Menopause and Beyond

Our skin through menopause

Thanks to adequate nutrition, modern medicine and technology, human life expectancy has increased over the past 150 years. Female life expectancy exceeds that of males and is approximately 82 years in Australia. The average age of menopause has remained stable at 45-55 years. This means that women will most likely live for 30-40 years post menopause. The dramatic shift in hormone levels after menopause means we must learn to adapt and thrive in a changed body, either accepting or becoming more active in the fight against ageing, particularly when it comes to the look and feel of our skin.

What happens to our body during menopause

As we enter the post-reproduction phase of our lives, signaled by the cessation of ovulation and menses, our hormone levels begin to fluctuate. This can lead to a range of symptoms including hot flushes, sweats, mood swings, irritability, insomnia, joint aches and vaginal dryness.

What happens to our skin during menopause

Falling estrogen and progesterone levels during menopause limit the ability of our cells to produce collagen, the protein that gives our skin structure and strength, plumping and firming its appearance. A decrease in sex steroid production also causes collagen degradation, or the breakdown of the connective tissue that supports skin firmness. So, whether we like it or not our skin will become thinner and start to form more noticeable wrinkles during and post-menopause. Skin may also become increasingly dry and need more intensive moisture to stay hydrated. The tone and texture of skin may also change as the gelatinous, interfibrillar ground substance between our cells decreases and causes some irregularities in the size and shape of our skin cells.

Skin ageing explained

Our skin ages for many reasons. Some skin ageing is caused by extrinsic factors such as sun exposure and the forces of gravity. But a large part of how and why our skin ages is intrinsic and takes place at a cellular level in the body. Some of these internal, physiological causes are influenced by menopause and the hormonal changes our body experiences throughout this time, but there are other factors unrelated to menopause too.

Although we don’t fully understand all of the underlying causes of ageing, an accumulation of cellular toxins and repeated DNA damage from environmental stressors, over time, are believed to be the main factors associated with ageing, and the visible signs of ageing we observe in our skin.

Could science discover a fountain of youth?

Despite the uncertainty in cause and effect, scientific research continues to move forward and offers us some hope. Scientists have successfully slowed the ageing process in flies, worms and mice by restricting calories and modifying genes/proteins that are associated with longevity. Some of the genes and proteins that have been associated with increased longevity in other species are now being explored for their potential to increase human life span and slow down our own ageing process

Of particular interest is the sirtuin proteins and their co-enzyme NAD+. The relationship between NAD+ and sirtuins is incredibly important. Sirtuins have the capacity to activate mitochondria, (the energy powerhouse of our cells), preventing physiological changes. NAD+ is essential for cellular energy production (ATP), and among other things, is critical in DNA damage repair and maintaining chromosomal integrity. Restoring NAD+ levels and activating sirtuins may have health benefits and play a critical role in slowing the ageing process. This notion is currently under rigorous investigation./span>

What can we do?

Menopause is a natural process, not an illness. We don’t necessarily need to treat menopause, but for some women finding relief for their symptoms can ease the transition into this next stage of life.

Positive lifestyle choices are important for women going through menopause. There is some evidence that foods containing phytoestrogens – soybeans (edamame), tofu, wholegrains and legumes can help reduce the severity of menopausal symptoms, along with regular exercise, adequate sleep, reduced alcohol consumption and cessation of smoking. Women who are of a healthier weight also report fewer menopausal symptoms, than women who are overweight.

Early prevention is key and caring for our bodies through lifestyle measures can help to preserve the health of all body organs, including our skin. Limiting our sun exposure is also incredibly valuable at maintaining the health and long-term integrity of our skin.

Hormone replacement therapy, (HRT) can be effective at treating many of the symptoms of menopause and some women report improvements in skin quality. This highlights the role our sex hormones play in maintaining skin structure. The side effects of HRT are serious, however, including an increased risk of endometrial and breast cancers. For many women, the risks outweigh the benefits when it comes to HRT.

One of the most powerful things we can do in the fight against ageing, is to simply stop fighting. If we accept our age, and the inevitable changes to our skin that come along with it, and instead begin to appreciate that these changes to our outward appearance don’t necessarily make us any less beautiful, we will not only feel better, but we might just look better too. The signs that we are healthy and happy are certainly visible to others, even through our wrinkles. Bright eyes, positive energy and a warm smile can go a long way towards other people’s perceptions of how attractive we are. My daughter tells me I am the most beautiful person she knows. She doesn’t care about the wrinkles around my eyes. And the lines that are forming around my mouth tell me I’ve spent a lot of time smiling.

Let’s work together and change the conversation. Let’s celebrate the remarkable functions our bodies have performed over our lifetimes, the lives they have created, nourished and nurtured, the work we have done, the physical feats we have attained. Stop waging war in a battle we can never truly win and just be happy with who we are today, and how far we’ve come to get here.

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Disclaimer:
Dr Hayley Dickinson is a research scientist with a PhD in women’s reproductive health, who does not claim to be a medical practitioner. We seek to offer insights into the health of women experiencing the reproductive, menstrual and hormonal characteristics of female biology. In addition, we offer scientific insight into wellness and lifestyle choices relevant to all. Neither endota nor Dr Hayley Dickinson accept any liability for the information or advice (or use of such information or advice) which is provided in this blog or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for evaluating its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest hospital Emergency Department. © endota, September 2018

References:

• Sator PG., Sator MO., Schmidt JB., Nahavandi H., Radakovic S., Huber JC., Honigsmann H (2007) A prospective, randomized, double-blind, placebo-controlled study on the influence of a hormone replacement therapy on skin aging in postmenopausal women. Journal Climacteric 10(4):320-334

• Philips N., Devaney J., (2003) Beneficial regulation of Type I Collagen and Matrixmetalloproteinase-1 expression by estrogen, progesterone, and its combination in skin fibroblasts. J. Amer. Aging Assoc., 26:59-62

• Estep PW., Warner J., Bulyk ML., (2009) Short-Term calorie restriction in male mice feminizes gene expression and alters key regulators of conserved aging regulatory pathways. PLoS ONE 4(4):e5242

• Garcia-Peterson ML., Wilking-Busch MJ., Ndiaye MA., Philippe CGA., Setaluri V., Ahmad N (2017) Sirtuins in skin and skin cancers. Skin Pharmacol Physiol 30:216-224

• Watroba M., Szukiewicz., (2016) The role of sirtuins in aging and age-related diseases. Advances in Medical Sciences 61:52-62

• Jean Hailes – Menopause management - https://jeanhailes.org.au/health-a-z/menopause/menopause-management