Perimenopause and Menopause: Estrogen-Deficient Skin and Impaired Quality of Life—Dermal Aging a Visible Mirror Reflecting Internal Aging and Health

Increased awareness in women’s health has taken place over the last 5 to 10 years, especially associated with aging, where perimenopause and menopause have been highlighted topics. This review examines how changes with age in women during perimenopause and menopause lead to estrogen-deficient skin and impaired quality of life (QOL). The topics presented include: (1) the reasons why women’s health (perimenopause and menopause) is finally taking a prominent position in the public and medical mindset, (2) chronological (intrinsic) and photo (extrinsic) skin aging characteristics and skin changes by each decade of life, (3) the importance of and the changes to estrogen levels in aging women (especially with perimenopause and menopause) that lead to estrogen-deficient skin, (4) in brief, hormonal and selective estrogen receptor modulators (SERMs), including polyphenolic and isoflavonoid treatments, plus influencing lifestyle factors, and (5) using skin changes, as the “observable organ” and a reflective mirror of internal aging in women that may signal the potential decline of various unseen tissue/organ systems. This represents a different paradigm for the functional aspects in the body associated with the shifts in and loss of estrogen. Thus, skin health with aging (and the decline in and loss of estrogen) may provide nutritional and medical professionals, especially dermatologists, with a unique position to lead a discussion with patients to consider healthiness beyond dermal changes. Finally, potential treatments to assist and/or enhance women’s healthspan and longevity may be part of this exchange in a collaborative examination. Graphical abstract available for this article.