Fleur-Louise Newsom explores the various physical and emotional symptoms associated with the menopause, and how these can be managed
Menopause naturally occurs in women aged between 45 and 55, although it can also start slightly earlier or later in a woman’s life. The beginning of menopausal symptoms is often known as the perimenopause. The symptoms can vary, and not all women experience each of the symptoms. Regardless, the menopause is a life-changing event for all women, and one that requires special care and attention from an aesthetic medical professional.
One of the first signs of the menopause is a change in a woman’s monthly cycle. It can become heavier or lighter, and become more irregular as time goes on. Amongst the symptoms of menopause are a few that can cause much discomfort. These can include hot flushes, headaches, urinary tract infecions, osteoporosis, vaginal dryness, pain and itching, cardiac issues, weight gain and skin ageing (amongst others).
These symptoms often last for a period of two to five years, during which time the body is accepting the fact that it will no longer be ovulating. This is caused by a natural change in the body’s sex hormones, as levels of oestrogen start to decrease. This prevents ovulation and marks the start of the symptoms stated above. There are, however, several coping strategies for dealing with the indicators of menopause. These are often dependent on the patient’s individual preferences; patients can opt to treat menopause medically with HRT (Hormone Replacement Therapy)1 or more holistically with alternative therapies such as herbal supplements, choosing a healthy diet and also with health care products designed for menopause issues such as Promensil, Menopace, Stratum C Menopause Skin Care, A.Vogel products, Balance Activ, and Wild Yam Cream.
During menopause, the reduction in oestrogen can cause the body to make permanent changes in its appearance and function, hence this time is often known as ‘the change’. Some noticeable differences include the hair becoming thinner and more brittle, often breaking more easily. The skin becomes drier, often becoming itchy and uncomfortable and there is a period of accelerated skin ageing as collagen and elastin levels begin to decline. Some women can experience further skin irritation and sensitivity due to the skin becoming thinner. For example, rosacea can occur, which sometimes appears as permanent redness and spots and can cause the person to feel that their skin is burning. The cause of rosacea is unknown, but it is reported2 that menopause is one of the possible triggers. The physical symptoms that occur as a result of menopause are often the most distressing, and the lack of oestrogen can initiate further health problems, such as higher risk of osteoporosis3 and heart-related illnesses2. This is caused because oestrogen usually regulates the body’s ability to maintain healthy levels of bone mass, and also helps to maintain blood pressure and cholesterol. Studies have shown that whilst hormone replacement therapy (HRT) can be used to prevent osteoporosis in women that experience early menopause3, it is not recommended for women with an increased risk of cardiovascular issues (also relating to many other external factors such as family history, for example)4.
Skin care can become more of an issue at this stage of life. It seems to me that ageing is something that we accept as time goes on and most of us understand that wrinkles are just an unfortunate part of dealing with ‘getting old’. However, as well as this, menopause can also initiate changes in the skin that are less ordinary and often uncomfortable such as itching, redness and dryness5. This change is caused by the body’s lack of oestrogen, which in turn causes your body’s natural supply of collagen (the structural protein of connective tissues in the body), elastin (protein found in the body’s connective tissues such as skin and organs) and Hyaluronic acid (found in the eyes and joints as a lubricant) to decrease as you age6.
These three naturally occurring substances help to keep your skin plump and moist. We always recommend that our customers sample new skin care products before they are applied to ensure that the products are suitable for their hormonally changing skin. We encourage people to read more about what they are putting on their skin, taking care to note down any ingredients that they may find problematic. The best products to keep the skin moisturised and to retain elasticity are those that stimulate natural synthesis of the body’s own supply of collagen and elastin, as actual collagen molecules are too large to penetrate the skin7 and so topical collagen will not have any effect. Though this is not the case for HA which will penetrate the skin and provide intense moisture where needed8. Education here is key to helping women understand the fundamental changes to their bodies and how to increase awareness of ways to reduce worsening symptoms. Some of the most common physical symptoms are hot flushes and night sweats, which can lead to further skin problems, such as itching5 due to raised stress levels, and can generally be an uncomfortable experience and often quite inhibiting for the sufferer. Another common symptom of menopause is drying of the vaginal membrane, also known as vaginal atrophy (VA)9. This occurs because of lack of oestrogen and can be very uncomfortable, sometimes even painful for the patient. VA causes issues when it comes to sex and can be treated with a lubricant or vaginal moisturiser that will help to restore levels of moisture to the area, relieve the dryness and bring normality back to a woman’s everyday life. The lack of libido during this time can often cause further psychological difficulties such as a lack of confidence and depression, which can be treated with the advice of a medical professional. Amongst the symptoms listed above, fatigue and mood swings are said to be associated with a decrease in hormones, though there is varying scientific evidence to support this10. Emotional support can be sought/provided to accommodate the needs of women on whom menopause may have had an emotional effect, such as counselling, and also to help them to adjust to the changes and manage the symptoms that menopause can bring. Treatments for menopause vary depending on the severity of symptoms suffered by an individual, and is dependent on their existing health. Many women opt for HRT if they have experienced an early menopause, though some sources11, would recommend that this does not need to be taken by all women and that cessation of HRT treatment should occur at the age of 50, as taking HRT for longer than necessary (average between two to five years) can cause unnecessary side effects, including an increased risk of breast cancer2. HRT is usually prescribed to help prevent osteoporosis, though it can also help to prevent or at least ease hot flushes and vaginal dryness.
One of the key aspects of managing menopausal symptoms is a healthy balanced diet. Many women have found that they are able to manage the various symptoms by eating certain types of food and avoiding others. These might include dairy in high quantities, alcohol, sugar, caffeine, spicy food, processed foods/saturated fat and hot food and drink when suffering severe flushes. This is to help relieve and prevent symptoms that can often be exacerbated by eating these particular foodstuffs. Women should generally eat a healthy and balanced diet as part of their lifestyle, which will help to improve their physical wellbeing and also help to prevent weight gain, which is reportedly common during this stage of life.
There are many foods that are said to help during menopause, but the research on these is inconclusive and arguably lacking in substantial scientific evidence. However, large numbers of females who have incorporated these foods into their diets have claimed that they made a significant difference in helping them to cope with their menopause symptoms, including black cohosh, red clover, wild yam, evening primrose oil and angelica sinensis. I’m not saying that menopausal women should stock up on supplements. Numerous people worry about their calcium and vitamin D levels, but it is clear that these can be managed successfully with a balanced diet of fruit, vegetables and healthy fats and proteins found in foods such as avocado, nuts, legumes, fish and many other food types12.
Another important factor to help prevent ageing is to drink enough water. This of course applies to all patients, and not just to menopausal women, as drinking water can not only help improve your digestive health, but can better the appearance of skin13 and make the patient feel revitalised and refreshed. I have mentioned that skin ageing is a great concern for many women and it is important for patients to know that there are many ways in which this can be controlled. Eating and drinking well is a prominent factor as skin excretes the toxins we put into our bodies, and the physical signs of this can be blemishes, oiliness and wrinkles14.
Skin can also be cared for using the correct skincare products and cosmeceuticals, ensuring that they contain no harmful ingredients and that they suit the patient’s skin type, which changes during this stage of life. Products that contain alcohol based ingredients are often too harsh for sensitive, thin or dry skin and can cause allergic reactions or cause the skin to become oily15. Using specific products targeted for menopause will assist in caring for changing skin and also help to prevent the accelerated ageing that is expected during this period. Many women choose more invasive procedures, however this can often be problematic due to the high sensitivity and thinning of the dermis during menopause. In the optimum quantities, and according to the latest scientific research, Matrixyl helps to increase collagen levels by up to 70%.16 Matrixyl 3000 (a combination of the peptides: Palmitoyl Oligopeptide and Palmitoyl Tetrapeptide 7) has been used in many ‘antiageing’ products, but is often not used in the correct quantities to make an impact on skin ageing. The correct quantities used should be between a 3-8% concentration, as per the research published in the Journal of Molecular Pharmaceutics16. Products tailored to treat menopausal skin should, in my opinion, contain high levels of quality ingredients that replenish vitamins and anti-oxidants. Skincare products targeted at menopausal women also often contain high levels of hyaluronic acid, a naturally occurring substance that helps keep your skin hydrated and improve elasticity8. It is essential to care for the skin with high quality products to prevent it from becoming dry, itchy and above all, wrinkly. The skin is, after all, the largest organ in the body, and must be taken care of, particularly during this period. Menopause is a time for change, but it does not have to be a change for the worse. By advising your patients as to the right way to care for their bodies, and realising the importance of managing symptoms properly, women can navigate their way through the menopause whilst paving the way to an overall healthier lifestyle.
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