You’d never know how many millions of women were affected by one single very flawed medical report released in July 2002 called the “Women’s Health Initiative (WHI).” It stated, loud, clear, and wrongly that hormone replacement was very dangerous; the breast cancer and heart attacks risks were too high. DOCTORS: “Do not prescribe hormones.”
What followed was an entire generation of physicians who simply stopped prescribing hormones and an entire generation of women who were physically and emotionally miserable. And then, ever so slowly, over the next twenty years, reports from around the world were published first showing the WHI had been very flawed (women entered the study with breast cancer, were over age 65, etc.). Other reports showed that hormone replacement provided many benefits with very few side effects. Not only relief of menopause symptoms but also better bones, less heart disease, better brain health and overall sense of well-being.
Unfortunately, to this day, too many physicians keep quoting the incorrect data of the WHI and women still have worries when they hear their primary doctor say, “I never prescribe hormones. You’ll get breast cancer.”
Just find a different doctor. Or come to WholeHealth Chicago.
ESTROGEN AND LOOKING YOUR VERY BEST
Some recent research measuring blood levels of estrogen in several hundred young women and then making facial “composite photos” showed that those with normal to high (but not too high) levels of estrogen were more physically (read “sexually”) appealing.
But then, come your late forties and you’re trotting into the foothills of menopause. Your estrogen levels start to drop. The late Nora Ephron titled her book well, “I Feel Bad About My Neck and other Thoughts About Being a Woman”. Yes, look carefully (or even not so carefully) in the mirror and you’ll see changes in your skin that you might not like. It’s not only your estrogen, but you’ve been exposed to the great outdoors. If you smoke cigarettes, you’ve pressed the “Ultra-Fast Forward” button on the whole skin aging process.
Estrogen deficient skin has a lengthy list of unique characteristics, all generally less than desired: dryness, wrinkling, itching, thinness. Your skin becomes more sensitive to itchy fabrics, soaps, and beauty products. You may get more skin rashes or hives; you bruise easily, and because of less collagen production, even minor cuts and bruises seem to take forever to heal.
The usual culprits of perimenopause/menopause I’ve written about many times: hot flashes, night sweats, mood changes, vaginal dryness, weight gain (especially mid-section), brain fog, virtually all of which can be pretty dramatically helped by bioidentical hormone replacement therapy (BHRT).
So, a reasonable question: does BHRT, whether capsules, cream, or those twice weekly estradiol skin patches, actually help your aging skin as well? Yes, sometimes.
Also, interestingly, I have had patients who used estradiol vaginal cream (for lubrication) twice weekly for years, saving a pea sized dollop to apply around their eyes. Seemed like a good idea and their eyes looked wrinkle free. You could do the same with your estradiol vaginal cream if your vagina is willing to share your cream with your face.
Better yet is a compounded face cream containing the following:
- DMAE (Dimethylaminoethanol): Added to help firm and tighten the skin, improve muscle tone, and brighten uneven skin tone.
- Hyaluronic Acid: A powerful sugar molecule that draws water into the skin to deeply hydrate and plump fine lines.
- DHEA: A precursor hormone that converts locally into androgens and estrogens to support structural tissue thickness and moisture
- Estriol: (E3): a mild form of estrogen with no system absorption and can be used in a situation where estrogen is contraindicated (like history of breast cancer). It acts locally in the skin to help boost firmness, elasticity, and collagen synthesis.
Schedule at WholeHealth Chicago offices with your questions.
Be well,
David Edelberg, MD
How does the compounded face cream’s estriol component work locally in the Block Blast skin without significant systemic absorption, particularly for someone who cannot use systemic estrogen?
Alicent Hightower
Thank you for such a thorough write-up — the story of how one flawed WHI report sidelined hormone therapy for an entire generation of women is genuinely shocking, and I’m glad you’re setting the record straight on these myths. The note about compounded face creams with estriol and hyaluronic acid is especially helpful; it’s nice to see the skin side of hormones taken seriously. On a lighter note, I needed a mental break after all this reading and discovered a free little browser game where you drive through Lagos traffic — a surprisingly fun way to decompress! Thanks again for sharing this knowledge.
Lagos Run
This is an interesting look at the common myths surrounding hormones and how they can influence the way people think about health and appearance. I like the emphasis on separating popular assumptions from more nuanced information, especially when discussions about hormones can become confusing very quickly. The connection between hormonal changes and facial or skin concerns also makes the topic particularly relevant to everyday health conversations. After reading through the discussion, a quick round of slope sounds like
BrianAdams
What an eye-opening post! I never realized how many hormone myths were out there. Your insights are incredibly helpful. Looking forward to trying the skincare tips you shared! By the way, I’ve been enjoying “run 3” as a fun break; it’s great for keeping my mind sharp while learning this stuff!
run 3
I would love to come in for a consultation soon as I sincerely would like to know if your practice consults on how to go about taking bHRT when you have estrogen dominance, slow COMT snps and some poor detox genetics that interfere with proper breakdown of estrogen? And family history of breast cancer. I could really use guidance on this and would love to know which provider I should request to see. Thank you very much.
Odessa Aronson
Hi Dr E, this prejudice is exactly what I’ve run into in NC! Looking for a new MD yet again. ATM was ‘allowed’ to suddenly drop my patch to a 50% strength one. Not good! Is there any cream u can buy otc to boost estrogen please?
Tina Hepworth
Hi and thank you! Do you recommend a particular face lotion that has all the ingredients you listed?
Susan
Thank you for this. The WHI fallout is one of the great cautionary tales in modern medicine — a single flawed study shape-shifted into two decades of unnecessary suffering, and too many doctors are still practicing on autopilot because of it. The point about finding a different doctor can’t be overstated; you shouldn’t have to argue your way into feeling well.
Bumper LT