Menopause, Hormone Therapy & Aging Skin--is There a Connection‪?‬

Menopause hormone therapy (HT) offers probably the biggest example in modern medicine where enthusiasm for a drug's reputed benefit trumped existing supporting science. As we've said before, menopause hormone "replacement" therapy was a triumph of marketing over science. By 2002, some 38% of menopausal and older women in the U.S. were taking or had taken some form of HT. (1) While evidence of HT's effectiveness for menopausal symptom relief was well-supported, its supposed long-term health "benefits" (preventing everything from heart disease, osteoporotic fractures, dementia, and even colon cancer) actually had very little solid science behind them. We now have solid data from numerous clinical trials that HT poses multiple risks and provides few benefits to aging women's health, and many women have stopped taking HT. But, one belief that continues to this day is that taking HT after menopause benefits a woman's skin and can combat the natural signs of aging. Is there any proof that HT helps aging skin? Estrogen's effects on skin are largely believed to result from the hormone's ability to increase collagen production and water content, two factors that seem to influence skin's elasticity and moisture. (2) The standard view is that, as women age, decreasing estrogen levels are responsible for skin's wrinkling, sagging, and dryness. (Even though, as we all know, men's natural aging process also leads to wrinkles, sagging, and dryness!) Menopausal women, who naturally have less estrogen, might be expected to have drier or more wrinkled skin than younger women. However, men also have estrogen receptors in their skin, and this basic cellular biology does not consistently translate into a simple relationship of: "more estrogen = better skin" and "less estrogen = wrinkles + dry skin" because studies trying to confirm that menopause makes women's skin worse and hormone therapy makes it better have yielded mixed results.