also support your aging heart and bones.

Here’s a look a specific skin problems and how different foods can help heal and soothe from the inside out.

Skin-Food Solutions

Dry skin: Add some healthy mono-saturated fats and omega-3 fatty acids to your shopping list.

“Olive oil and avocado are superb sources of healthy monounsaturated fats. Not only do these good-for-you fats help strengthen and protect your skin’s cell walls, but they help keep your skin lubricated, aiding in the prevention of dry flaky skin,” says Corinne Dobbas, M.S., R.D.

Likewise, omega 3-fatty acids will protect the skin membranes and increase moisture to give you a plumper skin effect. To get these, eat more fatty fish likes salmon, herring and tuna, along with flaxseeds and walnuts.

Leslie Bauman, board-certified dermatologist and New York Times bestselling author (www.skintypesolutions.net), also recommends foods with linolic acid since low intake of this oil is linked to dry skin. Good sources include canola oil, soy food like tofu, and pumpkin and sesame seeds. You can even put it directly on your skin, using safflower oil or olive oil.

Avoid: foamy cleansers and bubble baths. The suds in the soaps actually pull fats out of your skin. Instead, use a milky cleanser, suggests Bauman.

Sensitive skin (with conditions like rosacea and acne): Since every woman experiences perimenopausal hormone fluctuations differently, some end up suffering from adult acne.

One of the best ways to fight acne is to eat more sources of Vitamin A, such as leafy greens, spinach, carrots, sweet potato, and turkey. This vitamin is a main ingredient in many acne medications. “Vitamin A is known for overall skin health and helps prevent overproduction of cells in the skin’s outer layer, meaning less clogged pores and ultimately, blemishes,” notes Dobbas.

Keep up your intake of omega 3 fatty acids intake, which can lower inflammation in your skin, adds Bauman.

Sometimes, it’s not about what you should eat or avoid, but what you lack. Elissa Brenner, M.S. in nutrition therapy says, “A lot of acne sufferers actually have a zinc deficiency, which can control oil in the skin. Add more oysters, pumpkin seeds, ginger, pecan, oats and eggs to your diet.”

Avoid: dairy and sugar for acne. For rosacea, stay away from cayenne pepper, curry, hot sauces, and alcohol.

Wrinkles: To prevent skin aging and sagging, nothing beats antioxidants like blueberries, pomegranates, acai berry, and raspberries, along with spices and herbs like curry, oregano and ginger.

Sweet potatoes, broccoli, pineapple, kale and peppers provide Vitamin C, which research shows promotes the growth of collagen a protein that smoothes out wrinkles and allows for a fuller, more youthful face, adds Dobbas.

Avoid: sun, smoking, processed foods, simple carbohydrates (white pasta and bread) and trans fats (processed and junk food). Once your collagen breaks down, you’ll begin to develop wrinkles, aging and crepey skin.

Everyone wants to age well, and nothing contributes more to that than healthy skin. Feed your skin the right way and it can stay youthful for a long time. In a study where more than 4,000 middle-aged women were assessed on the relationship between aging and skin aging, those who had less protein, potassium, vitamin C, and Vitamin A in their diet had a more wrinkled appearance, says Martina M. Cartwright, Ph.D., R.D., adjunct faculty member at University of Arizona, in the IDEA Fitness Journal.

Here’s my final advice for an instant, glowing face: aerobic exercise. It increases facial vascularization and oxygenation, which creates an unmistakable rosy luminance that influences perception of age, health, and attractiveness.

Food remedies by Elissa Brenner

a) Acne: Drink cucumber juice and/or apply thin slices of fresh cucumber for 15 minutes.

b) Dry skin: Separate an egg, beat the yolk, smooth onto your face, let the yolk harden, and splash off with water. Use eggs with extra omega 3 fatty acids

c) Aging skin: Wash a hand full of strawberries, smash with a mortar and pestle and then apply mixture to blemishes. Let dry for 20 minutes and rinse off.

d) Neck wrinkles: Dip a towel in warm olive oil, wrap around your neck and then wrap that with hot dry towel to steam away toxic waste and lock in moisture.

Homemade Gorgeous Skin Date Bars

Recipe by Lisa Roberts-Lehan, Certified Health and Nutritional Consultant, and Holistic Chef

16 medjool dates, pitted (or any kind of dates)

1/3 cup goji berries (or small-sized cranberries)

1/3 cup pumpkin seeds

1/3 cup sunflower seeds

3 tablespoons flaxmeal

? cup raw cocoa nibs or dark chocolate chips

Method:

1. Line a 9 x 9 inch straight-sided pan with parchment paper so the paper hangs over the long edges. Set aside.

2. Place the pumpkin and sunflower seeds in a food processor fitted with a metal blade. Pulse until they are uniformly chopped. Add the goji berries, flaxmeal, and chocolate and pulse again until finely chopped. Pour the mixture into a bowl and set aside.

4. Add the dates to the food processor and process until a paste forms. Add the mixture from the bowl. Process until evenly combined. Scrape into the prepared pan.

5. Press the mixture evenly over the bottom of the pan. Wet your hands and use them to make the mixture as smooth as possible. Fold the excess parchment to cover the mixture and refrigerate for at least 2 hours before slicing.

6. Transfer mixture from the pan to a cutting board. Cut into desired size and store in the refrigerator in a sealed container.

Yield: 20

Nutritional Information: Calories: 90, Fat: 2. 3 g, Carbs: 18.3 g, Protein: 1.5 g

Dry Skin and Menopause – HealthyWomen

When I was younger, the skin on my face was always slick with oil. And as only an adolescent girl can do, I let it get me down. Each time I caught a glimpse of myself in the mirror, I’d recoil at that shiny reflection looking back at me. Of course, now, being in this so-called midlife, I wish there had been a voice of reason to calm me.

If there had been, it might have said something like this: Be grateful for all that oil! You’ll miss it one day.

But alas, there was no such voice. Instead, my youthful indignation—however misplaced—made me shun that sebum, creating an aggressive arsenal of anti-oil measures: I rubbed, I scrubbed, I wiped, I swiped. But to no avail. The oil resurfaced quickly, and I, feeling defeated, only became more determined to do what I could to overcome my body’s natural tendencies. (Where was that voice when I needed it? Voice to Sheryl: “You can’t control everything, you know. “)

And now all these years later, I miss that free supply of oil. I also suspect that I damaged my skin in all my tiresome efforts to eradicate that oil (just like I damaged my skin, as so many others of the boomer generation did, by using—horrors!—sun reflectors).

Menopause sure has a way of getting back at you. Years later, that shift in hormones took care of the excess oil and moisture on my face—and my arms, legs, feet and hands (and nether-regions, too).

Learn more: The Beginner’s Guide to Menopause.

What’s menopause got to do with it?

Here’s what: What estrogen gives—collagen and oils—it taketh away. So, as menopause approaches and causes a decline in estrogen, you get dry, itchy skin. This decrease in moisture can begin with perimenopause, the years before menopause sets in.

Not only is your skin’s moisture production diminished, but so is your skin’s ability to hold on to, or retain, whatever moisture it has.

Next up? A body full of dryness—your face, your elbows, knees, feet, nails and many other areas.

Some best ways to tackle that dryness? 

1. Your diet. Essential fatty acids (EFAs) are those that your body can’t produce on its own. But your body, including your skin, needs these to stay nourished and hydrated, especially omega-3 fatty acids, which can be found in oily fish like salmon, mackerel and sardines, and in canola oil, walnuts, soybeans, ground flaxseed and fortified eggs. Balance it out with other healthy fats from omega-6 fatty acids, which are found in seeds, nuts, grains, vegetable oils, avocado and green, leafy veggies.

2. Always use sunscreen. While it won’t replace the skin’s moisture, it will help protect it and keep it healthy (and help stave off future sun damage and wrinkling!). There are so many great ones out there; I personally love this one from Roche-Posay.

3. Avoid hot showers and baths. It’s best to use warm, rather than hot, water, which can pull moisture from your skin and dry it out. Try to limit your time in the water, too. If you see the tips of your fingers and toes looking wrinkled, you’ve been in for too long. Tip: If you’re a fan of baths (I am!), these relaxing and healing Epsom salts by Dr. Teal can add back moisture with nourishing avocado. Epsom salts also help to soothe sore muscles and offer stress relief. And who can’t use that?

4. Apply moisturizer while skin is still damp. Doing this will help trap the moisture that exists in your skin. I love the lavender fragrance of this one by Aveeno, which is super-creamy and comforting.

5. When toweling off, be gentle with your skin, and pat, rather than rub it dry. Our skin becomes thinner and more fragile with age and is thus more prone to irritation. A towel like this, made with microfiber, is gentle on your skin.

6. Consider a moisturizing mask. Facial masks are all the rage, and they’re a great way to deliver nourishing and soothing ingredients to your skin. Allure magazine offers some great picks for under $20. I recently fell in love with this one, from beauty brand Chaleur.

7. Add some moisture back into the air. Wintertime can suck the humidity out of the air. Add it back with something like this, which looks pretty while it dispenses not just cool humidity, but lovely essential oils, too.

This post originally appeared on mysocalledmidlife.net.

Disclosure: MySoCalledMidlife is an Amazon affiliate, which means that the author receives a small commission for any purchases made through these links. Opinions are solely the author’s.

90,000 symptoms in women [Vichy expert opinion]

What happens to the cells of the epidermis and its natural protective barrier during the premenopausal stage?

With the onset of menopause, due to imbalance in hormones, the amount of free radicals in cells and intercellular space increases, which contributes to the disruption of the extracellular matrix – the basis of connective tissue responsible for nutrition, reproduction and regeneration of skin cells. This is the main reason why the condition of the epidermis is deteriorating.What skin changes entails a decrease in estrogen levels:

• thinning of the upper layer of the epidermis and a decrease in its barrier function;
• activation of the degradation of extracellular matrix enzymes and a decrease in the synthesis of natural collagen and elastin;
• reduction of proliferation of dermal fibroblasts;
• decrease in sebum production and thinning of the hydrolipidic film of the epidermis;
• dehydration, dryness, peeling of the skin ;
• allergic reactions and itching appear ;
• violation of blood microcirculation, leading to hot flushes , as well as a decrease in oxygenation and malnutrition of cells;
• increased sensitivity and susceptibility of the epidermis to external negative factors of influence;
• thinning and thinning of hair;
• the appearance of cellulite;
• deceleration of scar recovery.

30% of the protein structure of the dermis is lost during the first 5 years of menopause (2).

Thus, the process of chronological (natural) aging, caused by internal hormonal changes in the body, is accompanied by a decrease in estrogen production, which provokes the appearance of fine mimic wrinkles against the background of increased dryness and thinning of the skin, as well as its decrease in elasticity and firmness. This process occurs rather quickly and already five years after the onset of menopause, in the absence of any additional care, a loss of 30% of the protein structure of the skin occurs (2) and it becomes difficult to smooth out the existing age-related changes, as well as prevent the emergence of new ones.

Remember that a number of external factors also affect the condition of the epidermis, such as:

• the harmful effects of ultraviolet rays provoke photoaging of the skin;
• environmental pollution violates the hydrolipid barrier of the epidermis;
• Alcohol and tobacco use increase oxidative stress.

All of the above factors also lead to the appearance of deep dermal creases, age spots, the complexion becomes dull, the relief is uneven, gravitational ptosis appears, due to which the contour of the face changes (sagging of tissues appears).

Sources:

1. The role of estrogen in cutaneous aging and repair.

Wilkinson HN, Hardman MJ.

Maturitas. 2017 Sep; 103: 60-6

2. Symptoms of menopause – global prevalence, physiology and implications.

Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T.

Nat Rev Endocrinol. 2018 Apr; 14 (4): 199-215

Menopausal dry skin. What to do? | HEALTH FOR ALL!

Dry menopausal skin is one of the manifestations that our body is changing.But why is this happening, and what tricks can we take to avoid it?

Dry menopausal skin

The causes of dry skin in menopause are the same as all other typical changes of this period: a decrease in estrogen and, in particular, typical physiological aging, dehydration.

In fact, in women between the ages of forty and fifty-five, estrogen production drops, the menstrual cycle disappears, and a number of estrogen-related effects occur.

Estrogens, the main female sex hormones, perform a number of functions in the body, including stimulating the production of collagen and sebum, which moisturizes the skin and counteracts free radicals that accelerate cellular decay. Consequently, at this stage, the skin becomes less elastic, thin, dry, and the course of its recovery and healing slows down.

As for the dehydration associated with aging, on the other hand, it is a physiological phenomenon associated with the fact that with age we tend to lose more fluid and at the same time feel less thirsty.

What to do?

To maintain hydration during this difficult period, you need to consume water – 1.5-2 liters per day (6-8 glasses), not forgetting that we also take it with food.

Even the choice of soap helps counteract dry skin by choosing gentle cleansers enriched with emollients and moisturizers. It is also necessary to get used to using water at the right temperature and at the right time, while refraining from exposure to a hot and too long shower, since the hydrolipid film on the skin is destroyed (this protective oil layer).

The hydrolipid film has a hyper important protective purpose, and it is useful to use a cream suitable for this type every day to preserve it. Our skin is exposed to hot air, cold weather and ultraviolet radiation, but these circumstances, which affect the hydration itself, can further worsen the situation during menopause.

The change in lifestyle is equally important. It is worth giving up addictions and starting to play sports, followed by a good reintegration of the lost fluid.Good physical activity is essential to reduce the risk of osteoporosis and to promote good muscle tone in the body, blood vessels, heart, , as well as for the health of the skin, due to the transformation of oxygenation.

Menopausal skin care, care for aging skin

The choice of procedures in the menopausal period is focused on the following problems: wrinkles, laxity, swelling, muscle ptosis, discoloration (either associated with pigmentation in the form of brown spots or associated with vessels), rash or dryness.

It must be understood that a woman must prepare for this state in advance. The sooner she starts doing this, the better. “So that you have something to lose” – that’s exactly what I say to my patients. Begin active care at age 35. How we bring our skin to the menopausal state will determine how a woman will look during this period.

Laser resurfacing will help us improve the look. During menopause, the epidermis regenerates more slowly – resurfacing will remove all the irregularities on the skin’s surface and visibly transform it.After this procedure, you can hear: “How fresh you are! What is your skin color! ” Second, we are fighting at the inner level, at the collagen level. We “build” new collagen within our skin. In all, this will manifest itself to varying degrees, but we can definitely speak of an improvement in the quality of the skin.

The second procedure, which solves almost all problems with skin discoloration, as well as vascular pathologies and rashes, is BBL Forever Young phototherapy. We raise the immune system of the skin, work with collagen, pigment, blood vessels.In addition, after the procedure, the skin is rejuvenated at the genetic level. The genes that are responsible for the youthfulness of the skin and for its immunity are activated. At the same time, we suppress the genes responsible for skin aging.

Fractional RF lifting RF – Scarlet – a procedure during which 25 microneedles are applied to the skin. This stimulates the production of collagen and elastin. As a result of the procedure, fine wrinkles disappear, and skin turgor increases. It becomes denser and more elastic.

Plasma therapy is also very effective. It can be combined with hardware procedures or as a stand-alone procedure. Botulinum toxin relaxes active muscles and prevents the appearance of new wrinkles.

It is very important to engage not only in aggressive methods, but also to maintain the condition of the skin with care in the form of serums and masks in order to enhance metabolic processes, saturate the skin, give it a fresh look, radiance and maintain the effect of hardware procedures.

In home care, give preference to products containing retinol, which stimulates the formation of collagen, with peptides, vitamins (C, K), acids that help to exfoliate the skin and avoid hyperkeratosis; with plant extracts, hyaluronic acid. Home care is always selected individually after consultation with a beautician.

How hormones and skin affect each other – Wonderzine

Diurnal, or circadian, rhythms are present in all living organisms – they help to adapt physiology and behavior to day and night.In a person per day, not only a change from sleep to wakefulness occurs – food behavior, hormone secretion, blood pressure, and body temperature change. Leather is no exception. Skin parameters such as temperature, barrier properties, microcirculation, pain sensitivity, itching, sebum production, pH change with time. Thus, in typical women, cutaneous microcirculation reaches its peak at night. Sebum production is at its maximum at noon, skin pH decreases at night (becomes more acidic) and rises during the day. The temperature of the skin changes during the day, while on the face it reaches its maximum in the early morning. Recovery of skin damage slows down from 20:00 to 23:00, and by three in the morning, on the contrary, reaches a peak.

All types of skin cells have a similar clockwork, but the most pronounced one is found in hair follicle cells, in the so-called secondary growth zone. These are the cells that are activated first before the hair shaft begins to form; the activity of the circadian cells of the hair follicles quite accurately repeats the periods of wakefulness and sleep of a particular person.

It is known that wild mammals have a seasonality of hair growth – it depends on the activation of genes that regulate circadian rhythms. Certain changes in hair (gray hair and shedding) are common symptoms of aging in mammals. Having linked all these data, scientists suspected that circadian genes may be involved not only in the regulation of circadian rhythms. They are involved in processes such as DNA repair or regulation of the accumulation of reactive oxygen species in cells, which means they are likely participants in the aging process.

In case of sleep disorders or work at night, the activation of circadian genes is lost, and this affects health: body weight and waist circumference increase, cell tolerance to glucose and insulin sensitivity decrease. The same shift occurs in the skin and hair, but has not yet been studied in detail. When sufficient data is available, it can be used to improve the condition of the skin and hair, or, for example, indirectly diagnose metabolic disorders.

The main hormone of circadian rhythms is melatonin.It is produced in the pineal gland, cells of the retina, brain, intestines, thymus, in the placenta and, of course, in the skin. It is already known that melatonin is an antioxidant, photoprotector and circadian synchronizer; it helps to overcome the effects of circadian rhythm disturbances associated with lack of sleep, shift work or flights. Perhaps in the future it will be able to be used for cosmetic purposes as well.

90,000 The effect of menopausal hormone therapy on the skin as a component of healthy aging

10.21518 / 2079-701X-2018-6-156-160

S.V. YURENEVA, MD, DSc, L.M. ILYINA, Ph.D.

National Medical Research Center for Obstetrics, Gynecology and Perinatology. Academician V.I. Kulakova, Ministry of Health of Russia, Moscow

EFFECTS OF MENOPAUSAL HORMONAL THERAPY ON SKIN

AS A COMPONENT OF HEALTHY AGING

Healthy aging (anti-aging; anti-aging) implies the prevention of diseases and disabilities, maintaining high mental and physical activity, maintaining the meaning and purpose of life.Women refuse to age and want to look younger for as long as possible. The skin is the only organ whose condition can be assessed visually, a kind of mirror reflecting the age-related changes taking place in the body and the state of health in general. All natural age-related processes at the cellular level occur in the skin, therefore it is often used as a convenient model for studying the biological mechanisms of aging in humans as a whole [1]. The increase in life expectancy and the stable age of menopause have led to the fact that modern women spend an increasing number of years in postmenopause.The direct effects of the menopause-related decrease in the level of sex hormones include loss of fertility, vasomotor symptoms, and long-term – osteoporosis, cardiovascular disease (CVD) and skin aging, which is a subject of pronounced discomfort, especially for women [2, 3].

Keywords: menopausal hormone therapy, skin, drospirenone, estradiol. S.V. YURENEVA, MD, L.M. ILYINA, PhD in medicine

V.I. Kulakov National Medical Research Center for Obstetrics, Gynaecology and Perinatology of the Ministry of Health of Russia, Moscow EFFECT OF MENOPAUSAL HORMONE THERAPY ON THE SKIN AS A COMPONENT OF HEALTHY AGING

Healthy aging (anti-aging) involves the prevention of illness and disability, keeping mental and physical activity in tip-top shape, maintaining the meaning and purpose of life. Women refuse to age and want to look younger as long as possible.The skin is the only organ which condition can be assessed visually, a peculiar mirror that reflects age-dependent changes that take place in the human body and the state of health as a whole. All regular age-dependent changes that occur at the cellular level happen in the skin, therefore, it is often used as a convenient model for studying the biological mechanisms of human aging as a whole [1]. An increase in life expectancy and a stable age of menopause has led to the fact that modern women spend more and more years in postmenopausal state.The direct effects of menopause-related sex hormone production slowing down include loss of fertility, vasomotor symptoms, and the long-term ones such as osteoporosis, cardiovascular disease (CVD) and skin aging, which causes marked discomfort, especially for women [2, 3]. Keywords: menopausal hormonal therapy, skin, drospirenone, estradiol.

With the help of various and constantly improving preventive and therapeutic measures aimed at arresting internal and external signs of skin aging, modern dermato-cosmetology opens up unique anti-aging opportunities for women [4, 5].In recent years, researchers have been paying more and more attention to the effects of sex steroids on the skin and issues of the possible preventive effect of menopausal hormone therapy (MHT) on the aging process of the skin [3, 6]. At present, it is difficult to imagine women who manage to maintain youthful-looking skin in middle age in the absence of estrogen [6]. Most often, the optimal aesthetic result is provided by a combination of several methods aimed at the main pathophysiological mechanisms of skin aging, including careful care.

This review presents current knowledge about the role of estrogens in skin aging and wound healing. Particular attention is paid to the constantly expanding possibilities of clinical intervention in these processes, including the influence of MHT.

SKIN AGING AND RISK FACTORS

With age, human skin undergoes profound regular changes associated with atrophy of all its layers (epidermis, dermis and hypodermis), which are manifested in a decrease in its thickness and flattening of the epidermal-dermal junction zone.Histological changes in the skin include indiscriminate desquamation of certain areas of the epidermis, a decrease in hydration due to the loss of the interstitial extracellular matrix, impaired production of glycosaminoglycans (GAGs) by fibroblasts, collagen disintegration, etc. [7]. Clinically, this manifests itself in an increase in the number and depth of wrinkles, an increase in dryness and sensitivity, a decrease in firmness and elasticity, the development of flabbiness and the formation of hanging folds, associated, among other things, with a decrease in the content of subcutaneous fat.

Aging is accompanied by a progressive decrease in the functional and reserve capabilities of all structural elements of the skin, it is a complex process

som and the result of the influence of both non-modifiable (chronological aging, ethnicity and regular anatomical changes) and modifiable factors, which can also accelerate these disorders [8]. The latter include: smoking, which reduces skin elasticity and blood flow and reduces nutrient delivery; excessive exposure to ultraviolet rays, leading to a decrease in the content of hyaluronic acid in the connective tissue and skin moisture; excessive physical activity; chronic stress; decrease in the duration and impairment of the quality of sleep; insufficient intake of fruits and vegetables, etc.More and more data are accumulating that hypoestrogenism in women during the transition period can also be attributed to modifiable factors of skin aging [3].

The skin serves as a primary barrier to invasion of pathogens, dehydration and traumatic injury, with the earliest and most pronounced signs of skin aging, which can have complex negative effects on social activity, sexual function and general well-being in women.A survey conducted in the UK showed that 64% of women who applied to menopausal clinics complained of signs of skin aging that are extremely unpleasant for them [8].

POSSIBLE ROLE OF GENDER STEROIDS IN SKIN AGING

The study of age-related morphological changes in the skin showed that in women they begin after 30 years, ie, long before the appearance of other obvious signs of aging, and intensify after 40 years in parallel with the stages of aging of the reproductive system [9].After the onset of menopause, the age-related processes in the skin are accelerated, which correlates with a decrease in the levels of estrogen in the blood [3]. It has been shown that hypoestrogenism is associated with many clinical changes (dryness, atrophy, wrinkles, poor wound healing, etc.) that develop due to thinning of the epidermis, a decrease in the amount of collagen, a decrease in moisture and hygroscopic properties, and elasticity [10].

Aging is largely the result of the sequential accumulation of reactive oxygen species (ROS), capable of destroying the antioxidant defense of the body, which leads to mitochondrial dysfunction, DNA damage, disruption of protein, lipid and carbohydrate metabolism [1, 11].ROS can disrupt many important cellular functions, from proliferation and differentiation to the survival of cells in general, including skin.

Ovariectomy in animals is widely used to create an experimental model of menopause in humans and demonstrates many signs of oxidative stress due to increased ROS formation and DNA damage, as well as the development of various age-related somatic pathologies [12]. Introduction of exogenous

estrogens in experimental models after oophorectomy showed clear protective effects at the cellular level in relation to the skin: a decrease in age-related oxidative stress, incl.including due to lipid peroxidation in keratinocyte rats and apoptosis [13]. In other studies, estrogens neutralized the effects of oxidative damage to human skin fibroblasts and keratinocytes, and contributed to the maintenance of normal collagen synthesis and cell proliferation [11].

Estrogens exert their effects by interacting with two nuclear receptors – estrogen receptors (ER) a and ß, while their expression in the skin depends on the cell type and location.Thus, ERs are expressed in large quantities in the epidermis, sebaceous hair follicles and sweat ducts, and less in the dermis and sweat glands themselves, however, all structural elements of the skin are under the negative influence of menopause. Expression of ERs and their localization are extremely important for maintaining normal skin function, especially in postmenopausal women, while ERß signaling pathways act as a key inhibitor of the skin aging process [14], in both sexes, ERß expression in epidermal cells decreases with age [15].Thanks to the so-called “intracrinology” [16], estrogens can be synthesized locally in the skin, since its cells contain all the necessary enzymes involved in their metabolism and produced by skin cells and hair follicles [3, 14].

There is a lot of evidence that menopause significantly accelerates the aging process of the skin [8, 14, 17]. Against the background of estrogen deficiency, the thickness of the skin in women decreases annually by 1.3%, and the collagen content – by about 2%, so that during the first 5 years of postmenopause there is a significant loss (by 30%) of type I and type III collagen, which occurs parallel to the decrease in bone mass [14].There was also a difference in the content of certain subtypes of collagen in postmenopausal women compared with the premenopausal period – a decrease in the ratio of type III / type I collagen in the dermis. Importantly, a decrease in skin thickness and collagen content correlates more clearly with the period of estrogen deficiency than with the chronological age of women [3]. In addition, in postmenopausal women, the skin not only becomes thinner, but also loses its viscoelastic properties (viscoelasticity).

A number of postmenopausal women have oily, porous skin, accompanied by acne, seborrhea and hirsutism.This is due to the fact that, in comparison with estrogens, the level of androgens decreases more smoothly, therefore, in some cases, a relative predominance of the content of androgens secreted by ovarian stromal cells under the influence of an increased level of gonadotropins may develop. Prescribing monotherapy with estrogens has an inhibitory effect on the activity of the sebaceous glands and reduces these manifestations, but the use of a combined MHT regimen with an “androgenic” progestogen in women with an intact uterus may

increase sebum secretion and cause acne and seborrhea.It has been proven that the activity of the sebaceous glands of the skin depends on the level of sex hormones: estrogens reduce the number and size of these glands, while androgens have the opposite effect, stimulating their secretory activity.

POSSIBILITIES OF MENOPAUSAL HORMONAL THERAPY

Many of the effects of estrogen on aging skin have been studied by comparing skin conditions in postmenopausal women with and without MHT.In an early large population-based study First National and Health Nutritional Examination Survey (NHANES I) (n = 3875) using a standardized dermatological study, the authors demonstrated that estrogen intake significantly reduced the likelihood of developing senile dry skin in postmenopausal women (hazard ratio ( RR) = 0.76, 95% CI 0.60-0.97) [18]. Recently, many studies have been carried out using objective laboratory methods (corneometry, tevametry, sebumetry, etc.), which made it possible to elucidate the mechanisms of the complex effect of MHT on individual structural components of the skin in women in transition and postmenopausal women and to confirm that the state of the skin surface, hygroscopicity, collagen content in the dermis and viscoelasticity improve with the intake of estrogens [14, 19, 20].

Effect on the epidermis. Convincing data have been obtained on the improvement of quantitative and qualitative characteristics of the epidermis against the background of MHT, an increase in the proliferation of corneocytes is noted; improving the ability to retain moisture; normalization of the characteristics of sebum lipids, indicating an improvement in barrier functions and the ability of the skin to resist external aggressive influences.

Proliferation of corneocytes. In aging skin, the mitotic activity of cells in the basal layer of the epidermis decreases, which is accompanied by a slowdown in the renewal processes of corneocytes forming the stratum corneum and its thickening. Keratinocytes – the main cells of the human skin epidermis (up to 90% of all cells) express both types of ER (3Pa and ERb); at physiological concentrations, estradiol especially increases the ERb content, inducing the proliferation of these cells [21].In addition, the stimulating effect of estradiol on keratinocytes was confirmed by increasing the expression of the antiapoptotic protein Bcl-2 and suppressing apoptosis of these cells, as well as activating important regulatory proteins of the cell cycle – cyclin D1 and D2 by interacting with membrane receptors, which indicates an important role non-genomic pathway of estrogenic influence on the proliferation of cells of the epidermal layer of the skin [22, 23].

Improved hydration.Earlier, several groups of researchers studied the effect of MHT

for the hydration of the epidermis, which plays an important role in maintaining the barrier function of the skin [24-26]. The index of transepidermal water loss (TEWL) was studied not only under physiological conditions (at the same time of the day at a temperature of + 21 ° C and an air humidity of 40-50%), but also during highly sensitive plastic occlusive stress test (plastic occlusion stress test (POST) [25] in women with postmenopausal duration from 2 to 6 years (mean age – 52 ± 3 years) who complained of increased dry skin.An increase in the ability of the stratum corneum of the epidermis to retain moisture against the background of estrogen intake was demonstrated compared to that in the control group of women, which directly correlates with an improvement in the barrier functions of the epidermis. Morgulis et al. in a study involving 55 women aged 27 to 57 years (mean age 44.2 ± 1.3 years) with surgical menopause, corneometry was performed to determine the TEWL index and showed that the level of skin hydration before the start of treatment averaged 13, 4 ± 0.7 cuThat is, which indicated its pronounced dehydration, since normally it should exceed 45 cu. That is, [27]. In women who received MHT, the normalization of the skin moisture index was noted by 6 months. from the start of admission and corresponded to physiological values, while in the patients of the comparative group, the corneometric parameters for the entire observation period remained at an extremely low level.

F. Paquet et al. [28] studied the hygroscopic properties of the stratum corneum of the epidermis by measuring such an indicator as the rate of water accumulation (RWA) in women aged 48 to 54 years with “sensitive” skin at various indicators of humidity and ambient temperature. and also while taking MGT.The authors showed an improvement in the barrier function of the skin according to RWA data due to an increase in its water-holding properties in women who received MHT, compared with that in women from the control group (by 40% and 15%, respectively).

Normalization of the characteristics of the lipid layer. Several studies have shown changes in the ultrastructural characteristics of the lipid layer covering the epidermis in postmenopausal women compared with those in women of reproductive age, as well as those receiving and not receiving MHT.Misra et al. revealed in postmenopausal women insufficient lipid coverage of underlying corneocytes of the facial skin and deterioration of their ultrastructural characteristics, while the use of MHT significantly improved these quantitative and qualitative indicators to values ​​comparable to those in young women [29]. In the above work, Morgulis et al. [27] the patients used a combination of 1 mg of estradiol (E2) + 2 mg of the antiandrogenic progestin drospirenone (DRSP), an improvement in sebumetry indices was revealed due to the saturation of the surface layers of the epidermis with the fatty base with the formation of visually non-

noticeable and non-discomforting grease film.This treatment restored the balance of water-retaining and lipid characteristics of the epidermis, while the excretion of sebum was within the physiological norm (on average 20 μg / cm2).

In a randomized, double-blind, placebo-controlled study, dermis thickening by 30% was demonstrated within a year of taking MHT in postmenopausal women [30], and this was mainly due to an increase in collagen type III [14].Interestingly, in women with a low initial content of collagen in the skin, estrogens initially have a therapeutic and only then a preventive effect, while in women with moderate loss of collagen in the first years of postmenopause, the effect of estrogens is purely preventive, which speaks in favor of the timely appointment of therapy [ fourteen]. It has been shown that the topical use of estrogens can also increase collagen content by increasing the levels of type III and type I procollagen [31].In addition, estrogens increase the expression of transforming growth factor receptors TGF-ß and TGF-ß type II, which leads to rapid proliferation of fibroblasts and increased secretion of extracellular matrix, but inhibition of matrix metalloproteinases-1; all this in a complex also contributes to an increase in the collagen content in the skin [31].

The formation of wrinkles is a key visual reflection of skin aging associated with a decrease in its elastic properties and loss of connective tissue structures, but can also be the result of adverse external influences and hormonal changes.In early postmenopausal women, skin elasticity can decrease by an average of 1.5% per year, while topical use of estrogens increases the number and thickening of elastic fibers, improves their orientation in the papillae of the dermis [32]. In 5-year postmenopausal women who received continuous oral estrogens, the mean wrinkle score was significantly lower than in women who did not receive such treatment [32]. In two domestic studies [27, 33], the authors noted a decrease in the number of mimic and static wrinkles and the index of skin wrinkling by 20% in women in early postmenopausal women with the use of MHT for 3-6 months.

Thus, the normalization of root-seburetric parameters, moisture-retaining properties and a decrease in subjective sensations of dryness, the number of fine wrinkles, and improvement in the appearance of the skin in women using MHT testify to its broad preventive and therapeutic benefits in the care of aging skin. However, the clinician should remember that MHT should only be used for approved indications for the treatment of menopausal disorders and should consider the improvement in skin condition in their patients as a bonus.

DECORATION OF SKIN WOUND HEALING WITH AGE AND POSSIBILITY OF MGT

Pathological wound healing remains one of the most important, unmet clinical and therapeutic medical needs. Chronological aging is a key risk factor for the appearance of chronic wounds, which is due to the fragility of aging skin and deterioration of healing processes due to impaired differentiation of myofibroblasts, changes in matrix remodeling, and slowing of wound re-epithelialization due to decreased proliferation of keratinocytes [34, 35].

Despite the fact that chronological aging is the main risk factor for the deterioration of reparative processes in the skin, there is increasing evidence that estrogen deficiency, along with other factors, can also contribute to delayed healing of skin wounds. There is growing evidence that the chronic course of skin wounds is associated with an excessive inflammatory response, and that a decrease in sex hormone levels with age may have a significant effect on the inflammatory response in vivo [3].A lot of data have been obtained indicating the beneficial effects of estrogens for skin repair, including a modulating effect on inflammation processes, the formation of granulation tissue, regulation of proteolysis and acceleration of reepithelialization: in aging cells in vitro, in the study of wound healing in vivo and in clinical studies, incl. including acute wounds in postmenopausal women [36-38]. Estrogens contribute to a decrease in the expression of the proinflammatory cytokine tumoronecrotic factor-a (TNF-a) and the activity of macrophages, contributing to the improvement of angiogenesis, tissue remodeling and faster healing of the wound surface [39].

Perhaps the beneficial effect of estrogens is associated not only with their anti-inflammatory effect, but also with protection from the effects of an infectious factor [3]. Experimental studies have shown that estradiol has a protective effect against bacterial-induced inhibition of wound healing, and in young individuals [40]. These age-independent effects may indicate an even more significant role for estrogens in skin wound healing.

The prophylactic role of MHT in relation to chronic skin ulcers of the lower extremities is also important. Thus, in postmenopausal women aged> 65 years who received MHT, the risk of developing trophic ulcers caused by disease of the veins of the lower extremities and pressure ulcers decreases [41]. Age-related impairment of wound healing leads to an increase in morbidity and mortality, along with an increase in financial costs of medical care.

CONCLUSION

In addition to providing a lasting aesthetic effect, the use of MGT has a beneficial effect on the external

types of women and quality of life.An additional argument in favor of MHT is a favorable effect on similar and parallel atrophic processes in other collagen structures: in the bone matrix, urogenital tract and vascular wall, which fully fits into the concept of maintaining the “healthy aging” phenotype.

Currently, there is a need to conduct large studies with good design to obtain results that meet modern requirements

Evidence-Based Medicine Concerning the Preventive Effect of MHT on Skin Aging.Combining the efforts of gynecologists, dermatologists, cosmetologists and women actively motivated and informed on these issues seems to be a very promising direction. f

Conflicts of Interest: The authors declare no conflicts of interest at the time of writing this article.

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11. Bottai G, Mancina R, Muratori M et al. 170-estradiol protects human skin fibroblasts and keratinocytes against oxidative damage.akir B et al. Estrogen protects against oxidative multiorgan damage in rats with chronic renal failure. Ren Fail 2009, 31: 711-725.

13. Tresguerres JA, Kireev R, Tresguerres AF et al. Molecular mechanisms involved in the hormonal prevention of aging in the rat. J Steroid Biochem Mol Biol, 2008, 108: 318-326.

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17.Calleja-Agius J, Brincat M, Borg M. Skin connective tissue and aging. Best Pract Res Clin Obstet Gynaecol, 2013, 27: 727-740.

18. Dunn L, Damesyn M, Moore A et al. Does estrogen prevent skin aging? Results from the First National and Health Nutritional Examination Survey. Arch Dermatol 1997,133: 339-342.

19. Verdier-Setvrain S. Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators.Climacteric, 2007, 10: 289-297.

20. Masuda Y, Hirao T, Mizunuma H. ​​Improvement of skin surface texture by topical estradiol treatment in climacteric women. J Dermatol Treat, 2013, 24: 312-317.

21. Verdier-Sevrain S, Yaar M, Cantatore J et al. Estradiol induces proliferation of keratinocytes via receptor mediate mechanisms. FASEB J, 2004, 18: 1252-1254.

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23. Maggiolini M, Picard D. The unfolding stories of GPR30, a new membrane-bound estrogen receptor. J Endocrinol 2010,204: 105-114.

24. Pierard-Franchimont C, Letawe C, Goffin V, Pierard GE. Skin water-holding capacity and transdermal estrogen therapy for menopause: a pilot study.Maturitas, 1995,22: 151-154.

25. Berardesca E, Maibach H. Monitoring the water-holding capacity in visually non-irritated skin by plastic occlusion stress test (POST). Clin Exp Dermatol 1990,15: 107-110.

26. Schmidt JB, Binder M, Demschik G et al. Treatment of skin aging with topical estrogens. Int J Dermatol 1996,35: 669-674.

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32. Wolff EF, Narayan D, Taylor HS. Long-term effects of hormone therapy on skin rigidity and wrinkles. Fertil Steril 2005, 84: 285-258.

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34. Velnar T, Bailey T, Smrkolj V et al. The wound healing process: an overview of the cellular and molecular mechanisms.J Int Med Res, 2009,37: 1528-1542.

35. Komosinska-Vassev K, Olczyk P, Winsz-Szczotka K et al. Age-and gender-dependent changes in connective tissue remodeling: physiological differences in circulating MMP-3 MMP-10, TIMP-1 and TIMP-2 level. Gerontology, 2011, 57: 44-52.

36. Hardman MJ, Emmerson E, Campbell L, Ashcroft GS. Selective estrogen receptor modulators accelerate cutaneous wound healing in ova-riectomized female mice.Endocrinology 2008,149: 551-557.

37. Campbell L, Emmerson E, Davies F et al. Estrogen promotes cutaneous wound healing via estrogen receptor ß independent of its antiinflammatory activities. J Exp Med 2010,207: 1825-1833.

38. Emmerson E, Hardman MJ. The role of estrogen deficiency in skin aging and wound healing. Biogerontol 2012,13: 3-20.

39.Routley CE, Ashcroft GS. Effect of estrogen and progesterone on macrophage activation during wound healing. Wound Rep Regen, 2009, 17: 42-50.

40. Crompton R, Williams H, Ansell D et al. Estrogen promotes healing in a bacterial LPS model of delayed cutaneous wound repair. Lab Invest. 2016, 96: 439-449.

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90,000 Hot flashes and sweating in women with menopause

The main vegetative-vascular (vasomotor) symptoms of menopause in women are:

• characteristic hot flashes and sweating. Usually the upper half of the body and face are captured. They are considered one of the most frequent and early manifestations of menopause, in many cases they occur almost simultaneously with menstrual irregularities.The frequency of hot flashes varies. They worsen the state of health, affect the quality of sleep, contribute to the appearance of increased fatigue and general weakness during menopause. If there are 20 or more hot flashes per day, they speak of a severe course of menopause. According to statistics, hot flashes as a symptom of menopause, on average, last 3-5 years in women and then disappear.

• headaches. In women with menopause, they can accompany hot flashes or occur independently of them. Their appearance is mainly associated with the tone of the arteries of the head and neck, the level of blood pressure and the full value of the outflow of venous blood from the skull.Moreover, migraine-like headaches with menopause in women speak rather of episodes of hyperestrogenism, and pain in the back of the head causes suspicion of hypertension.
• chest discomfort (in the area of ​​the heart), palpitations. This is sometimes combined with accompanying anxiety up to the fear of death. Such symptoms require a mandatory dynamic assessment of the state of the heart and blood vessels feeding it, control of the level of blood pressure. [1]

In menopause, symptoms of a vegetative-vascular nature usually gradually subside 2-3 years after the end of menstruation, and hot flashes are no longer bothering.[2]

At the same time, local symptoms of menopause begin to develop, such as:

• Dryness
• Burning,
• Incontinence
• Discomfort during intimacy

Unlike vegetative-vascular symptoms such as hot flashes, these symptoms of menopause without therapy progress with age and after consultation with a doctor, local menopausal hormone replacement therapy may be prescribed [3]. This is a therapy that acts mainly in the area of ​​application (vulva, vagina, urethra) and helps to eliminate all local symptoms of menopause.

Moreover, preference is given to local estriol-containing agents, for example, Ovestin in the form of a vaginal cream or suppositories (suppositories). Such therapy already during the first weeks helps to alleviate the main symptoms of menopause by reducing the severity of atrophy of the mucous membrane of the vagina and urethra, increasing the production of lubricant, significantly improving the composition of the vaginal microflora, and improving blood flow to the genitals. Moreover, even long-term use of local forms of Ovestin does not contribute to increased cell division (proliferation of the endometrium and cervix, breast tissue, in other words, does not increase the risk of menopausal cancer, according to a number of studies.[4], [5], [6]

What are the most common symptoms of menopause?

Insufficient moisture of the vagina and the resulting feeling of dryness in the intimate area is one of the most frequent and early-onset symptoms of menopause. At least 75% of women face such a phenomenon, although the majority do not attach due importance to it. [7] For only 25% of them, this problem becomes a reason for going to a doctor, and in 2/3 of cases the specialists themselves lose sight of it.Traditionally, vaginal dryness during menopause is as natural and inevitable as the appearance of wrinkles on the face. Such an attitude to this problem leads to its inadequate diagnosis and a low percentage of the appointment of adequate therapy. But this not only reduces the quality of life, but also creates the preconditions for the development of more serious menopausal disorders.

Why does menopause so often lead to a feeling of discomfort in the intimate area?

Vaginal dryness arising from menopause is the main manifestation of the atrophic process.First of all, it covers the mucous membrane of the vagina, external genital organs and urethra, which leads to characteristic discomfort. Such changes occur due to pronounced estrogen deficiency, which is a key sign of menopause and the main cause of all its symptoms, including intimate symptoms.

Estriol belongs to the group of female sex hormones with versatile action and is a type of estrogen. It affects the state of many organs, indirectly changes the activity of regulatory nervous structures and the cerebral cortex, and participates in the control of basic metabolic processes.

The vagina is one of the most sensitive organs to estriol. Therefore, the lack of this hormone very quickly leads to a change in the state of the mucous membrane, which is associated with a deterioration in the blood supply to tissues and a decrease in the normal number and quality of cells. And the resulting vulvovaginal atrophy is considered one of the early and reliable signs of climacteric estrogen deficiency.

What happens in the vagina during menopause?

Severe estrogen deficiency leads to atrophy of the vaginal tissues, with the most pronounced changes in its mucous membrane.

Menopause changes include:

• progressive decrease in the number and activity of glands , as a result of which lubrication and, consequently, vaginal moisture disappear. This leads to the appearance in a woman of a constant feeling of dryness during menopause, with discomfort, pain during intimate life and even a decrease in the intensity of orgasm;
• restructuring of the mucous membrane : thinning of its surface layer (epithelium) with thickening of the lower (main) layer.As a result, the tissues of the vagina become thinner and, as it were, stretched, become less elastic, prone to damage and irritation. They are no longer able to quickly regenerate and sufficiently resist the penetration of pathogenic bacteria, which creates the prerequisites for the development of vaginitis (inflammatory process). Therefore, dryness with menopause is often complemented by a sensation of itching and burning;
• changes in the composition of the vaginal microflora. Since a clear lack of mucus against the background of atrophy leads not only to dryness in the intimate area during menopause, but also to a decrease in the number of lactic acid molecules and hydrogen ions.Together, these substances form what is called glycogen. Its deficiency leads to the fact that the vaginal mucus becomes more alkaline (less acidic). This environment is extremely unfavorable for beneficial lactobacilli. As a result, lactobacilli die and the local immunity in the vagina ceases to cope with the influx of pathogenic microbes and bacteria. That is why, during menopause, women tend to have vaginitis, vaginosis and other “osmosis” more often.

Vaginal atrophy is rarely isolated, in most cases, similar changes develop in the tissues of the urethra (urethra) and external genital organs.Therefore, they usually talk about the development of the so-called urogenital climacteric syndrome, which is characterized by the presence of both gynecological and urological disorders.

How does menopause manifest in the intimate area?

Climacteric atrophy of vaginal tissues leads to a complex of symptoms:

• feelings of dryness, most palpable near the entrance to the vagina;
• discomfort during intimate life, up to the onset of pain;
• concomitant feeling of itching and burning, which indicates irritation or inflammation of the walls of the vagina;
• unpleasant odor and abnormal vaginal discharge.This is not a mandatory sign, such symptoms indicate infection of the vagina with the development of vaginitis.

If the estrogen deficiency created during menopause is not compensated for by anything, then the tissue atrophy that has already arisen will grow steadily. [8] Therefore, after the onset of menopause, vaginal dryness does not go away, in many cases its severity even increases and other local symptoms of menopause are added to it (incontinence, recurrent urinary tract infections, etc.).etc.). By the end of the first year of postmenopause, urogenital syndrome is detected in 64.7% of women, and after 6 years its prevalence is already 84.2%. [9]

Treat menopause or endure?

Unfortunately, many women do not consider dryness in the vagina as a reason to see a gynecologist. And the phytoestrogens and various non-hormonal agents used by them as self-medication are not able to have a long-term effect. [10] But this does not mean that the problem of dryness with menopause is irreparable.

According to the recommendations of the International Menopause Society, if the very first local symptoms of menopause appear, you can already think about starting hormone replacement therapy and consult a doctor .. At the same time, local forms of estriol-containing drugs are shown to correct the emerging local symptoms of menopause and prevent further complications cream or suppositories for climacteric dryness). [11] One of the effective remedies for dryness during menopause and other local symptoms of menopause is Ovestin (estriol) in the form of a vaginal cream or suppositories (suppositories).

Therapy with local forms of Ovestin for vaginal dryness leads to relief of the condition of a woman with urogenital symptoms of menopause. By the end of the 2nd week of use:

• decreases the severity of atrophy [12] of the mucous membrane of the vagina, urethra and external genital organs,
• improves local blood supply,
• increases the amount of vaginal mucus, normalizes its acidity and the number of beneficial lactobacilli. [13]

Against the background of the use of suppositories against dryness in menopause, the composition of the microflora of the urogenital area improves within a month [14]: the number of lactobacilli increases and up to 90% [15] of pathogenic microorganisms die.Moreover, to achieve such an effect, the use of progesterone preparations or additional intravaginal administration of lactobacilli is not required. The microflora is normalized in a natural way, by the woman’s production of her own beneficial lactobacilli, since normal conditions in the vagina are created for them.

Therapy with estrogen-containing suppositories for dryness during menopause (for example, local forms of Ovestin (estriol) should be carried out for a long time. [16], [17], [18], [19] Since this will prevent complications (climacteric urinary incontinence, ascending urogenital infection , recurrent vaginitis and others).[20], [21], [22], [23]

[1] Dyukova GM The quality of life of a woman during menopause // Attending physician. – 2003.

[2] Lobo R.A. Treatment of the postmenopausal women / basic and clinical aspects III ed., 2007.

[3] T. S. Perepanova. “Modern approaches to the treatment of urogenital disorders in postmenopausal women.” Journal “Obstetrics, gynecology, reproduction”, No. 1, 2011.

[4] V. E. Balan. “Genitourinary or urogenital syndrome.The possibilities of long-term therapy ”. Honey. Council, No. 12, 2016.

[5] V. N. Serov. “Modern pathogenetic therapy of urogenital disorders in postmenopausal women.” 2008.

[6] O. V. Trokhanova, M. V. Khitrov, M. D. Bryantsev, Yu. A. Chizhova. “The effect of estrogen monotherapy on the state of the mammary glands in women with menopause.” “Gynecology”, No. 4, 2015.

[7] Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric 2010; Early online: DOI: 10.3109 / 13697137.2010.522875.

[8] T. S. Perepanova, P. L. Khazan. “The role of estriol in urogenital disorders in postmenopausal women”, Urology. 2007.

[9] F. Palmaa, *, A. Volpea, P. Villa b, A. Cagnacci, Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: The AGATA study, Maturitas, 2016.

[10] Clinical guidelines “Menopausal hormone therapy and maintaining the health of women in adulthood.” Letter of the Ministry of Health of the Russian Federation 15-4 / 10 / 2-5804 dated 02.10.2015.

[11] R. J. Beber, N. Panay, A. Fenton, IMS Recommendations, Climacteris, 2016.

[12] V. E. Balan. “Genitourinary or urogenital syndrome. The possibilities of long-term therapy ”. Honey. Council, No. 12, 2016.

[13] I. A. Apolikhina, E. G. Sycheva. “Correction of estrogen deficiency states in women with urogenital disorders.” Obstetrics and gynecology. No. 4. 2015.

[14] E. A. Gorbunova, I. A. Apolikhina. “Atrophic cystourethritis as one of the facets of the genitourinary syndrome.”Effective pharmacotherapy. No. 36.2015.

[15] M. N. Kostava, L. K. Bashirova. “Atrophic exocervicitis and vaginitis. Opportunities for Therapy “, Federal State Institution” Scientific Center for Obstetrics, Gynecology and Perinatology. V. I. Kulakov “. Gynecology. No. 2. 2010.

[16] T. S. Perepanova. “Modern approaches to the treatment of urogenital disorders in postmenopausal women.” Obstetrics, gynecology, reproduction. No. 1. 2011.

[17] Clinical guidelines “Menopausal hormone therapy and maintaining the health of women in adulthood.”Letter of the Ministry of Health of the Russian Federation 15-4 / 10 / 2-5804 dated 02.10.2015.

[18] R. J. Beber, N. Panay, A. Fenton, IMS Recommendations, Climacteris, 2016.

[19] T. S. Perepanova, P. L. Khazan. “The role of estriol in urogenital disorders in postmenopausal women.” Urology. 2007.

[20] V. E. Balan. “Genitourinary or urogenital syndrome. The possibilities of long-term therapy ”. Honey. Advice. No. 12.2016.

[21] V. N. Serov. “Modern pathogenetic therapy of urogenital disorders in postmenopausal women.”2008.

[22] I. A. Apolikhina, E. G. Sycheva. “Correction of estrogen deficiency states in women with urogenital disorders.” Obstetrics and gynecology. No. 4. 2015.

[23] O. V. Trokhanova, M. V. Khitrov, M. D. Bryantsev, Yu. A. Chizhova. “The effect of estrogen monotherapy on the state of the mammary glands in women with menopause.” Gynecology. No. 4. 2015.

Trichologist in Odintsovo and Golitsyno, favorable prices, registration – the network of medical centers “Baby Plus”

If you notice that something is wrong with your hair, you should definitely consult a trichologist.It is quite possible that we are not talking about cosmetic defects, but about hormonal disorders or other diseases that require serious examination and treatment.

In the center of family medicine “Baby Plus” an experienced specialist-trichologist conducts an appointment, who will carry out the necessary diagnostics and prescribe the required treatment. The initial appointment is usually of a consultative nature, during which the doctor finds out the patient’s lifestyle – adherence to the diet, the presence of stress. The question of the presence of allergic reactions must be clarified.

The doctor will examine the head, if necessary, prescribe tests – general blood and urine tests, blood tests for hormones. In the course of the study, the condition of the scalp and hair will be diagnosed using computer microscopy, trichogram, skin biopsy.

Methods of hair and scalp treatment

After receiving the results of the examination, the doctor will prescribe cosmetic or medical procedures.

You should know that a trichologist doctor does not treat the effect, but the cause.Therefore, it is possible to appoint consultations with specialized specialists in order to clarify the complete picture of the disease.

The main methods of treatment include:

Mesotherapy

Helps to stop active hair loss, improve nutrition and blood supply to hair follicles, and normalize the function of the sebaceous glands. The procedure is a series of injections into the scalp. Differs in high efficiency, but does not restore atrophied and dead bulbs.

Plasma therapy (plasma lifting)

It is used for diseases of the scalp (dandruff, seborrhea, fungus), with active hair loss and slow growth, in the presence of thin and weakened hair, with increased hair fat. The procedure is carried out in three stages – blood sampling, separation of platelet-rich plasma, injections of the obtained fraction into the scalp after local anesthesia.

Plasmolifting involves monitoring the hormonal status of patients.If necessary, the procedure is carried out a second time with a break of 1 month.

Laennec therapy (placental therapy)

Laennec is a placenta-based injection drug. Possesses exceptional versatile properties. A feature of the drug is the fact that it itself determines the weaknesses in the body and acts on them.

It is often used to treat any hair problem – dryness, brittleness, baldness. The solution can be administered subcutaneously, intravenously, or at biologically active points.