It must be my hormones. And now it is often repeated to explain the series of problems it causes to different parts of our body for a certain group of women, especially middle-aged people. But learning more about our hormones, and estrogen in particular, has shed more light on their role in our overall health and why we should pay so much attention to them.
What is Estrogen?
Estrogen is a group of hormones (three types are estradiol, estrol, and estrone) that help regulate the menstrual cycle and affect various parts of the body, including the urinary tract, bones, breasts, skin, heart, and the throat. . Blood vessels, pelvic muscles and brain. And estrogen plays an important role in female genital health. "Estrogen helps maintain the structure and elasticity of the vagina, helps keep the walls thick and flexible, and helps with vaginal lubrication," says Somi Javid, MD, board-certified OB/GYN and founder of HerMD. Recently in New York. York. City. . Sweater. Because there are more estrogen receptors in the female brain, there is also a cognitive connection (with learning, attention, memory and development). "Estrogen affects areas of the brain such as the prefrontal cortex and hippocampus, affecting mood, motor coordination, pain perception, cognition and protection against stroke, as well as Parkinson's disease and Alzheimer's disease ”says Mary Jacobson, MD, an obstetrician-gynecologist. . and Ciao Alpha Medical Director. "It also plays a role in regulating serotonin, the feel-good hormone in our body, which has a positive effect on our mood and prevents anxiety and depression," Javid said.
What does estrogen have to do with the skin?
As you can see, it takes a lot to keep your skin healthy. "Estrogen increases the production of dermal collagen and elastin, which are responsible for keeping skin firm, firm, and youthful-looking," says Javid. In addition, estrogen promotes wound healing, protective functions of the skin and most importantly, increases hyaluronic acid to nourish the skin. "It does the same for the foreskin, keeping the vaginal lining moisturized," says Mona Gohara, a Connecticut dermatologist who trained at Yale University.
When does estrogen decline occur?
During the second half of each menstrual cycle, most women experience a decrease in estrogen levels for the first time. "During menstruation, estrogen levels undergo physiological changes based on a complex interaction between the hypothalamus, pituitary gland, and ovaries," adds Jacobson.
As we go through and approach menopause, the levels of estrogen in our bodies (as well as progesterone and, as research shows, testosterone) gradually decline. But this decline may not be sustainable, Javid says. After a woman goes through menopause for 12 consecutive months without menstruating, estrogen levels are consistently low.
What are the effects of these estrogen drops?
In short, the impact is enormous. When estrogen levels drop briefly during menstruation, it triggers PMS symptoms such as mood swings, migraines, breast tenderness, and skin sensitivity. Javid says that the drop in estrogen levels during menopause reduces the number of beneficial lactobacilli in the vagina, maintaining the pH level that protects against infection, disease and inflammation. According to Javid, estrogen is thought to contribute to the mild cognitive impairment (affecting up to 62 percent of women) associated with perimenopause and menopause, such as confusion, forgetfulness, inattention, and difficulty finding words. In Bridget Everett's excellent HBO comedy Somewhere, Sam asks Joel why he can't remember anything. "Menopause? Perimenopause." [ Laughter ] “What's the difference? Shit, nobody knows." When the skin on the vulva and face sags, it becomes very dry. "People often don't associate estrogen or lack thereof with the aging process, even though it does play a role," Gohara explains. wrinkles are more visible, she says.
How to replenish lost estrogen?
Some doctors recommend that women take oral contraceptives (such as pills or patches) for the first discomfort of early menopause. Treatment options during menopause generally combine lifestyle changes, non-hormonal interventions, and often hormone therapy (HRT). Despite hormone therapy's problematic past, recent NAMS (North American Menopause Society) guidelines have confirmed it as the gold standard choice. Estrogen-containing hormone therapy (with or without progesterone) can generally be divided into local or systemic therapy. "Local therapy refers to treating the affected area, such as the penis," Javid said. "Systemic therapy, which is administered by a variety of methods including orally, patches, sprays, gels and rings, and generally contains a higher dose of estrogen than the local dose, which enters the bloodstream and is distributed to all body parts." Systemic estrogen therapy helps with hot flashes, vaginal dryness, night sweats and bone loss, Jacobson says, and improves sleep and sexual function, as well as a better quality of life. Javid points to new research on the benefits of testosterone therapy for improving sexual function, arousal and desire. Among all these brain-related menopause studies, recent studies have shown that hormone therapy can prevent cognitive decline and improve some brain health conditions in women with certain genotypes. However, Jacobson cautions against using bioidentical hormones because they aren't highly regulated.
Is there too much estrogen?
Yes, and it's already known as estrogen, says Monica Grover, MD, OB/GYN and chief medical officer of VSpot. "This could be an imbalance of testosterone or progesterone, which regulates estrogen levels," explains Grover. This excess can cause some diseases including cancer. Downey says he was relieved by the number of patients with estrogen receptor-positive breast cancer and various cancers of the uterus, endometrium, and cervix. "For some, it can be like estrogen," she says.
Are topical estrogens good for the skin?
The opinion of doctors on this matter is divided. Ellen Marmur, MD, board-certified dermatologist and founder of MMSkincare, who takes on TH, often overlooks the role of hormone therapy in skin. "Topical use of estrogen on the skin may be helpful in treating dry skin and rosacea," Marmur said, adding that high-dose estrogen should be used with caution as a systemic treatment. "Decreased estrogen hormones reduce collagen production, which reduces hydration and vascular and lymphatic circulation. Applying estrogen to the skin can relieve these symptoms and improve hydration." While there isn't enough evidence that topical estrogen is beneficial for skin cosmetics, Janine Downey, MD, a cosmetic dermatologist in New Jersey, sees the benefits. Recommend an alternative to estrogen. One favorite he recommends for menopausal patients is Emepele, which uses MEP (methylestradiol propionate) technology (note that Downey has worked on clinical trials) “It's a non-hormonal treatment and it really helps to get better. "Collagen loss, dryness, dullness, sagging, and wrinkles," Downey says, adding that topical estrogen-like medications also work like retinol. Gohara, on the other hand, prefers treating patients with Gold Skin Care for building collagen. adding a cream rich in lipids). What everyone agrees on is that the same cream cannot moisturize the face and vulva twice. "It's not a good idea because facial skin is sensitive, but vulva skin is more sensitive," says Grover. They can irritate and even irritate, she says, not to mention mess with your pH. "I've had patients use the same cream on their face and vagina and have yeast infections, so I definitely don't recommend it," says Downey.