HEALTH UPDATES

What’s Old is New

Hormone therapy’s anti-aging benefits are substantiated in small study

Pick up any women’s magazine or visit your local department store these days, and it is hard not to notice the sheer number of products touted to reduce the visible signs of aging. Because these products are being marketed as cosmeceuticals and not drugs, they are prohibited from making claims regarding structure and function. Yet, despite the lack of data proving safety and efficacy, their price tag is often steep - oftentimes exceeding $100.00 for a small bottle. Now, women may have added weapon in the fight against aging, and one with some science behind it - hormone therapy. A recently published study points to the benefits of using menopause hormones to help combat the signs of aging.

For years, women believed that hormone replacement therapy helped to keep their complexion youthful. Anecdotal reports and animal studies also suggested that hormone therapy can influence the thickness and collagen content of the skin. But, human studies have been limited in this area.

Hugh S. Taylor, M.D. and other researchers from the Yale School of Medicine examined the effects of long-term hormone therapy on skin rigidity and wrinkling. The results from the study were published in the August 2005 issue of the medical journal Fertility and Sterility. The small study involved twenty women; eleven who had never used menopause hormones and nine who were long-term hormone users. The women were similar in terms of age, race, sun exposure, sunscreen use and smoking history. Each participant went through menopause at least 5 years before the evaluation.

A plastic surgeon, with no knowledge of which women were using hormone therapy, rated the number and severity of wrinkles using the Lemperle scale. The women were studied for wrinkles at 11 facial locations including forehead lines, frown crease and upper-lip wrinkles. Skin elasticity was also measured using a device known as a durometer.

The researchers found that skin rigidity was significantly decreased in hormone therapy users compared to non-users in the cheek (1.1 vs. 2.7) and forehead (20 vs. 29). Average wrinkle scores were lower in hormone users than in non-hormone users (1.5 vs. 2.2) on the Lemperle scale. Based on the study results, the researchers reported that long-term estrogen therapy used earlier in menopause is associated with fewer wrinkles and less skin rigidity in postmenopausal women.

Taylor states, “We don’t believe hormone therapy will make wrinkles melt away once they’re already there, but the results of our study shows that hormone therapy can prevent them. Hormone therapy makes wrinkles less severe and keeps skin more elastic.” It seems that hormone therapy keeps the skin healthy but can’t reverse existing skin damage. Taylor and his colleagues plan to replicate the findings in a larger follow-up randomized prospective study.

While these study results were positive, many women have been reluctant to take replacement hormones during menopause. In 2002, researchers discontinued the large, well-designed, Women’s Health Initiative (WHI) because the women on hormone therapy had a higher risk of heart attack and breast cancer. Since then, the results from more recent studies have shown that the risks are more closely associated with older women long past menopause, and not younger women.

A study published in the February 13, 2006 issue of Archives of Internal Medicine highlighted some of the differences between older and younger women. In the study, a total of 10,739 women between the ages of 50 to 79 years and who had previously undergone a hysterectomy were randomized to receive conjugated equine estrogen (CCE). Half of the women received 0.625 mg/d of estrogen while the other half received a placebo. Overall, estrogen did not provide protection from cardiovascular events or coronary death in the postmenopausal women. However, among the women 50 to 59 years of age at baseline, there was a suggestion of lower coronary heart disease risk.

Based on these studies, women in their 50’s may benefit from taking hormone therapy to not only relieve menopausal symptoms but to keep other organs of the body younger including the skin and heart.

Sources:
Wolff EF, Narayan D, Taylor H.S. “Long-term effects of hormone therapy on skin rigidity and wrinkles”. Fertility and Sterility. 2005 August; 84(2):285-8.

“Effects of Conjugated Equine Estrogen in Postmenopausal Women with Hysterectomy: The Women’s Health Initiative Randomized Controlled Trial”, The Women’s Health Initiative Steering Committee, JAMA, 2004: 291: 1701-1712

JoAnn E. Manson et al, “Conjugated Equine Estrogens and Coronary Heart Disease: The Women's Health Initiative”, Arch Intern Med. 2006;166:357-365