Synergie Skin
Navigating Menopause: Symptoms, Treatments, and Coping Strategies
Learn about the many aspects of menopause and HRT with Terri (Vinson) Jones: cosmetic chemist, founder of Synergie Skin, and author of Skinformation: A Clean Science Guide to Beautiful Skin.
This educational video will guide you through vital topics concerning menopause and addressing its effects on the skin, including:
– The difference between menopause/perimenopause and their symptoms
– Current data on the health benefits of HRT, estrogen, and progesterone
– Menopausal collagen loss and the anti-ageing ingredients that prevent it
– How to address pigmentation, hyperpigmentation, and hypopigmentation
– How to address Menopausal Acne
– How to address skin sensitivity and redness associated with menopause
– Treatments to address an increase in facial/body
– How to address dry skin
– Exfoliation tips for dull skin related to menopause
Today I'd like to talk to you about juggling menopause but also what skincare to look for and what skin issues can occur during menopause So what is menopause? It's a period where you've had twelve months since your last menstrual period So that's the definition of menopause. but I personally think the period surrounding menopause which is perimenopause is probably the worst time because your hormones are doing that sometimes you have a period sometimes you don't your body is in a complete state of flux It is a time of fluctuation I believe no woman should have to put up with all these symptoms there are ways of managing it the 2002 study from the Woman's Health Initiative or the WHI resulted in tens of thousands of publications that were very very negative about HRT to the point where many women would not even consider HRT who are going through menopause or perimenopause or women who are on it and needed it stopped it the problem with the study firstly they studied women 65 and over in this study these are older women they're on the other side of menopause they're not even perimenopausal A vast majority of these women were obese or had cardiac issues so these were unwell women they did not study healthy, vital women from their mid forties to the mid eighties for example and it wasn't a large cohort the findings of this study were that HRT increased the rate of breast cancer, cardiac problems and blood clots another flaw in the 2002 study was that they didn't use body identical hormones they actually used estrogen from the urine of pregnant horses. now what we tend to use now or what most hormone replacement therapy courses would use and these are the ones I'd use our body identical hormones that means they're absolutely recognised by our estrogen receptors, our progesterone receptors and they're not used from other animals so you can see that that study was very, very flawed the evidence has now been retracted in many cases I'm here to tell you that I'm on HRT I have been on HRT for a number of years, and I will never go off it when you stop producing estrogen and progesterone, your bone density is reduced your ability to have cognitive repair is reduced so you may be more prone to Alzheimer's you are more prone to heart disease so I see HRT, even if I'm no longer having hot flushes, as a way of protecting my body as I go into the aging process I want a health span I also want a long lifespan but I want to be really fit and healthy during that so that's really important we really need to talk about that we need to allay women's concerns and reservations about HRT I'm not telling you to go on to HRT, far from it I'm just letting you know what my experience with HRT has been it's been a really positive one so far I know it is protecting my bones, my brain, my sleep, my skin health, my heart health everything so I believe that it's something needs to be talked about so many of my girlfriends have been talking to me about this over the last few months and we need to talk about it take away that stigma and embrace it because there are so many women that even if you haven't got symptoms you should be on HRT In my opinion women need to be given choices and they need to know the benefits of HRT whether you have symptoms or not this was a 2022 study in the Journal of Obstetrics and Gynecology and they studied over 300,000 women a very large cohort aged between 46 and 64 years of age so a wide range we're talking now perimenopausal and menopausal women and it showed that hormone replacement therapy body identical with estrogen and progesterone reduced the risk of all cause mortality, that's all cause all types of death by 9% that's pretty compelling evidence for every woman going on to HRT I believe in a combination personally of hormone replacement therapy along with skincare to help me stay as vital and youthful and healthy as I enter my sixties, seventies, eighties and nineties so we're going to touch on ten areas of the skin that are affected by hormones and particularly during menopause loss of estrogen and loss of progesterone so perimenopause it's fluctuating menopause It's virtually not happening anymore so the first thing that happens is there's a significant loss of collagen and as we've discussed many times collagen is kind of like the padding in the mattress It keeps the skin firm, supple It's like the mattress stuffing basically the little cells in our skin, in our dermis that are sensitive to estrogen are called fibroblasts and they make the collagen they also make elastin which gives our skin the springiness and also hyaluronic acid so if we've got less sensitivity to the fibroblast to make collagen we're going to get reduced collagen we're going to get sagging skin more fine lines and wrinkles In the first five years of menopause we lose 30% of our collagen and then 2% every year thereafter through our lives so that is significant So how can we address that? there's peptide technology for example, palmitoyl tripeptide 38 is something that I use in my formulations But in terms of your general skin vitamins, your retinoids, your encapsulated retinol hydroxypanicolone retinoate is my favorite retinoid. Vitamin A, obviously, vitamin A is really, really important to stimulate those fibroblasts Vitamin B also stimulates the fibroblast on a different level and it also increases the production of collagen Vitamin C we know is vital as a precursor for collagen production as well so all those skin vitamins are really important and we need to maintain our collagen. collagen on the skin in a jar of skin moisturiser not a big fan okay you need to have ingredients that stimulate collagen collagen is a massive molecule It sits on the top of the skin It's a lovely film form It makes the skin look nice but the minute you take it off at night you've got the same skin so instead opt for the ingredients that get into the dermis that stimulate those fibroblasts that have been sort of they're falling asleep from menopause and wake those fibroblasts back up again to make collagen another sad result of menopause is sagging skin and the sort of jowly appearance and pretty depressing often and one of the major causes of that sagging is funnily enough not collagen loss collagen gives you that that plumpness from firmness but you actually lose bone density during menopause and perimenopause you can see that through bone scans and often osteoporosis is a result of menopause Incidentally, HRT helps with osteoporosis, sort of stop the progression of it It doesn't reverse it but in terms of bone loss, our face gets smaller the skeleton inside our skin gets smaller what can we do? well skincare does not make your bones bigger sorry guys sorry to deliver that bad news you can do the collagen but not the bones so what we need to do is keep our bones strong and that is calcium, vitamin K, vitamin D eat really healthy foods, take HRT but also you can intervene a little bit with dermal filler that will restore lost volume you can also help with firmness and stimulating collagen and getting a little bit more plumpness in your skin with modalities like fractional laser, skin needling Ulthera which is radio frequency skin tightening and that will actually really, really stimulate those fibroblasts to make collagen It won't increase the bone density or the bone size but it will plump up the skin a little bit final option is having a facelift but that is absolutely not for everybody and that's something you need to discuss with a highly qualified plastic surgeon that will address the sagging but it is literally a very aggressive resort to addressing it so I would look at the other options first before going down that path Menopause and acne can often also go hand in hand It's often also in perimenopause when we've got that fluctuating hormone level but it's often to do with androgens and androgens in the female body are basically hormones such as testosterone and, yes, women have testosterone too and it's a really, really important hormone for us really, really important for libido however when there's an imbalance between estrogen progesterone and testosterone you can get hormonal acne so my advice is perhaps have your blood levels tested but it does settle It's more likely during perimenopause than menopause to have menopausal acne the best way of addressing it is to ensure you use good exfoliating ingredients such as your beta hydroxy acid, your salicylic, to pull the oil and debris out of the pores you use your lactic to resurface the surface of the skin also niacinamide and vitamin A both of those ingredients vitamin B three and retinoids actually regulate oil production It's a great ingredient to use when you have too much oil and vitamin B also is very very good at reducing inflammation and regulating oil In terms of treatments, definitely your peels are fantastic, as long as your skin isn't sensitive focusing primarily on your Beta hydroxy acids layered Jessner peels and looking at mandelic lactic and even some of your other Alpha hydroxy acids your poly lactic as well so focusing on exfoliation, getting the debris out of the pores and regulating oil production is really important in menopausal acne skin redness is also something that goes hand in hand with perimenopause and menopause and interestingly estrogen reacts directly with blood vessels this is why we get the flushing the heat It interferes with the thermoregulatory mechanisms in our body and often it stimulates a condition called rosacea sometimes people who've never had rosacea before can be triggered by perimenopause and menopause because of the interaction with the blood vessels so we get that skin redness, that heat, that facial flushing so there are a number of things we can do for that and in terms of HRT, obviously that would be your primary focus but also looking at reducing spicy foods, reducing your alcohol consumption trying to to avoid extremes of temperature, but also ingredients my favorites are Seabuckthorn Oil, Beta Glucan, Acetyl Tetrapeptide 40, which is a fantastic peptide that actually combats facial flushing and just gorgeous gentle ingredients that don't irritate the skin at all so it is a part of menopause redness and facial flushing, but something that can be controlled we also noticed in menopause that we can get changes in our level of facial and body hair unfortunately, there's not a lot of topical ingredients that can address that It is due to increased androgens as well or an imbalance between estrogen and androgens however, there are a few things you can do clinically If you go to a qualified skin therapist or a dermatologist they may recommend IPL hair reduction or laser hair reduction or even electrolysis electrolysis is particularly good for isolated facial hairs so there are things you can do about it and once the levels basically balance out you will see a reduction in that increase in facial and body hair I know one of the things I noticed in perimenopause and menopause was my skin used to be really robust, really tough, I could take almost anything and then it started to become a little bit more sensitive the barrier is not as robust and strong as it used to be we don't have as many lipids in our skin an example is ceramides ceramdies are in our epidermis and they're like the raincoat of the skin they stop water leaving the skin, keep it lovely and hydrated also the PH of our skin drifts a little bit, it drifts to the more alkaline level so if you think our skin is normally about PH 5.6 during menopause it may shift to be a little bit more alkaline and when that happens, that can also disrupt the bacteria on the surface of our skin or our microbiome and when our microbiome is out of whack when we've got less natural lipids when our skin is actually thinner our epidermis is thinner and our dermis for that matter all these changes mean that our barrier is impaired we are less able to fight bacteria and we need ingredients that will help support that barrier. So we need to replenish our microbiome and I love pre and postbiotics for that. I also love vitamin B because as I always say, B is for barrier. It stimulates filaggrin, involucrin, keratin there are major barrier proteins, it also reduces inflammation. So I think my two most important things for when the skin is becoming more sensitive is niacinamide and pre and postbiotic skincare and also use really gentle products on your skin A lot of active ingredients can be quite aggressive. I would stay away from high-level AHA's and BHA's or anything too acidic. Be kind, be gentle to your skin and nurture it through this time. So skin pigmentation issues are another effect from menopause and perimenopause. It's actually quite complicated because too much estrogen, which may occur in perimenopause or prior can cause melasma which is symmetrical pigmentation on the face. Often it's related to pregnancy as well. It's really really interesting that estrogen is sensitive to the melanocytes but then the melanocytes become weakened during menopause and they're less able to fight sun damage. So you may have more surface pigmentation, more sunspots as a result of menopause because your body is less able to fight the causes of the pigmentation from the sun as well as pigmentation spots. You may also notice hypopigmentation or white patches where your melanocytes are no longer active so that can occur as well. Unfortunately there's not a lot you can do to get back the pigment to do with skincare. If there are large areas of loss of pigment you can have a melanocyte graft which can only be performed by a qualified doctor or dermatologist. But failing that, if you've got hyperpigmentation or sunspots, the best option is using ingredients like tranexamic acid, kojic acid, vitamin C is great. L ascorbic acid niacinamide helps with pigmentation because it prevents the transfer of melanin from the melanocyte to the skin cells on the upper level in the epidermis. Vitamin A is fantastic for pigmentation. It reduces the activity of the enzyme tyrosinase that makes melanin. So if you are suffering from hyperpigmentation or spots on your skin, it's fantastic to do the AHA's, your A, B and C and your acids, your kojic acid and tranexamic acid. You can also have skin peels, IPL or laser if you've got more obvious signs of pigmentation. But again, it's a balance. You need to talk to your doctor if you're experiencing large scale pigmentation issues, but if it's minor, topicals are fantastic. Excessive skin dryness is something that I really suffered from through menopause. It's multi-layered. So firstly, remember the fibroblasts we were talking about before, the ones that make the collagen and elastin? Well, they also make hyaluronic acid. And hyaluronic acids are little molecules that can actually bind 1000 times their weight in water. So they are fantastic for plumping up the skin from the inside. Hyaluronic acid in skincare is great, but very very few hyaluronic acids, unless it's hydrolyzed, gets actually to the deeper layers of the skin. So most hyaluronic acid skincare, I'd say over 90%, I would hesitate to say over 95% of hyaluronic acid in skincare is just on the surface making it look plump on the outside, but it's not really getting in there. You need to replace that lost hyaluronic acid. So there's ingredients you can use to actually stimulate hyaluronic acid, which is really important as well. The other cause of dryness is, again, the loss of the natural oils in our skin, such as the cermides and other lipids. So our skin, when it's got less lipid level, it actually is unable to hold the moisture. You get what's called trans epidermal water loss. So your body is losing moisture all the time. But our skin is meant to be waterproof or water resistant. It's not meant to let too much out. So we find our skin gets drier, and then with that comes flakiness, redness, irritation, and that good old barrier that gets broken down. And if the barrier is impaired or disrupted, what happens? Water goes out, bacteria can come in, pollutions can affect it, you can get affected by other skincare products. Even the littlest things can affect your barrier. So it's more important than ever when your skin is very, very dry and impaired to support that barrier and prevent all those things happening. So, again, I can't speak highly enough of my friend Niacinamide vitamin B3. It will do so much to protect that barrier. It increases cermamides, it increases barrier proteins, it reduces inflammation. It is just the bomb at protecting the barrier. Couple that with your pre and postbiotic to keep that microbiome balanced, and those bacteria will keep everything running at an even keel and prevent sensitivity. That's your other best friend, but also nurture your skin with really, really good quality emollient oils. Not the cheap filler oils, not your safflower oil, your sunflower or your almond oil, and not those oils which go off in less than twelve months. Primrose doesn't have a long shelf life. Rose hip oil doesn't have a long shelf life. Go for your long shelf life. Precious oils. Examples are meadowfoam oil, marula oil, squalane, not squalene. Squalane's got a longer shelf life and jojoba. So look at your bottle, look at these oils and say, these are the ones that I want to nurture my skin. Emollients will hold the moisture in. You can even go for semi-occlusive products, because if you're not prone to congestion or oiliness, put an occlusive dressing on your face overnight and put your actives underneath it and really wake up with fully hydrated skin. So there's a number of things we can do, but dryness is very, very common in menopause and something we can all address. Another thing that many women notice during menopause is they may bump their leg, cut themselves, even just having a treatment, that their healing time is significantly longer during menopause. And there's a number of reasons for that. Obviously, our fibroblasts aren't as good at producing collagen, and collagen is a major protein that's produced during wound healing, elastin as well, and also hyaluronic acid is important for hydrating and creating the right environment for wound healing. Blood vessels there's estrogen receptors on the blood vessels. The blood vessels aren't as healthy during menopause, and blood vessel health is essential in wound healing because you need the blood to take all those factors, the interleukins and everything, all those things that are going to help to heal the skin during that chronic inflammatory phase. Interestingly, we say we hate inflammation in the skin, but when there's a wound, inflammation is really, really important, and that's called the acute inflammatory phase. It doesn't stop in menopause, but it's not as optimal. So we really need to make sure that we preserve the strength of our barrier during menopause. And again, going back to the barrier, that's your vitamin B and your pre and postbiotics. If you do have a wound, I do recommend an occlusive dressing with something like niacinamide underneath and cover it and give it its best chance for healing. Another really common menopausal skin complaint is just dull, lifeless skin. Your skin just doesn't have that luminosity it had in your thirties and early forties. And unfortunately, that dullness can get worse and worse as we age unless we do something about it. So why is that happening? So when we're young and vibrant our skin cells turnover at about a rate of every 30 days If we've got acne or a condition where like eczema, psoriasis, the skin cell turnover is much, much higher. That's why you're seeing all this shedding. But as we get older, it gets slow and sluggish a little bit like the fibroblast. They just don't want to do their thing anymore. So we need to give them a gentle helping hand. One of the best things we can do to increase the rate of cell turnover and get those beautiful new fresh cells starting at the basal layer and working their way up and sloughing off and producing this beautiful luminosity is vitamin A, the retinoids. One of the key things retinoids do is increase or regulate the rate of cell turnover. If it's too slow, it increases it. Once those fresh new cells come from the base, they're on the surface, they need to be sloughed off, and sometimes they stick there. When you're older, they don't get sloughed off that easily, so you need to give them a bit of a helping hand and that's where your AHAs or your exfoliants come in. So lactic acid is amazing, malic, mandelic all your alpha hydroxy's are lovely. If you've got a sensitive skin, however, you can use a peptide-based exfoliant that isn't acidic, and that's usually based on yeast and soy peptides, which I love for people with sensitive skin. And we also find that if we've got higher turnover skin cells from the surface, it sends a feedback mechanism right down deep to the skin to say, make baby new cells. So it actually sends that lovely feedback loop. So if you do have dull, lifeless skin, I think the best things you can look at would be your retinoids. And you can also get prescription retinoids from your doctor, but vitamin A is the bomb. And then look at your exfoliants, either your AHAs or your non-acidic ones. Or a gentle scrub would be good too. 100 years ago, women died in childbirth. They died in their forties and fifties. So they didn't experience menopause like we will today. Most of us will be in a menopausal state for, I don't know, 30, 40, 50 years. And we don't need to live through hot flushes and mood swings. We don't need to live with bone loss and loss of cognitive function and heart disease and all the other things that go along with losing estrogen and progesterone and testosterone. So I'm a great advocate and I think we can combine that with skincare. So I hope today I've given you some ideas about how to optimise your skincare routine through menopause, but also talk about some of the truth related to the studies and what I personally believe in. I want to go through this journey for many more years to come and and I hope I've helped you on your journey too.
#Navigating #Menopause #Symptoms #Treatments #Coping #Strategies
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