Therapy should be therapy

Here's the thing. It is pretty much accepted that throughout a woman's life hormone changes will influence her skin. So when research shows otherwise I always want to see how the research was done so I can learn something new.

I recently read a medical study that at first glance gave me the impression that hormones given for menopause would not help skin continue to look good. I regularly talk to dermatologists who tell me otherwise. They tell me that women who take appropriate hormones after menopause have much nicer, less wrinkled skin than women who choose not to or aren't given an opportunity to treat their hypogonadism (menopause).

This study talked about hormone therapy for postmenopausal women. Since there is only one way to become post-menopausal, and that is to have no gonadal (ovarian) function, either because the gonads have failed (menopause) or they have been surgically removed, saying hormone therapy for menopause means only one thing, ovarian hormones have been replaced.

So I began to read the article and I saw something very different.

The hormone therapy given was equivalent to using 1 birth control pill a week. I continued to read this study to its conclusion, which was that this particular hormone therapy was ineffective. Ok, I can see that. A dose that low won't keep the skin soft or smooth.

What I can't see is why one birth control pill a week is called hormone therapy. Therapy for what? Giving a woman the equivalent of 1 birth control pill a week results in hormone levels similar to those just months before her ovaries completely fail and she is in menopause. So, what is this therapy for? Creating near complete ovarian failure? Where are the health benefits in that?

If this study used an estrogen cream made of estriol or estrone or only a progesterone cream they too would likely have been called hormone therapy. Many combinations of hormones are all given the same name, hormone therapy. There are healthy hormonal combinations and unhealthy ones, so how can you tell the difference if all combinations are called the same thing?

If the term hormone therapy is ever going to be meaningful it has to really be therapy.

Every woman recruited for this study had profound hypogonadism (menopause) and treatment for it is very clear. Just look at treatment for men with the very same condition. All of the gonadal hormones, estradiol, testosterone, progesterone and dhea, are monitored to make sure none of them are too low because the treatment should be effective for gonadal failure. Why isn't this the attitude towards women? If someone is going to offer hormone therapy to a person, woman or man, with hypogonadism, then it should treat hypogonadism.

As for the question of whether ovarian replacement will slow the aging of the skin, ask any dermatologist. They know. The answer is yes.