What you need to know about offering bioidentical hormone therapy in your clinic

Bioidentical hormones do exactly what they say on the tin; they have exactly the same effects on the body that your own hormones do. This is in contract to synthetic hormones that have some of the effects but also some unwanted and potentially dangerous side effects because the molecules are not identical to your own hormones. They are administered in the form of creams, capsules and lozenges. 

Centuries ago people would not have lived past the age of 50, so it would have been fine that our organs stopped producing hormones. Now, during the menopause, women experience a drop in hormones – oestrogen, progesterone, testosterone and DHEA (dehydroepiandrosterone).

This drop contributes to skin ageing, which results in the skin thinning, wrinkle depth increasing, extra dryness, and a decrease in plumpness and elasticity. 

The skin is sensitive to the actions of oestrogen, progesterone and testosterone. Oestrogen and progesterone stimulate collagen production and also inhibit MMP-1, which causes collagen and elastin to be clumped and disorganised.  

Testosterone causes a reduction in collagen production. Oestrogen deficiency also means skin is less protected, causing impaired wound healing, hair loss, pigment changes and cancer.

With this knowledge, as well as all the classic symptoms of the menopause such as hot flushes, low mood, and loss of libido and confidence, it is mad that more women do not take hormone replacement. The reason is largely due to misinformation. 

Doctors and women are very aware of the studies that showed that there is a significant increased risk of breast cancer in women taking HRT for more than five years. However, what is not widely known is that if a woman takes bioidentical and not synthetic progesterone then the risk is not there. 

Women should be asking for utrogestan as their progesterone and also having testosterone levels checked as a small amount of testosterone can not only improve libido and confidence, but the skin too. Offering Bioidentical hormone replacement therapy to aesthetic patients is the way to truly provide holistic care.

Dr Ros Debenham is owner of Radiance MediSpa, Exeter, which won Professional Beauty’s Medical Aesthetic Clinic of the Year Award 2019. Read Debenham’s piece on what to do when you start looking like your mother.