Hormonal aging is one of the least known or discussed causes of wrinkles, dry, and sagging skin. Knowing the impact of waning estrogen on our skin can provide you with understanding of how combat some of the fallout of hormonal aging.
Today I became brave enough to buy one of those tiny but powerful magnifying mirrors in order to better check my eye makeup (I'm still in denial of my 50-something declining vision). It's frightening to face in (15X) focus the reality of the deepening crow's feet. What I know about this I have explained to many of my patients for years: with menopause it is the loss of elasticity that causes these changes; in the face, in the joints, in the walls of our arteries...and of course in the vaginal tissues. The fact is that estrogen has a very powerful role in the promotion of our human elastic glue: collagen. This means that with hormonal aging (accelerated by menopause) we women stand to lose more than our reproductive responsibility.
It may sound like vanity to wax poetic about the plumped up lips I have envied in my estrogen-ripe OB patients, or the flowing hair of my 14 year old as she matures into her femininity. But what of other areas that seem less shameful to miss: bone and joint flexibility, moist eyes, resilient ligaments, and so many other features that seemingly come "unglued," as collagen declines with hormonal aging? It simply isn't fair for the females of our species to abruptly lose such an important substance... and why? Of course estrogen enhances flexibility in the pelvic bones to help with vaginal delivery, and I can understand that the "glow" of peaking estrogen in skin is useful as a signal of who is fertile (and who is not) for the warrior or hunter returning home on a brief leave from his duties, but what is the evolutionary benefit of the matriarch becoming a "little old lady" as a result of her menopause-accelerated loss of bone matrix collagen?
Men have a very gradual decline in testosterone (also a collagen supporter) as their gonads do not have a programmed retirement; this helps them maintain their bone density, muscle strength, even experiencing less wrinkling compare to same aged women for whom Mother Nature has relieved reproductive duty. It's an unfair advantage, and it can put women out of sync with men... a potential problem on many levels.
What can be done?
• Avoid collagen killers: Smoking, too much sun, diabetes, poor nutrition, stress (from excess cortisol), and poor hydration.
• HRT (hormone replacement therapy) can dampen the effect of declining skin elasticity, loss of bone density, and even positively effect elasticity in arteries; but there are well-defined risks along with these benefits. Ask your doctor to help you understand the full risk-benefit profile if you feel you are in need of HRT.
• A diet high in plant protein (soy protein, hummus, nuts, nut butters, foods made with almond flour, etc) can offer the support of plant estrogens, or phytoestrogens, which have been demonstrated to have a positive effect on collagen.
• Omega 3 fatty acids (fish oils and flax seed oils) are excellent "lubricators" of joints (to help with flexibility), improve dry eye, and a host of other metabolic and mood elevating properties.
• Vitamin D: (at least 1000 IU a day) now being thought of as a hormone as it has so many varied effects on body systems, can contribute to a healthy, flexible, bone matrix...and has positive effects on skin as well.
• Calcium: 1000mg prior to, and 1500 mg a day, after menopause through diet or supplements; best spread out through the day, as the body cannot absorb more than 500 to 600mg at once.
• Vitamin C: 400mg day can help support healthy collagen.
• Exercise: Muscle development can stimulate new growth of collagen and prevent atrophy, or loss of muscle mass that can contribute to sagging tissues and declining bone density.
• Biotin: 1000 mcg a day may help support hair and nail strength that often decline with menopause.
• Phytoestrogen supplements: With the decline of estrogen at menopause plant estrogen supplements can help offset the fallout. For a woman not on HRT, 70 mg of isoflavones a day may help support collagen and promote bone health.
• Topical vaginal estrogens: Very effective for vaginal dryness and loss of elasticity, ask your doctor to consider if a prescription is right for you.
As bone density is strongly tied to collagen content, a bone density test can be said to roughly reflect a body's collagen. I'm just as afraid to step into my office bone density (DEXA) machine (now that I've hit menopause), as I was to pick up the magnifying mirror. My inspiration? My dear friend and patient Melinda: slender, late-forties, osteopenic, not on hormones; just had her test. She is devoted to exercise, eats the right foods, takes the right supplements, corrected her low vitamin D level 2 years ago, and despite my trepidation, her density is up...and she has glowing skin! With an understanding of the challenges and a strategic plan, you can hold off the collagen loss...even if you don't have you-know-who's lips.