Ménopause et peau (Pour les professionnels)

Menopause and the Skin (For Professionals)

How to Take Care of Your Skin during Menopause ?

• The middle to late 40s is a critical period in a woman’s life. It is the age when menopause occurs. In medical literature, menopause is defined as the day a woman has been diagnosed as not having a menstrual period for 12 consecutive months. This signifies the permanent cessation of menstruation.
• During menopause and the period of its transition, known as “perimenopause”, fluctuations in menstrual cycles and hormonal changes occur. This is evident from the signs and symptoms that a woman may experience. During this phase, a woman may experience irregular menstrual periods, hot flushes or night sweats, difficulty in sleeping, mood swings and depression, and vaginal dryness. However, what is remarkable is that some disturbing problems that menopausal women encounter manifest themselves as skin problems, such as dryness, laxity and falling hair.

But why does these happen?

• We may not be aware of this but our hormones affect our skin in some ways. Our skin has abundant receptors for estrogens.  To remain healthy, these receptors have to be activated to maintain our skin thickness, elasticity, hydration, and vascularized. There is no problem with these for healthy young women because the ovaries secrete enough estrogen and progesterone.
• But, in postmenopausal women, there is reduced estrogen secretion, thus collagen content also decreases, especially on sun-exposed areas. If collagen is decreased, wounds cannot heal adequately. In addition, there is a decrease in firmness, while at the same time there is a decrease in the elasticity of skin.

• Thus we can see that postmenopausal women are prone to a lot of skin diseases. We are going to mention them here below:

1. Vulvovaginal candidiasis (less frequent in this age group than in younger women). This means that there is fungal infection around the vaginal region. If you once used oral contraceptives or other hormonal therapies, you are prone to develop this.
2. Menopausal flushing is also common. This occurs in 70-80% of women and manifests as a reddening of the face, neck and upper chest. This lasts 3-5 minutes and subsides quickly. This may be associated with sweating, palpitations, anxiety and sleep problems.
3. Hirsutism, which is abnormal hair growth in women. Facial hirsutism is common in women not using hormonal replacement therapy. Conversely, some women may have alopecia, or hair loss from areas where it is not usually present. This usually occurs at the front and on the top of the scalp (frontal).
4. Keratoderma climactericum = skin on the palms and soles of the feet are thickened. This commonly occurs in obese post menopausal women. As a result, there may be itching and painful cracking or splitting on the said skin areas.
5. Vulvar lichen sclerosus et atrophicus (LSA). This is a chronic, atrophic skin disease that affects mainly the anogenital area. The patient may feel itching and irritation, and the vulva may have white, thinned, wrinkled skin prone to fissures and tears. This leads to painful intercourse. This is possibly related to autoimmune diseases.
6. Vaginitis. It is an inflammation of the vagina often due to an infection. It can result in discharge, itching and pain, and is often associated with an irritation or infection of the vulva. The three main kinds of infectious vaginitis are bacterial vaginosis, vaginal candidiasis (yeast), and trichomoniasis (protozoa). A woman may have any combination of vaginal infections at one time.
7. Vulvodynia. It is chronic vulvar burning, irritation, stinging and rawness, rather than itching. This may also involve thighs.
8. Atrophic vulvovaginitis means thinning of the vaginal skin including the entrance to the vagina. The patient may feel itchiness, tenderness, a burning sensation, painful intercourse and painful urination. What is noteable about this condition is that the vulva is less affected. This is because it contains fewer estrogen receptors than the vagina.

Knowing these things, how can menopausal women prevent these skin problems?

• One is placing them on hormonal replacement therapy or HRT.  Hormone replacement therapy (HRT) has been shown to have beneficial effects in preventing many of the signs and symptoms experienced in menopause, including urogenital and general skin and hair problems. HRT may consist of eestrogen tablets, patches, vaginal rings, implants or creams (for atrophic vulvovaginitis), or a combination of estrogen and progesterone as patch or tablet. However, HRT is no longer recommended for healthy women without specific problems caused by the menopause.

• Aside from these, you can take control by avoiding soaps and harsh rubbing of the affected area to prevent further irritation of the skin. Your doctor will prescribe you with topical or oral antibiotics if infection is present.

• Use emollients and bland lubricants to keep the area moist. If there is pain, some anti-inflammatory pills or antidepressants prescribed by the doctor may help.