6 things that happen to your skin in menopause and perimenopause – and what this top skin doctor recommends
October 16th 2020
May 21st 2021 / 0 comment
Menopause and perimenopause symptoms range from anxiety to low libido to joint pain. We spoke to experts about how to help to ease the symptoms
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Since Davina McCall’s menopause programme Davina McCall, Sex, Myths and the Menopause aired on Channel 4, there’s been a spike in Google searches for all things menopause and perimenopause. It’s clear we’re realising just how much we didn’t know and are eager to learn more.
One area that’s garnered more interest since the programme aired is supplements for peri- and menopause. It’s a life stage that can begin anything up to a decade before our periods stop for good at the average age of 51, although one in 100 women has early menopause at the age of 40, according to leading menopause specialist Dr Louise, who featured in the documentary. Over the last year, Boots has seen a 61 per cent increase in sales of menopause products, from supplements to ease symptoms to lubricants to help with vaginal dryness, including Vitabiotics' Menopace Plus, A. Vogel's Menoforce Sage tablets and Boots' Menolieve Black Cohosh Root Extract.
While perhaps the best-known symptoms of menopause are hot flushes and vaginal dryness, there are many lesser-known ones such as itching, tinnitus, migraines, acne, an altered sense of smell, breast tenderness, brain fog, anxiety which can begin in perimenopause and continue when you are post-menopausal (menopause is technically defined as the one year anniversary of your periods stopping.). Dr Newson lists 45 physical and 10 mental health symptoms on her menopause support app Balance and every woman experiences them differently.
Advertising planner Rebekah Brown had symptoms in her mid-40s -anxiety, brain fog, complete loss of mojo and unhappy skin. “I felt so unattractive and joyless, like a walking black cloud,” she says. Her GP dismissed her suggestion that what she was experiencing was down to hormonal changes because she was still having periods and therefore “too young to be menopausal”. She began researching perimenopause supplements and couldn’t find anything in the supplements aisle that addressed that life stage, so she set about making her own plant-based smoothie powder. With the help of a naturopath she created MPowder Peri-Boost, £69, which launched in 2021, and Meno-Boost, £69, which is just out. I’ve tried both and take the Meno Boost, which has a well-researched ashwagandha (called KSM-66) to manage stress, libido and mood, red clover for hot flushes and slippery elm for gut health. It also has a 20ug vitamin D, vital to help prevent bone loss, which accelerates at this stage. And yet I also take HRT; which brings me on to…
Caveat – they aren’t like-for-like alternatives. Dr Newson is keen to stress that while supplements can help with symptoms (as can HRT) they can’t address most of the long-term health risks that menopause creates for women caused by the loss of oestrogen. They may make you feel better but aren’t an alternative to HRT in any way.
As she said in Davina’s documentary, from an evolutionary perspective we were meant to die after menopause (cheery!) so we haven’t evolved to live without oestrogen for the 30 or so years that many of us live happily beyond menopause. Oestrogen, it turns out is vital for so many functions including cognition and cardiovascular health.
“There’s a huge misunderstanding that the menopause is hot flushes and sweats and periods stop and you get on with it. What [people] don’t realise is the health risks associated with low hormones - heart disease, osteoporosis, heart disease, dementia. The best time to start treatment to top up those hormones that are lowering is in the perimenopause, so your health risks reduce as much as possible.”
Supplements do have their place though. Dr Louise told me that specific ones are important at this life stage (indeed she sells her own under her clinic brand Newson Health ), vitamin D, probiotics, magnesium, fish oils and vitamin C. Phyto-oestrogen supplements (plant compounds which mimic oestrogen such as soy) can be useful early on. “With perimenopause, you can often help [hormone levels] by having phyto-oestrogens to top them up a little bit, ” she says. “But as soon as they start plummeting, you just can’t [top up hormones naturally] it’s impossible”
She adds: “If your symptoms are debilitating and you want to improve your symptoms short term then [supplements] are fine but you have got to remember that there are health risks with the menopause.”
The final word? “You should be looking at whether you need to supplement, but it shouldn’t be seen as an alternative to HRT.”
We spoke to experts about the best supplements to manage the symptoms of menopause and perimenopause; here’s what they recommended. (Always seek professional advice before taking supplements)
During menopause and perimenopause your oestrogen and progesterone levels fall. When our hormones are off kilter, our adrenal glands, which modulate stress and energy levels, start producing more of the stress hormone cortisol, hence why women could feel more stressed and anxious than usual.
"Mood swings can happen because the adrenal glands release excess cortisol," explains Shabir Daya, pharmacist and founder of online pharmacy Victoria Health “Some women may find their moods fluctuating because oestrogen levels vary from week to week, month to month and so on."
He suggests taking Magnolia Rhodiola Complex to rebalance your mood and lower your cortisol levels. “It relaxes your muscles and nerves and has also been proven to reduce your cortisol levels and boost serotonin levels,” he advises.
"CBD is useful for reducing anxiety, promoting relaxation and helping to achieve restful sleep, plus it helps to reduce muscle tension, restlessness and fatigue," says Healthspan's medical director Dr Sara Brewer.
Each CBD Support Mellow capsule contains five mg of a distilled and pure CBD with ingredients proven to support psychological and cognitive function, mental performance and your nervous system, including a full complex of B vitamins and vitamin C, plus essential minerals magnesium and zinc.
“At night, serotonin is converted into melatonin, which is your sleep hormone,” explains Shabir. “If you have sufficient levels in your body you will have your six to eight hours a night. However, cortisol [which we can have an excess of in menopause and perimenopause] prevents the uptake of serotonin to the brain.”
This powder, which should be added to water and drunk half an hour before bedtime contains an extract of cherries, which are rich in naturally occurring melatonin. “It won’t send you to sleep on day one, but over the weeks as you build up your melatonin levels you will notice a difference in your sleep pattern,” Shabir says. “It also contains magnesium to relax muscles and red dates, which have nerve-calming properties.”
One in four women suffers from vaginal dryness, in menopause according to Shabir. The neck of the womb is designed to release a slightly acidic lubricant that keeps everything moist and supple and also prevents infection. It produces less lubricant during perimenopause and menopause. “Taking a good quality essential fatty acid omega 7 supplement, such as Pharma Nord Omega-7 Sea Buckthorn Oil will help to rectify this,” says Shabir.
“In my opinion, nearly every woman over the age of 35, with a few exceptions, should consider the use of phytoestrogen supplementation on an ongoing basis,” says Shabir. “Phytoestrogen is a scientific term for naturally-occurring plant compounds that are chemically similar to oestrogen and thus mimic oestrogen, often without side effects.
“Victoria Health's Sage Complex contains the right amounts of varied phytoestrogens to achieve hormonal balance. It contains natural herbs that help to mimic the female hormones and help alleviate common menopausal concerns including hot flushes, night sweats and vaginal dryness," he continues.
This is also good for hot flushes, says Dr Sarah Brewer. “This supplement includes 40 mg soy extract and 50 mg flax extract which both provide a significant oestrogen boost for women whose own levels are falling due to perimenopause and menopause. It also includes sage extract (which reduces sweating and hot flushes) to support hormone balance.”
“Black cohosh a traditional herbal medicine believed to reduce menopausal symptoms through normalising the oestrogen-progesterone balance,” explains Dr Sarah Brewer. “It also has an effect on dilation of blood vessels and helps to relieve hot flushes, night sweats, low libido, anxiety and mood swings as well as improving sleep quality.”
“There is a strong link between hormones and neurotransmitters in the brain,” says Shabir. “When hormone levels are low [as in menopause] brain function can be affected often resulting in the inability to focus or in some cases an inability to recall information.”
This supplement includes magnesium which is essential for cognitive function to reach the brain tissues. It helps out when oestrogen dips.
“Oestrogen protects our joints from degeneration and has anti-inflammatory properties. Low oestrogen levels will often affect the joints causing the symptoms of arthritic pain and unlike other menopausal symptoms, joint pain will not diminish even after the hormones level out so this is a good time to start taking a supplement to help," says Shabir.
During menopause the fluctuations between oestrogen and progesterone stop following the usual monthly pattern which can make fluid balance difficult causing fluid retention. Nettle leaf supplements work as mild diuretics, helping to eliminate excess water retention, particularly around the legs.
Vitamin D is essential in menopause to help prevent bone loss, which accelerates at this life stage. Dr Louise Newson told menopause site MPowered that this is her vitamin D of choice. "I have taken vitamin D for many years and will continue to do so," she said. "Taking vitamin D has many effects including to our bones, brain and immune function. It is very cheap and readily available."
June 26th 2018