A common comment I hear among women who are in menopause is “I feel like I’ve aged overnight.”

Although this sounds “impossible”, it is plausible as there can be significant changes in the skin when our hormones (particularly oestrogen, progesterone and testosterone) decline to “nothingness” as we move through this natural progression in a woman’s life.

The top skin concerns I see in my practice in this season are:-

1. Dry skin (+/- itchy or sensitive)
2. Increasing lines and wrinkles
3. Redness or flushing (e.g. rosacea or dermatitis)
4. Hormonal acne

This blog is not about addressing these concerns when you are suffering from it. This is about preparing your skin to minimise these drastic changes so you don’t feel like you’ve aged overnight but rather gradually and more in control. 

This also applies preparing your skin for surgical menopause.

Surgical menopause is menopause induced by surgical removal of both ovaries commonly undertaken during hysterectomy to treat various medical conditions. Women who go through surgical menopause can feel and see the changes more drastically as the body would not have the natural run up to menopause through perimenopause.

Perimenopause is the time before your last period. It typically starts from mid-40’s but for some can be as early as 35. Symptoms e.g. low energy, mood swings, PMS, low confidence, low libido and change in your periods can all be the norm. For some it can be mild but for others, it’s like navigating through turbulent seas.

This is due to ovaries slowing down in releasing eggs so hormones don’t follow the predictable monthly pattern and fluctuate (sometimes wildly). During this time, women not only FEEL a difference in themselves but can also SEE a difference in their skin.

Before we get stuck into specific routines, I want to make sure you know what happens to your skin during peri / menopause?

Quick anatomy of the skin and overview of hormones. 

The skin is made up of epidermis, dermis and subcutaneous laying over muscle and bones to protect internal organs.

PERIMENOPAUSE

Perimenopause generally comes in 2 phases

Phase 1 (Early Perimenopause) – Progesterone starts to drop first.

This is a skin and mood calmer, helping you sleep better and control cravings. When progesterone is low, skin can get oilier, it breaks out, becomes more sensitive and flushed. Oestrogen then becomes relatively more in the equilibrium, resulting in water retention, puffiness and increased pigmentation.

Phase 2 (Late Perimenopause) – this occurs in later years when Oestrogen starts to fall too.

Oestrogen keeps us sharp, feminine, calm and on the ball. It also protects our bones, heart, gut and brain. For the skin, it controls skin hydration and collagen production.

Skin becomes dry, itchy, sensitive. Dryness from loss of water from the thin epidermis, loss of oil which protects the skin. It thins so it becomes more translucent and we lose the glow. Vessels become more fragile so we bruise easier and can have broken veins. Wrinkles and folds become more prominent. Fat distribution changes – it depletes in some areas (e.g. the eyes) and expand in others (e.g. the jowls). Bone density reduces so the facial bones become flatter and shorter, creating an ageing look.

There are also other hormones involved:-

1. Testosterone drops which reduces muscle tone and skin firmness
2. Cortisol increases which increases inflammation, wear & tear and indirectly disrupts sleep, gut health and sugar regulation which invariably affects immunity and skin repair.
3. Thyroid becomes sluggish which causes dry skin. It’s also important for regulating weight, metabolism, energy levels, skin, nail and hair growth, brain health and fertility.

Growing old might sound scary but my aim is to educate you on what goes on with your hormones and skin so you can choose how to improve it or change it if you wish to.

So let’s dive a little deeper into preparing your skin for this new season of your life (whether naturally or surgically).

Skin care routine

The aim is to strengthen the epidermal barrier, nourishing it so it repairs and regenerates, boosting hydration and protecting the skin against external damages.

Step 1: Gentle cleansing (PM) to remove pollution and makeup, while soothing and hydrating the skin.

Step 2: Repairing (AM + PM) e.g. with Niacinamide and Peptides to support skin repair, brightening the skin, reducing irritation and wrinkles.

Step 3: Nourishing (AM + PM) e.g. with Antioxidants, Vitamins A, C and E to feed the skin. Vitamin A + C helps to produce collagen and maintain skin’s elasticity. Vitamin E hydrates the skin and prevents cell damage.

Step 4: Hydrating (PM) with hyaluronic acid serum and moisturiser.

Step 5: Protecting (AM) with SPF to protect against UV damage.

Food & Supplements

1. Eat more foods rich in Vitamin C, B6, Magnesium and Zinc which are important for the production of progesterone, skin repair and reducing inflammation. These include spinach, leafy greens, walnuts, lean red meat (for zinc), seafood, fish, beans, pumpkin seeds, bananas, dark chocolate, watermelon and chick peas.

2. Eat Healthy fats e.g. avocado, chick peas, nuts, oily fish, olive oil, pasteurised chicken eggs, butter from grass fed cows and coconut. This will help maintain skin hydration and strengthen skin cell walls.

3. Eat enough protein as you need it as building blocks to make collagen e.g. chicken, eggs, lean meats, beans, quinoa and low mercury fish. Aim for 70-90g of protein a day, even more if you exercise regularly.

4. Maintain copper – an essential element for optimal collagen formation. The recommended daily allowance is 2mg/day. Foods rich in copper are liver (e.g. 1 TBS of pate = 0.5mg), oysters (1 wild caught = 0.5mg) + sesame seeds (1 TBS = 0.4mg).

5. Take a multivitamin + multi-mineral supplement especially if you live a hectic or stressful lifestyle or know you’re not getting enough nutrients from your food. I usually recommend taking an extra Vitamin C 750mg/day for added immunity.

6. Take an Omega 3 at least 2000mg/day as it reduces inflammation, reduces cortisol and reduces the skin susceptibility to UV damage by 50%.

7. Optimise Vitamin D levels as it increases immunity and protects the skin. I recommend a maintenance dose of 2000IU/day.

8. Take a collagen supplement or make your own healthy bone gelatin broth. There are collagen powders, capsules and liquids. Aim for at least 5g/day. Go up to 10g/day if you’re exercising regularly or if you’re due to have collagen skin boosting treatments.

9. Take Epsom salt baths (2 cups in a bath 2-3x a week) or use a magnesium oil spray every day to boost your magnesium levels. If you prefer, you can take a magnesium glycinate capsule in the evening. Magnesium can help improve PMS, calm nerves and improve sleep.

10. Consider taking Vitex (Agnus Castus) or chaste berry which has a weak progesterone effect so helps with PMS, mood swings and sleep.

I want to introduce you to brand of supplements that I recommend to my patients going through the transition. Personally for me, I’ve been able to swap my 10 bottles of different pills and frills. I can definitely feel the difference in how I go about my day. I have more focus, more calm and my energy feels more stable when I take them.

It’s called Menopause Support by NuMind Wellness and it’s formulated by my brilliant friend, Charlotte Hunter, a functional nutritionist specialising in hormonal balance.

NuMind Wellness was originally started by two brothers who suffered from anxiety. From sleepless nights, panic attacks and deliberately avoiding social situations, they seeked out, working with professionals to create an all-in-one Stress Support Formula which was their first hero product. Now they are helping women like me to better handle the stresses of life in our fabulous years… with a little more resilience and grace.

It comes in daily sachets with 6 capsules containing essential vitamins, minerals, adaptogenic ancient herbs, flower remedies and a hormone supporting blend. So it’s easy to carry and less likely to forget.

I love that her formulation contains proper doses that will actually make a difference including Vitamin D 2000IU for skin and bone health, Magnesium 250mg for better sleep, Inositol 50mg and chromium for better insulin sensitivity and sugar regulation. You can purchase it from The Natural Dispensary and use TLOONG10 for 10% off. 

Lifestyle

1. Remove sources of stress and get better at managing your stress because stress depletes progesterone even more through a process called “cortisol steal”. Stress also increases the hormone cortisol which increases inflammation, collagen breakdown and premature ageing.

2. Minimise or avoid caffeine because this increases the stress response and forces your body to excrete important minerals required for healthy hormone production.

3. Minimise or avoid alcohol because it’s dehydrating, affects deep sleep and disrupts healthy liver detoxification.

4. Get good quantity and quality of sleep (if you only do this, it will make a HUGE difference) as your skin, body and brain repairs overnight.

If you’re in perimenopause, you may be suitable for body-identical HRT to help stabilise the hormone fluctuations and replacing hormones that are depleted.

extra I hope this blog helps to give you some guidance on where to focus your efforts on in preparation for the next decade. Every woman goes through perimenopause and menopause (natural or surgical) differently. We can do our best to prepare for it but sometimes it hits us “out of the blue” and leave us scrambling to make sense of all the changes inside and outside of us. We can only do our best, be compassionate to ourselves and others and know the season will pass. 

If you do suffer from any of the skin concerns I mentioned above and need support managing them, I’ve written more detailed blogs on the topic below.

Combatting Dryness and Dehydration in Your Skin

Wrinkle Rebellion

Improving Skin Laxity: Solutions for Firmer Skin

8 Reasons Why Your Skin is Not Clearing as an Adult

If you resonate with my approach and would like some help to prepare for your next decade, get in touch by emailing [email protected] 

Until next blog, here’s to embracing the next decade with fabulousness.

Dr Terry