Even the most serious and global changes occur gradually. And the same goes for menopause. A woman may still not notice anything, but the body is already preparing with might and main – hormones change, the activity of the endocrine glands changes, the hormonal background is disturbed, the reproductive function decreases.
About why a comprehensive approach to the treatment of dermatological diseases during menopause is necessary and also about modern methods of hormonal correction, read in an exclusive interview on estet-portal.com with a cosmetologist, a specialist in aesthetic medicine, Irina Phillot.
The need for an integrated approach of a cosmetologist during menopause
IF: I would start by saying that menopausal women are the group of patients who most often go to clinics for aesthetic procedures.
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Therefore, for us, as practicing cosmetologists and dermatologists, plastic surgeons, it is important to know about everything that actually happens with the hormonal background of a woman during menopause, that is, we ourselves must educate ourselves in this direction, and also provide information to our patients. Thus, the aesthetic correction itself can be more significant, more satisfactory. Also patients' expectations will be more realistic when they understand that they really need to approach this issue in a comprehensive manner.
Changes in the condition of the sebaceous glands during menopause
Physiological changes in the body of a woman during menopause
IF: Since we are all doctors first and foremost, we must understand all the physiological processes that take place in the body of a woman during menopause.
Hormones related to menopause are sex steroids (estrogens, progestogens, androgens) and hormones of the hypothalamic-pituitary-ovarian system.
Estrogen, our beauty hormone, is the main steroid responsible for secondary gender characteristics in women, affects most body systems. The main circulating estrogen in reproductive age is 17β-estradiol. 95% of circulating estradiol is produced by the ovaries, small amounts by the adrenal glands and by peripheral conversion of testosterone and estrone.
After menopause, the main circulating estrogen is estrone (biological activity is approximately less than 30% of that of estradiol). The rate of production of estrone and estradiol in the reproductive years & nbsp; 80 and 500 mcg/day, and in postmenopausal women 40 and 6 mcg/day, respectively. These facts speak for themselves, how significantly the hormonal background of a woman changes.
As ovarian function naturally declines, less estrogen is produced. Physically, to one degree or another, this manifests itself in the form of such subjective symptoms & nbsp; like breast ptosis, dry mucous membranes, no or scanty menstruation, menstrual cycle too long or too short, migraines during menstruation,
The skin is the second most hormonally dependent organ after the reproductive system. With a decrease in estrogen levels, atrophy and dryness of the skin is noted due to a decrease in the secretion of the sebaceous glands and the level of glycosaminoglycans in the skin, since estrogen controls the expression of some pro-inflamatory cytokines - skin immunity decreases and wound healing worsens, and of course the skin becomes less dense and elastic due to a decrease in the content collagen and elastin.
According to one data, the content of collagen decreases by an average of 2.1% per year during the first 15 years of postmenopause. According to other scientific studies, 30% of collagen is lost during the first five years after menopause. As you can see, the approach to therapy during menopause − it's a complex issue, but we need to be aware of it and also educate our patients.
Today, women can avoid or limit some of the side effects of menopause with hormone replacement therapy, herbal medicine, and appropriate cosmetics can complement the beneficial effects of HRT on the skin.
First of all, for effective treatment during menopause, correct diagnosis is necessary.
Today, we have the opportunity for laboratory analyzes of the hormonal background, but at the same time, we can simply conduct a clinical analysis, focusing on subjective symptoms that indicate a reduced level of a particular hormone.
Because it's not just about estrogen, but progesterone and androgens also affect a woman's condition during menopause. In this regard, having basic knowledge & nbsp; endocrinology, we can conduct our own analysis and, for example, if we simply focus on the state of the woman's menstrual cycle, then we can already afford to draw some conclusions about the hormonal background.
Features of skin diseases during menopause
The use of phytoestrogens to correct hormonal levels during menopause
I.F.: In our clinic, for the correction of hormonal levels, we use, as directly hormone replacement therapy, but I also believe in the effectiveness of mild hormonal correction by natural means, namely phytoestrogens.
Phytoestrogens are plant derivatives that structurally resemble endogenous estrogens, isoflavones being the most common. For example, the isoflavone genistein has been shown to benefit aging skin in terms of photoprotection, elasticity, and skin hydration.
Although the scientific evidence base for the use of phytoestrogens is still weak, but examples in our practice have a very positive result, and I believe that this is the future. Because if we recognize the symptoms of hormonal imbalance in a timely manner, before the onset of the menopause period, if we start correcting the hormonal background, soft correction with phytoestrogens in time, then in this way we can make the entire period of menopause more harmonious, more comfortable for a woman.
Today, there are a lot of natural active ingredients and herbs with an optimal content of phytoestrogens, or herbs with other active ingredients that are relevant for correcting the unpleasant symptoms of hormonal changes. There are certain protocols that we focus on when prescribing, but in a strict order only on the basis of clinical or laboratory analysis, taking into account the individuality of the patient. If a woman has already entered the menopause period and is very difficult to endure this period, then here, as a rule, we work in collaboration with gynecologists to correct the hormonal background.
Menopausal hormone therapy can prolong life
What is very important, we must not forget that with regard to hormone replacement therapy, we should not use it for aesthetic purposes, we must always be aware of the serious side effects that can occur with long-term use of hormones, such as the risk of developing breast cancer glands, heart disease, stroke and blood clots! But phytoestrogens, when properly administered, act more gently, and if we use them correctly, prescribe them on time, then of course this will lead to a good result.
Prospects for hormonal correction as a preventive technique in aesthetic medicine
IF: I think that in general, this is the future. Because we are still trying today to see some prospects in the development of aesthetic medicine and preventive medicine in this regard is very interesting to us. And competent correction of the hormonal background − this is part of just these preventive programs. If you focus on this, if you go deeper, then this is a very interesting topic.
And in general, we need to rethink how we view menopause, not as a state of "loss" but as a life transition in which the health professions can provide significant support. Ideally, cosmetologists should work in synergy with gynecologists and endocrinologists.
"Dry" problem: genitourinary syndrome during menopause
If you really master this knowledge, if you find an opportunity to produce environmentally friendly natural components, which, unfortunately, is not possible everywhere, then this is a very interesting direction, which can become part of not only the prevention of those undesirable processes that occur to a woman during menopause in the field of aesthetic medicine, but also in preventive medicine in general.
Fever Again: Vasomotor Symptoms During Menopause
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