More Than Menopause: A New Standard of Support

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Menopause marks the end of a woman’s reproductive years and is accompanied by significant hormonal changes, especially a decline in estrogen. These hormonal shifts impact nearly every bodily system, including skin, bones, and brain.

Every day in treatment rooms, skin professionals support clients navigating the visible signs of aging: fine lines, dehydration, dryness, laxity, and skin that doesn’t bounce back the way it used to. But for clients in their 40s and 50s, there’s a deeper physiological shift at play that we often overlook: hormonal change, specifically estrogen deficiency.

Whether a skin professional identifies as an aesthetician, dermal clinician, dermal therapist, skin therapist, beauty therapist, or something else, we’re skilled at treating what we see on the surface. But midlife skin is influenced by more than sun exposure and time. Estrogen decline affects not only skin, but the entire body, and it shows up in all clients at this life stage, whether we realize it or not.

THE MENOPAUSE SHIFT

Consider this: in the first five years of menopause, a woman loses up to 30% of her collagen and 10% of her bone mass. Fat redistribution in the face is also common, with loss of volume in the cheeks and temples and increased heaviness around the jowls. Muscle tone declines subtly in the facial structure, and natural hydrating factors like hyaluronic acid diminish, reducing skin’s ability to retain moisture.

Estrogen’s Role

Estrogen plays a direct role in regulating sebum production, supporting epidermal thickness, stimulating fibroblast activity, and maintaining healthy vasculature in skin. As estrogen levels decline, its regenerative effects diminish, microcirculation slows, wound healing is delayed, moisture retention drops, the barrier weakens, and collagen loss accelerates – all leading to dryness, thinning, and sagging. These changes are not just superficial; they reflect deep, systemic shifts.

More Than Skin

Skin professionals are often the first to notice or hear about these changes. Yet we tend to treat these signs in isolation. We exfoliate dryness instead of supporting barrier repair. We address hyperpigmentation concerns without exploring inflammation or hormonal triggers. We tighten laxity without acknowledging the hormonal and structural changes beneath.

While our tools are powerful, they only address part of the story. What about symptoms that go beyond skin? Estrogen decline can also impact mood, weight, sleep, cognition, digestive function, and vaginal and urinary tract health. Tissues of the vagina, bladder, urethra, and pelvic floor are particularly sensitive to hormonal changes, often resulting in symptoms like dryness, discomfort during intercourse due to tissue thinning, urinary incontinence, and even frequent urinary tract infections (UTIs). Understanding this broader picture helps us ask the right questions and guide clients appropriately.

TREATING INSIDE & OUT

A holistic approach helps professionals ask more meaningful intake questions (about energy, mood, sleep, and libido), recognize when skin changes align with hormonal shifts, build a referral network of menopause-literate professionals, and tailor treatments for hormonally sensitive skin.

By 2025, over one billion women worldwide will be menopausal. This isn’t a niche issue; it’s a mainstream, underserved one. And while skin is often where symptoms show up first, what we are seeing is part of a much bigger picture.

Perimenopausal women may present with breakouts or flushing, disrupted cycles, poor sleep, and digestive shifts. In post-menopause, skin changes become more pronounced: dryness, crepiness, volume loss, and sensitivity. As estrogen drops, skin loses its resilience, the lipid barrier weakens, and reactivity increases, often requiring us to rethink our go-to treatments and actives. Clients may also report weight gain and fatigue – physiological responses often misunderstood as emotional. Emerging evidence links gut health and hormonal balance. A disrupted gut microbiome may reduce estrogen recycling and worsen skin and other symptoms. Estrogen supports healthy skin structure by enhancing collagen, hydration, circulation, and repair. Its decline leads to thinner, more reactive skin, a biological reality.

Clients may ask about, or be on, menopause hormone therapy (MHT), as hormone replacement therapy (HRT) is now known. While it may not be suitable for everyone, evidence supports its ability to improve hormone deficiency-related symptoms. It’s not our place to prescribe, but we can normalize the conversation and refer appropriately.

CARE ON A DEEPER LEVEL

We don’t need to diagnose or treat menopause, but we do need to understand it. We can be the professionals who validate, refer, and adapt. By looking beyond skin’s surface, we position ourselves not just as service providersbut as partners in care. Let’s not just treat skin. Let’s support the woman it belongs to.

References

Brincat, M. (2000). Hormone replacement therapy and the skin. Maturitas, 35(2), 107–117.
Thornton, M. J. (2013). Estrogens and aging skin. Dermato-Endocrinology, 5(2), 264–270.
Mosca, L., et al. (2011). Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: A guideline from the American Heart Association. Circulation, 123(11), 1243–1262.
Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas, 103, 45–53.
Verdier-Sevrain, S., & Bonté, F. (2007). Skin hydration: A review on its molecular mechanisms. Journal of Cosmetic Dermatology, 6(2), 75–82.

Chiza Westcarr is a university-qualified nutritionist, aesthetician, speaker, and educator with over two decades of experience in the aesthetics and wellness industries. She is currently undertaking a PhD researching the role of personalized nutrition, coaching, and exercise in improving the cardiometabolic health of postmenopausal women. In 2025, she hosted the Australian Medical Aesthetic industry’s first-ever highly successful menopause symposium, Thriving Through Menopause by Chiza Westcarr and thereafter founded the Menopause Skin Academy – a global online community of skin professionals with a special interest in menopause.