Restoring confidence in menopausal and perimenopausal patients
Menopause is a natural stage in a woman's life that marks the end of her reproductive years. However, the journey leading up to menopause, known as perimenopause, may begin up to ten years earlier.
It’s a challenging and transformative time, where hormone levels, particularly oestrogen and progesterone fluctuate, leading to various physical and emotional symptoms, including hot flushes, night sweats, mood swings, fatigue, insomnia and reduced bone density. For these women, their skin can become dry, more sensitive, and prone to irritation, and previously tried-and-trusted skincare products often no longer have the same impact. A sharp drop in collagen production causes skin laxity with a loss of youthful volume and tautness.
Besides the physical symptoms, perimenopause also has a significant impact on a woman's self-esteem and body image. I often hear my patients in this age group say they feel like their skin and body are ‘letting them down’ or they no longer recognise themselves. As such, I believe as an industry, we can step up as powerful allies to women, by not only addressing some of the visible changes but by helping women navigate this life stage with confidence and grace.
Seeing and understanding the whole patient
Women experience perimenopause and menopause differently, so we need to tailor treatment to their unique needs. That means building trust and exploring their multi-faceted concerns and aspirations.
Although the typical age of a ‘first time’ aesthetic patient may be in the late 20s or early 30s, I’m seeing an increasing number of women in my practice in their 40s and beyond, who seek advice because of how the menopause is making them feel. While physical changes are a significant aspect of perimenopause and menopause, the emotional toll cannot be underestimated. Mood swings, anxiety, and feelings of self-doubt are common during this period. Interestingly, unlike the younger cohort who are typically motivated by a specific life event or season, perimenopausal and menopausal patients are looking for a longer-term solution. For them, it's not about instant fixes – very often, what they’re actually looking for is an entire lifestyle reset, so I try to explore that as fully as possible in my consultations.
Beyond looking at the skin, I also spend a lot of time looking at their medical history, lifestyle, diet, exercise, alcohol, stress management, and I ask about family life and relationships and sexual health. If they have children, another significant milestone can be when they leave home. Many feel that this is now their time to look after themselves, having spent many years juggling work and childcare. All of this can impact how they see themselves – and how they want to be seen.
As an industry, we need to take a holistic approach and meet these women where they are, with a better understanding of their unique needs and concerns. Besides being well-versed in the physiological changes, practitioners should be trained to listen to their patients' concerns and provide empathetic care, so they feel valued and understood during this challenging time. In addition to physical treatments, we need to be able to provide mental and emotional support alongside physical treatments, such as counselling services, support groups, or even simply creating a calming and welcoming environment in our clinics. As a practising GP, I can offer holistic women’s health solutions in my clinic, including pelvic floor chair therapy, counselling and other mental health services.
Taking patients on a skincare journey that is tailored to their unique needs
Injectables aren’t always the immediate solution. For me, the process is like climbing a ladder and the first step should focus on the fundamentals of good skincare as you’ll always see a far better result if you’re working with a great canvas. I start by reappraising their skincare products and routines, especially as they often find they’re not getting the same results they’ve always had. We might need to make adjustments to combat the effects of hormonal changes on the skin, such as increased dryness, laxity, lines and wrinkles, and uneven pigmentation. We look at things like Vitamin C, SPFs, ceramides, and retinol, before advancing up the ladder to other options such as energy devices, injectables and sometimes referral for surgical procedures such as upper blepharoplasty.
Choosing the right injectables
This group of patients is mostly looking for a subtle, natural look and they are typically very well-informed about injectables and the importance of hyaluronic acid and collagen. They are nervous about looking fake or overdone and understand that correcting the negative signs of ageing can be done gradually and carefully over a period of time. HArmonyCaTM, a hybrid injectable consisting of 70% hyaluronic acid (HA) and 30% calcium hydroxyapatite (CaHA) that was launched last year is one of my most popular treatments. It provides a natural, immediate result from hyaluronic acid, and then a gradual and long-lasting collagen stimulation from calcium hydroxyapatite. I was one of the first 100 clinicians globally to use the product, and both I and my patients are very satisfied with the results.
Male practitioners are powerful allies too
Having experienced menopause myself, I’m able to bring a certain perspective and empathy to my consultations, and I also learn a lot from my patients about how they are navigating this transition phase in their lives. But that’s not to say male practitioners cannot bring a similar level of understanding to their menopausal patients. It’s about listening, being open, sympathetic and up-to-date on treatment options. We all have sisters, wives, partners, and friends we can speak to and build our knowledge of the emotional and physical journey our patients are on.
Encouraging a positive self image
To better support women in perimenopause and menopause, it's vital to promote a more inclusive and realistic definition of health, well-being and beauty, and how to embrace the natural ageing process and the wisdom that comes with it. We can play our part in reshaping societal beauty standards, in the way we promote our work, by using imagery that features women of all ages to emphasise that beauty and joie-de-vivre are not limited to youth.
To conclude, the growing conversation in the media and the continued taboo-busting around menopause is helping a large group of women to reflect on this new phase of their lives and learn how to maximise their health, vitality and self-confidence for the coming decades.
As a group of medical professionals, we can help these women on their journey; our ultimate goals should be to help women feel and look their best with a sense of confidence and optimism, and in doing so, contribute to a more inclusive and supportive society that values women at every stage of their lives.
Dr Eithne Brenner has authored this piece in her capacity as an Allergan Medical Institute Faculty member.
