Just 10 percent of postmenopausal women in the UK take hormone replacement therapy (HRT) after numbers using it plummeted in the wake of studies 20 years ago that suggested it increased breast cancer risk.
These studies were later found to be flawed, and more recent research has shown that the overall benefits of HRT, such as protection against heart disease, generally outweigh the very small short-term risks.
But now it seems those 10 percent of women could benefit in some other way, with the first study showing that the stretchy, sagging appearance of postmenopausal skin could be reversed by the effect of HRT in stimulating of sex hormones.
Scientists from the Department of Dermatology at the University of Manchester are about to publish their research showing for the first time HRT users have more ‘elastic fibers’ in their skin and better levels of waxy moisturizing agents called lipids. that keep the skin barrier (and waterproof), compared to non-HRT users.
Just 10 percent of postmenopausal women in the UK take hormone replacement therapy (HRT) after numbers using it plummeted in the wake of studies 20 years ago that suggested it increased breast cancer risk [File photo]
Significantly, they also have higher levels of keratinocytes, the main group of cells that make up the skin’s barrier – these make up 90 percent of the skin and not only protect it from microbes and the sun’s harmful UV rays, they are also responsible for make and secrete lipids.
Estrogen helps stimulate the production of keratinocytes – and as estrogen levels drop during menopause, the skin becomes thinner.
But the new study, which took small, but entire skin samples from volunteers using a device similar to a paper hole punch, found that HRT preserved the keratinocytes, thinning the skin and reducing the loss of firmness in postmenopausal women. .
Although the research program is sponsored by Boots, which is working on cosmetic skin treatments to boost postmenopausal skin, Rachel Watson, a professor of skin sciences in Manchester, one of the lead researchers, said it has a bigger purpose.
“If we can identify which components in the skin change during menopause, we can think about ways to treat the skin deficiencies we see in old age,” she told Good Health. ‘Skin breakdown, failure of healing mechanisms, ulcers and other diseases in the very elderly are a real problem.’
Indeed, a report published last year in the BMJ estimated that 3.8 million people a year are treated by the NHS for skin ulcers and other chronic wounds, at a cost of £8.3 billion to the health service.
Professor Watson adds: ‘The more we know about skin structure and skin aging, the more likely we can treat these other problems.’
The Manchester study was based on comparing 28 women aged 40 to 65, divided into three groups: one group had not yet gone through menopause, a second was postmenopausal but not taking HRT, and the third was postmenopausal and taking form a variety of therapy.
These three groups were also compared with a group of 29 men of the same age, plus two other groups of nine women under the age of 30 and seven over the age of 70 who were not taking HRT — their skin analysis provided more information confirming that the number of keratinocyte cells indeed it decreases with age, but that HRT seems to stop that process.
This work builds on previous studies from the 1980s, which showed that when girls with the eating disorder anorexia became so thin that their periods stopped, the drop in estrogen levels had a catastrophic aging effect on their skin quality, and it became comparable to the thin papery skin of older, postmenopausal women.
‘I really applaud work like this Manchester project,’ said Mike Savvas, gynecologist consultant and menopause specialist at King’s College Hospital in London, who was involved in the earlier studies 35 years ago. ‘It is a pity that there has been no more interest in this very important field for so long.’
It may seem unfair that the men in the study had better skin than their female counterparts of the same age.
How it seems those 10 percent of women could benefit in some other way, with the first study showing that the stretchy, sagging appearance of postmenopausal skin could be reversed by HRT’s effect on stimulating sex hormones
This is because testosterone controls skin quality in men, explains Neale Watson, a gynecologist and menopause specialist at Hillingdon Hospital in West London.
Men don’t have the sudden hormonal decline of menopause, so their skin stays beautiful for longer. “If you look at a 65-year-old man and a 65-year-old woman, her skin has aged much more dramatically than the man’s,” Watson says.
‘For many years postmenopausal women were taking HRT, doing better and getting the benefits for their skin, then came these flawed studies linking HRT to breast cancer.’
He points to the first results of the Women’s Health Initiative, a 15-year study launched in 1991 that involved 160,000 women. In 2002, an analysis of the data showed that HRT had more adverse than beneficial effects.
Following these findings, many women stopped taking HRT and new prescription guidelines were issued for doctors.
However, in subsequent years, a re-analysis of the data showed that the benefits of HRT in younger women or in women in the early postmenopausal period outweighed the small (and short-term) cancer risk, and those taking HRT were also less likely to had on developing cardiovascular disease. disease and improved life expectancy.
Despite these findings, many doctors and middle-aged women continue to view HRT with suspicion. dr. Theodora Kalentzi, a menopause specialist at the private Medical Prime clinic in London, points out that although the Manchester study is too small to provide definitive evidence: ‘We know HRT has multi-functional benefits and the skin is one of them, but still only 10 percent of postmenopausal women use it.
“It takes so long to overcome this deep-seated negative message that it’s dangerous.”
Suzy Pilkington, a lecturer in skin aging at the University of Manchester and lead researcher in the study, said: ‘One of the key findings is the changes in lipids we’ve seen after menopause.
“It appears that some of this decline could be reversed by HST, which is a milestone. It is beyond our capabilities in this university department to develop a new treatment and there are still many health concerns surrounding prescription HRT anyway.’
But, she adds: ‘We are trying to raise awareness that women should talk to the doctor about their skin quality. People should talk about the possibilities for HRT.’
For those who can’t take HRT, for example women who have had hormone-dependent breast cancer, or who don’t want to take it, the future may lie in products containing lipids, she suggests.
“There are a few compounds in the pipeline. We’re looking at how those compounds improve recovery or alter skin aging.
‘We’re looking at combinations of new compounds, but including existing cosmetic ingredients for the skin, such as niacinamide, which helps build skin cells, and ceramides, types of lipids that make up the skin.
‘However, we need to better understand which ceramides are key in these women. You see changes in ceramides in many people older than 75, but we don’t know whether those changes start in the menopause.’
In fact, it is known that there are at least 1,000 different forms of natural ceramide and more are being discovered. A few that have been analyzed are now being used in cosmetic skin treatments to form a matrix between skin cells to keep it firm. dr. Mike Bell, the scientific skin care consultant at Boots, said the work in Manchester could lead to a form of lipid replacement therapy for postmenopausal women. “There is a complete lack of scientific information in this area,” he says.
‘We already have products that work reasonably well, but within two years we expect to have a new product that capitalizes on this new knowledge.’
How music can benefit your health. This week: Improves how you walk
Walking to the steady beat of music — fast or slow, instrumental or vocal — can help improve walking, especially for people with Parkinson’s disease (where walking can become slower and less stable).
In a 2019 study at the Sapienza University of Rome and other centers, researchers asked healthy young and elderly participants and Parkinson’s patients to walk while listening to songs from four music genres. They found a huge improvement in gait, especially in the participants’ speed and range of motion.
Rock, motivational and heavy metal songs were particularly effective, compared to classical music which, despite improving posture (such as excessive leaning), also reduced speed.
Listening to music is thought to provide a precise auditory cue that people tune their walking speed to, rather than relying on faulty internal timing.