Submit the Form Below and we will Respond

PromptlyDISCLAIMER: Pass the Pearls will select most frequently asked questions that will be featured and answered by our experts. We will not reply directly to you. This does not constitute a doctor patient relationship, nor is this direct medical advice. All questions and answers if selected will never contain personal or private information.

Question:

I had my hysterectomy and ovaries removed last year and I’m not taking HRT – as I’m 50 years old. I’ve noticed that fine lines have begun to appear on my face and the texture of my skin has changed. Is this something that is related to my HRT? 

Answer:

Hormonal aging begins with the decline in estrogen levels around the time of menopause. Estrogen is important in promoting collagen. The loss of collagen causes decrease elasticity in the skin, joints, vascular system and vagina. There is a notable thinning of the skin and fine lines and sagging may appear. These changes also have in impact on bone and joint flexibility. Hormones are important for reproduction, but as they decline there can be profound effects on aging beyond hot flashes.

I started noticing this change in collagen and skin with my patients from one annual exam to the next. Anne is a good example. I hadn’t seen her for a year at the time of her last well exam when she just started noting that she was skipping some periods. At her yearly visit, I noted that she looked different because her skin did not have as much of a glow and she had more fine lines around her eyes and mouth. Not surprisingly she told me that she no longer had her periods at age 51. We cannot prevent menopause so it is a natural aging process that all women go through. My dear friend and partner, Dr. Rebecca Booth, calls it “ovarian retirement” in her book, The Venus Week. She beautifully addresses hormonal aging and the amazing menstural cycle as well as the lack of menstruation at menopause or with ovarian removal.

Just because women can no longer reproduce with the decline in their ovarian hormones, it doesn’t seem fair that they should lose such an important anti-aging substance with menopause. Compare that to men who have a very gradual decline in their testosterone that helps to promote collagen. This helps men with muscle mass, bone strength and possibly less wrinkles in their faces! This can put women on a different aging path than their same-aged male counterparts.
This doesn’t mean that all women should go on hormonal therapy since there are risks involved, but it an important option that women have as they go through menopause and should discuss with their medical provider.

What can be done?

1. Avoid cigarettes, sun, poor nutrition, stress, and dehydration.
2. Hormone therapy may help slow down the hormonal changes that cause bone loss, skin wrinkles, joint pain, and vaginal pain. Be cautious because there are important risk factors along with benefits and it is important to determine with your doctor your individual risk factors.
3. Certain foods that are phytoestrogens can help promote collagen including, nuts, hummus, soy protien, and lentils.
4. Supplements such as omega 3 fatty acids (fish oils and flax seed oils) may help lubricate joints.
5. Vitamin D is very important for healthy skin and bones. Make sure that you get 1000 IU per day and consider having a Vit D level checked.
6. Calcium 1500mg per day after menopause is suggested and I encourage dietary sources.
7. Vitamin C 400mg per day helps with collagen support.
8. Biotin 1000 mcq per day helps with nail and hair strength.
9. Exercise should probably be at number one as it helps to maintain bones and muscles and new growth of collagen. And it improves circulation.
10. Topical Estrogen helps vaginal elasticity and moisture.
11. Over the counter phyto-estrogen supplements can also help with symptoms of menopause.