There are feel-good social-media posts about how “30 is the new 20” or “50 is the new 30,” but rarely are women over a certain age – unretouched, unapologetic, not medically intervened upon – portrayed as desirable or admirable, or even portrayed at all.  

In 2021, a 45-year-old Kate Winslet made headlines for demanding a director keep her stomach in a sex scene and not edit it to be flatter and tighter. Jane Fonda and Lily Tomlin in “Grace and Frankie” were one of the few television programs starring mature women. For the 2021to 2022 season, 42% of major female characters on broadcast networks were in their 30s, while only 15% were in their 40s. A slightly smaller, yet similarly steep decline occurred with streaming platforms.  

The annual Boxed In report, done by the Center for the Study of Women in Television & Film at San Diego State University, examined one randomly selected episode of original prime-times series from almost every network and streaming service available (ABC, CBS, NBC, Fox and the CW and Amazon Prime, Apple TV+, Disney+, HBO Max, Hulu, Netflix, Paramount+ and Peacock). Only 3% of major female characters were 60 and over, both for broadcast and streaming; a startling statistic, particularly because women of this age make up about 25% of the overall United States female population, according to 2019 census estimates. As the Boxed In study concludes, older women “continue to be dramatically underrepresented” – and that underrepresentation extends to skin and menopause. 

SEEN & UNSEEN CHANGES 

Menopause marks a profound biological and emotional transition for women, often beginning in the late forties to mid-fifties. Clinically, it represents the permanent cessation of menstruation following the decline of ovarian follicular activity, but for many women, it is far more than a physiological milestone – it is a whole-body and emotional transformation. In the treatment room, menopause reveals itself not just in skin, but in the voice, posture, and demeanor of the client. 

For many women, menopause represents a profound intersection of biological change and emotional evolution. While the visible effects – dryness, loss of elasticity, pigmentation shifts, scalp hair loss, and facial hair growth – are often the focus in the aesthetics setting, the unseen emotional layers can be equally, if not more, significant. 

A client entering the treatment room during perimenopause or menopause may not just be seeking smoother skin; she may be searching for reassurance, confidence, and a renewed sense of self. Understanding the emotional landscape of menopause allows the skin professional to provide more compassionate, holistic, and effective care. 

WHAT IS HAPPENING UNDERNEATH 

Menopause typically occurs between the ages of 45 and 55 and is defined clinically as the permanent cessation of menstruation for 12 consecutive months. Yet, it is not a singular moment; it is a gradual process that can span a decade, from perimenopause through postmenopause During this time, estrogen, progesterone, and testosterone levels fluctuate and eventually decline. These hormonal changes affect not just skin’s physiology but also neurotransmitters like serotonin and dopamine, influencing mood, motivation, and self-esteem. The emotional effects of menopause are therefore both chemical and circumstantial. Clients may struggle with the psychological implications of aging, changing roles, or altered body image, all of which can surface in conversation during skin care services. 

THE EMOTIONAL TERRAIN OF MENOPAUSE 

Understanding what a client might be feeling allows the professional to respond with empathy rather than assumption. While experiences vary widely, some emotional patterns are common. Hormonal swings can impact serotonin and gamma-aminobutyric acid (GABA) levels, leading to irritability, sadness, or anxiety. A client might appear less patient, more easily frustrated, or unexpectedly tearful. Recognizing this as part of a physiological shift rather than personality helps the professional respond with sensitivity. 

Hot flashes, night sweats, and hormonal imbalance often interrupt sleep. Chronic fatigue can heighten emotional sensitivity and reduce tolerance for stress. A tired client may arrive to an appointment needing quiet and calm more than conversation. Skin changes such as sagging, dryness, facial hair growth, scalp hair loss, and skin breakouts can feel like a betrayal of one’s former self. Many women describe feeling “invisible” or “less feminine.” This emotional impact often runs deeper than vanity – it is tied to identity and self-worth. 

PUTTING IT INTO PERSPECTIVE 

Societal pressure to maintain a youthful appearance intensifies around menopause. Clients may express worry about “looking old” or “losing their glow.” The skin professional’s role is not to deny aging, but to reframe it as a process of renewal and self-care rather than loss. 

For some, menopause symbolizes the closing of one chapter and the beginning of another. Feelings of grief over fertility, youth, or past identities can accompany the transition. Others experience liberation, embracing a newfound sense of autonomy. Both ends of this emotional spectrum deserve space and respect in the treatment room. 

Emotional states often reveal themselves through subtle cues. Being attuned to a client’s body language, tone, and energy helps the professional gauge their emotional needs. For example, a quiet or withdrawn client might be seeking comfort and relaxation rather than discussion. A talkative client might be processing feelings aloud, using the treatment room as a safe space to be heard. A critical or perfectionistic client may be expressing frustration about losing control over her appearance. The professional’s responsibility is not to diagnose, but to listen with empathy and respond with professionalism. 

SENSE OF SAFETY 

Touch is one of the most profound forms of nonverbal communication, and in the context of menopause, it carries unique healing potential. Aesthetic touch, when performed with presence and respect, can lower cortisol levels and increase oxytocin, the “bonding” hormone associated with calm and connection.  

Creating emotional safety in the treatment room begins with small, intentional actions. Maintain a soothing environment. Menopausal clients may be more sensitive to heat, scent, and stimulation. Keep the room temperature moderate, avoid overpowering fragrances, and use soft, ambient lighting to reduce stress. Explain each step before beginning to preserve a sense of control. Check in gently. Allow silence to be nurturing rather than awkward. These gestures communicate care and trust, meeting clients where they are emotionally as well as physically. 

In aesthetics, empathy is not only a soft skill, but a professional competency. Clients navigating menopause may be hypersensitive to perceived judgment. They need validation, not correction. Instead of saying: “You have a lot of dryness; that is what happens at your age.” Try, “Your skin feels a little more dehydrated today, very common when hormones shift. Let’s strengthen your barrier and bring back hydration.” 

The second phrasing educates the client without reinforcing shame or age-related stigma. Language shapes their emotional experience as much as touch does. 

EASING THE CLIENT 

Skin is deeply tied to identity. It is the visible self one presents to the world. When it changes rapidly, as it often does during menopause, it can feel destabilizing. For many women, caring for their skin has been a lifelong ritual of self-expression. When products stop working or skin texture shifts, frustration can arise. Some may feel betrayed by their skin and avoid mirrors. Some will step back from social engagements, fearful of being judged. Professionals can play a transformative role here by reframing skin care as adaptive, not reactive. This perspective shifts focus from “fixing flaws” to nurturing evolving needs. This approach restores agency and helps the client feel empowered rather than defeated. 

The sensory experience – the scent of a mask, the rhythm of a massage, the feeling of warmth – becomes part of emotional regulation. Many menopausal clients judge themselves harshly. Professionals can gently guide them toward self-compassion through thoughtfully framed professional advice. Instead of promising youth restoration, focus on vitality and resilience. Encouraging small, consistent rituals at home – gentle cleansing, sunscreen, hydration – can also reestablish self-care as a grounding practice. 

SCOPE-CONSCIOUS CARE 

While empathy is key, it is equally important to maintain professional boundaries. The treatment room can feel like a therapy couch, and clients may open up about anxiety, depression, or relationship struggles. Listen attentively, validate their emotions, but avoid offering psychological advice. 

A simple phrase like, “It sounds like this has been really difficult. Thank you for sharing that,” acknowledges their feelings without stepping outside the professional scope. 

Doubts, sadness, and depression can arise. If a client expresses significant emotional distress, gently suggest speaking with a counselor or healthcare provider. Build a relationship with a medical or mental health practitioner who specializes in women’s health as a referral recommendation. This approach preserves trust and ensures the client receives comprehensive care. 

TRUST-LED PRACTICE 

Menopause is not a brief phase – it is a lifelong transition. Many clients will appreciate having a service provider who understands their evolving needs and emotions. By maintaining open communication, following up after treatments, and remembering personal details, the professional reinforces connection and loyalty. Over time, their role expands beyond skin professional to trusted wellness ally. That relationship, grounded in respect and understanding, can have as much healing power as any treatment. 

Supporting menopausal clients can also nourish the professional and provide opportunity for growth. It challenges professionals to refine their listening, emotional intelligence, and ability to personalize care. Many professionals describe deep satisfaction in helping women rediscover confidence and self-worth during this stage of life. By approaching menopause with curiosity and compassion, professionals can elevate their practice from surface care to soul care – a form of service that honors the emotional as well as physical dimensions of beauty. 

Supporting Emotionally Sensitive Clients 

• Start slow: Adjust treatment intensity to both skin and comfort level. 

• Educate gently: Frame changes as natural adaptations. 

• Focus on relaxation: Incorporate breathing exercises or quiet moments. 

• Avoid comparisons: Never suggest “younger” skin as the goal. 

• Be flexible: Allow for breaks or room temperature adjustments. 

• Follow up: A simple message checking in after a service reinforces care and trust. 

Menopause brings emotional complexity as layered as skin itself. A client may walk into a treatment room carrying invisible burdens – fatigue, self-doubt, anxiety about aging, or grief over transition. Professionals have a unique opportunity to provide not just physical renewal but emotional refuge. 

By understanding the emotional effects of menopause, approaching each session with empathy, and tailoring treatments with both science and sensitivity, professionals transform their services into something far more powerful than skin care. They create a space where women can feel seen, safe, and valued – reminded that beauty at any stage of life is not something to regain, but something to redefine. 

HIGH-PROFILE COMMENTARY 

The taboo of speaking openly about menopause is slowly changing. A number of high-profile women have opened up about their personal experiences, positive and negative, with “the change.” Their courage has empowered other women to speak up for and about their own health.   

In 2021, Oscar winner and lifestyle guru Gwyneth Paltrow talked about being “solidly in perimenopause,” the transition into menopause that can last as long as 10 years. She reported experiencing all-over-the-place emotions and some physical symptoms such as a racing heart at bedtime, calling the hormonal shifts at this stage of life “no joke.” She added that she is “staying close to [her] doctor” during this time and credited a healthy diet, exercise, and supplements for women in their 40s with keeping her well. 

Michelle Obama opened up about her menopause journey in 2020 on The Michelle Obama Podcast. Candidly sharing a story about a time she had a hot flash on Marine One, the presidential helicopter, she recalled, “It was like somebody put a furnace in my core and turned it on high. And then everything started melting.” Obama discussed taking hormone therapy and emphasized the importance of women talking openly about menopause symptoms. “Half of us are going through this, but [we are] living like [it is] not happening,” she said. 

Oprah Winfrey emphasized both the positive aspects of menopause and the importance of removing the stigma around it. “So many women [I have] talked to see menopause as a blessing,” she wrote. “[I have] discovered that this is your moment to reinvent yourself after years of focusing on the needs of everyone else.” Winfrey also encouraged women to talk about the symptoms of menopause, noting that she had difficulty finding helpful advice during her own menopause transition and initially thought her symptoms, which included heart palpitations, were signs of heart disease. 

GRACE IN TRANSITION 

As women enter this new chapter in life, skin may change, but the spirit beneath it remains luminous. The skin professional’s role is to help that light shine through – with skill, compassion, and understanding. 

References 

1. LaMantia, Brooke, and Julie Ma. “25 Famous Women on Getting Older.” The Cut, February 15, 2022. https://www.thecut.com/article/25-famous-women-on-aging.html.  

1. Hinds, Julie. “Women 60 and Older Are Woefully Missing from TV’s Prime-Time Programming.” Detroit Free Press, October 28, 2022. https://www.freep.com/story/entertainment/television/2022/10/28/prime-time-tv-shows-mostly-ignore-women-60-and-older/69593124007/.  

1. Celebrities who have talked about going through menopause, n.d. https://www.healthcentral.com/condition/menopause/celebrities-menopause.  

A technician, educator, mentor, and business owner, Mary Nielsen has been at the forefront of the developments in medical aesthetics since its infancy in the early 1990s. A nurse by training and experience, Nielsen was drawn into advanced medical aesthetics with the advent of laser technologies and their use while working for a plastic surgeon. She went on to found her own successful skin and laser clinic. She is the author of “A Compendium for Advanced Aesthetics, a Guide for the Master Esthetician,” four publications on medical spa policies and procedures and safety policy and procedures. She is a contributor to “Milady Standard Esthetics: Fundamentals, Edition 12” and is the executive director of Spectrum Advanced Aesthetics.