Skin aging: treatment options for estrogen deficiency

In our century, women have learned to look young and attractive at 40, 50, and even 70 years old. Dermatocosmetology and anti-age medicine open up great opportunities for rejuvenation and prevention of aging at different age periods.

Representatives of the fair sex are most susceptible to hormonal fluctuations, and changes in their hormonal status are manifested by changes in appearance. A rash, a “swollen” oval of the face, excessive dry skin, pallor, dehydration, and age spots often become the main subject of complaints from menopausal women when visiting a cosmetologist.

A sharp drop in estradiol concentration explains the rapid appearance of signs of skin aging during menopause. At the same time, extraovarian synthesis of estrone takes place in subcutaneous fatty tissue from androstenediol through its aromatization. That is why, at the stage of decline of ovarian function, this hormone is the dominant estrogen, exerting a significant protective effect on the skin, especially in the case of overweight women.

Biological “targets” for estrogens in the skin are basal keratinocytes, fibroblasts, melanocytes, and adipocytes. During menopause, a slowdown in the rate of proliferation in the epidermis of basal keratinocytes is detected, which ultimately leads to its atrophy. Thinning of the epidermis and disruptions in the differentiation of keratinocytes lead to disruption of the barrier properties of the skin, disruption of the nutrient delivery system to the epidermis, smoothing of the basement membrane line, and increased transepidermal water loss (up to 30%). Clinically, these changes in the epidermis are expressed in thinning of the skin, dryness, and superficial wrinkles.

The optical properties of the stratum corneum also change: it becomes dull and acquires a yellowish tint. As for the dermoepidermal contact, already during premenopause there is a decrease in collagen content.

Currently, an important role in the formation of deep wrinkles and deformation of the oval face during menopause is assigned to changes not only in the epidermis and dermis, but also in subcutaneous fatty tissue and facial muscles. The volume and distribution of subcutaneous fat tissue of the face changes. Physiological atrophy of adipocytes occurs in the form of a decrease in the peroxisomal activity of fat cells, which leads to significant disruptions in the regulation of their population and a decrease in the ability to accumulate fats.

Against the background of hypoestrogenism, melanogenesis also intensifies, which manifests itself in the form of photoaging of the skin.

Complex pathogenetic therapy of menopausal skin changes

Modern aesthetic cosmetology most often uses mesotherapy, biorevitalization, RF lifting, fractional laser rejuvenation, and fractional photothermolysis in the fight against the above-mentioned age-related changes in the dermis.

Mesotherapy sessions help “nourish” the skin with ready-made cocktails based on hyaluronic acid and amino acids. The procedure activates blood supply, improves metabolic processes and skin nutrition, stimulates cell renewal and the production of new collagen, and increases the protective functions of the skin.

A course of RF lifting procedures allows you to “roll up” old, modified collagen and create a young collagen-elastin lattice.

Fractional laser rejuvenation procedures trigger the mechanism of fibroblast division: a new skin framework is formed, and rejuvenating processes are launched in the deep layers of the dermis. Externally, this manifests itself in increasing skin elasticity, narrowing pores, evening out texture and color, and reducing wrinkles.

Biorevitalization with hyaluronic acid provides deep hydration, improves skin microcirculation, stimulates collagen production, thereby improving skin tone and turgor.

However, in the practice of every specialist, there are often cases when a carefully selected course of procedures and homemade products do not give the expected effect in menopausal women. In this case, there is a need to use complex drugs for oral use, which stop estrogen-deficient hormonal aging and prevent involution of the skin and mucous membranes.

Now on the market there are already completely natural non-hormonal preparations for starting the functioning of fading ovaries in women at all stages. Their innovative formula is a unique complex that provides:

• reduction in menopausal symptoms (hot flashes, night sweats, insomnia, mood swings, irritability, nervousness);
• increasing skin elasticity and mucosal trophism (against vaginal dryness and dyspareunia);
• maintaining intestinal eubiosis and functional efficiency;
• counteracting the onset of development of genitourinary infections;
• preventing or slowing down the processes of physiological aging and increasing cardiovascular risks and osteoporosis;
• weight control and water retention.

As a rule, such preparations include regulatory complexes of phytoestrogens (pueraria, soy, clover), green tea extract, pre- and probiotics, and melatonin. The components have a mutually potentiating effect. An example of a drug that has proven itself in this case is Profem (Guna, Italy).

Most common phytoestrogens

Phytoestrogens are natural substances of plant origin that are not steroid hormones (unlike real estrogens). Their action is similar to that of weak estrogens, since they are similar in structure to 17-beta-estradiol, one of the main sex hormones in the female body. Phytoestrogens are less biologically active than natural human estrogens and do not have the same effect on estrogen receptors as intrinsic estradiol. If we take the effect of estradiol as 100, then the effect of phytoestrogens will be assessed as 0.001–0.2 (depending on its type).

The fundamental difference in the effects of human estrogens and phytoestrogens is as follows: phytoestrogens achieve the same effects as human estrogen, but only in a concentration exceeding its concentration by 5 thousand times or more. In other words, to obtain a certain effect, an amount of phytoestrogen must enter the skin cell from the outside, which is 5 thousand times or more higher than the dose of “native” estrogen produced by the body to obtain the same result.

Phytoestogens act on the skin in the same way as their natural counterparts. There are specific receptors on the membranes of skin cells. Hormones come into contact with receptors, and the most important processes are launched: cellular enzymes are activated, the rate of cell division increases. If there is a deficiency of estrogen, phytoestrogens will weakly activate the receptors, but if there is an excess, on the contrary, they will begin to compete with estrogens for the receptor. This suggests that phytoestrogens may have a “balancing” effect.

The most important advantage of phytoestrogens is that they are well absorbed by the body, do not accumulate in it and do not give side effects, unlike synthetic hormonal drugs.

Almost all phytoestrogens are powerful antioxidants and have bactericidal and fungicidal properties. The estrogen-like effect is manifested in the activation of fibroblasts, stimulation of cell division in the basal layer of the epidermis, activation of the synthesis of hyaluronic acid, collagen and elastin.

Kudzu extract (40% isoflavones)

It contains four main healing substances with proven properties: genistein, daidzein, daidzein and puerarin.

Doctors around the world have long established that genistein, daidzein and daizen individually can effectively relieve menopausal women from unpleasant symptoms. However, Italian developers went much further: they included puerarin in the complex and selected the ratio of active components that can literally “restart” the work of fading ovaries at the premenopausal level and give them a “second life” - to compensate as much as possible for the lack of estrogen and thereby delay aging of the female body.

In addition, kudzu extract has a hypotensive and antiarrhythmic effect, relieves spasm of coronary and cerebral vessels, reduces blood viscosity, and also regulates glucose/sugar levels in the blood, reduces cholesterol levels, tissue oxygen demand, and exhibits antioxidant activity.

Soybean extract (10% isoflavones)

The main method of correction and prevention of menopausal disorders today remains hormone replacement therapy, but it is often fraught with the development of various complications (breast cancer, thrombophlebitis, lipid metabolism disorders), and for some women it is completely contraindicated.

Scientists suggest using soy products instead of hormones, which help reduce hot flashes by up to 60% due to the high content of genistein and daidzein in this plant, isoflavones characterized by a structure similar to estrogens and having a similar effect. Thus, isoflavones play the same role as medications prescribed by doctors, but without the side effects.

Thanks to isoflavones, soy stimulates the synthesis of collagen and elastin - the main elements of the so-called supporting tissues of the skin, improves intercellular connections and thereby increases its density. Soy isoflavones accelerate the synthesis of proteins (collagen, elastin) and reduce skin sensitivity to androgens.

Soy can effectively fight osteoporosis in women during menopause. Firstly, because it contains estrogen-like isoflavones, and it is precisely because of the lack of estrogen that osteoporosis occurs in women during menopause. And secondly, soy protein contains a lot of calcium, which bones need to be strong and healthy.

Red clover extract (8% isoflavones)

The history of the therapeutic use of red clover in Ancient China and for more than a century in America has confirmed its positive clinical effect in various diseases of the liver, intestines, gall bladder, and gout. Red clover provides detoxification of the liver and the body as a whole, well cleansing the blood and lymph, improves the outflow of bile, and normalizes intestinal activity.

This legume contains four types of isoflavones (formononetin, coumestans, daidzein and genistein) that naturally reduce menopausal symptoms and support cardiovascular and skeletal health. In particular, coumestans are a group of isoflavones with high bioavailability and activity, characterized by high affinity for estrogen beta receptors.

Extracts of pueraria, soybean, clover, green tea have a low affinity for α -estrogen receptors (uterus, mammary gland) and a higher affinity for β -estrogen receptors (CNS, intestines, bone tissue, cardiovascular system, skin).

Substances that potentiate the action of phytoestrogens

Probiotics

Probiotics make isoflavones more biologically available and effective by activating them within the intestine. The most commonly used probiotics belong to either bifidobacterium or l actobacillus , which provide rapid colonization in various segments of the intestine for a long time due to high adhesion to the mucous membrane. Thus, drugs in this group are also recommended for women suffering from frequent urinary tract infections caused by E. coli (it is responsible for approximately 80% of all urinary tract infections).

Fructooligosaccharides (FOS)

Natural plant fiber has a proven prebiotic effect, is not affected by digestive enzymes, and enters the large intestine, where it selectively helps the growth of beneficial bacteria, such as lactobacteria and bifidobacteria. It promotes bowel movements and, due to its gentle action, stimulates peristalsis and helps prevent the formation of gases.

FOS improve the physiological functions of microflora and thereby promote the absorption of nutrients, including some minerals such as magnesium and calcium. They are beneficial for bones, for maintaining the structure of the intestinal mucosa and act as a physiological “barrier” to potentially hazardous substances.

Green tea extract ( Camelia sinensis )

The rejuvenating effect of green tea has been known for a long time. Camelia sinensis reduces inflammation and soothes skin irritation, protects collagen and elastin from damage, strengthens the walls of blood vessels, and improves skin microcirculation. Green tea polyphenols promote longer life of tissues that form blood vessels, the cornea of the eye, articular cartilage and heart muscle. In addition, ECGC catechin is an even stronger antioxidant than vitamin C and plays an important role in the prevention of cancer and cardiovascular disease. This catechin neutralizes oxidants before they can harm cells. Thus, it reduces the number and size of tumors and inhibits the growth of cancer cells.

Melatonin

An age-related decrease in melatonin signals a disorder of pineal and pituitary control over ovarian cyclicity and a progressive decline in a woman’s fertile function. The severity of menopausal mental disorders correlates with the hormonal profile of patients: the more severe the mental disorders of menopause, the lower the level of melatonin, estradiol and the higher the levels of luteinizing and follicle-stimulating hormones. It has been established that melatonin has a suppressive effect directly on the pituitary gland, reducing the release of luteinizing and follicle-stimulating hormones, thereby reducing the manifestations of menopausal disorders.

Melatonin is one of the most active endogenous antioxidants and protects the central nervous system from negative environmental influences. Therefore, any stress is accompanied by increased activity of the pineal gland and mobilization of the stress-protective function of melatonin. Melatonin has a positive effect on memory processes (by eliminating the consequences of ischemic damage to nerve cells), optimizes the light and color discrimination ability of the eyes, accelerates falling asleep, reduces the number of night awakenings, normalizes the duration and quality of sleep without any side effects, reduces stress reactions, stimulates cellular and humoral immunity (in diseases), regulates neuroendocrine functions.

Melatonin is able to normalize the process of lipid oxidation, thereby reducing the risk of developing atherosclerosis, participates in the hormonal regulation of blood pressure, reducing the release of adrenocorticotropic hormone, the production of norepinephrine, vasopressin, and renin.

***

To achieve the maximum effect from cosmetic procedures for women with manifestations of menopausal syndrome in the fight against age-related changes in the dermis, it is advisable to prescribe complex preparations: pre- and probiotics, as well as phytoestrogens, which, being flavonoids, give the body a lot of useful things, namely block toxic oxygen compounds, have an antitumor effect, regulate vascular tone, reduce blood pressure to normal and have a number of other properties necessary for successful adaptation in this difficult period for a woman.

This article is part of the special project Global anti-aging

You can read all the articles on this topic:

SPECIAL PROJECT. Global anti-aging

Literature:

Les Nouvelles Esthetiques 2015/№2