How It Is Given
Getting Started
Most Common
Hair and skin
Skin collagen falls fastest in the first five years after menopause, with roughly 30% lost in that period, which is why the change often feels abrupt rather than gradual. Some of this responds to treatment and some of it does not. One of the symptoms Los Angeles patients raise most.
What changes
Skin changes get dismissed as cosmetic, but the mechanism behind them is the same estrogen decline driving every other symptom a Los Angeles patient describes. Estrogen supports collagen production, skin thickness and the skin's ability to hold water. As it falls, skin becomes thinner and drier and fine lines deepen. The steepest decline is in the first five years after the last period.
Hair follows a different mechanism. Estrogen and androgens both act on hair follicles, and as estrogen falls the relative androgen effect rises. Scalp hair thins at the crown and parting while facial hair sometimes coarsens, which feels like an unfair combination.
Not all of it is hormonal. Thyroid disease, iron deficiency and low vitamin D all cause hair loss and all are common at this age, which is why those are checked before anything is attributed to menopause. Related reading: menopause symptoms, common questions and non hormonal options go further into it. Photograph your part in the same light each month, because a Los Angeles clinician can judge a series of pictures better than a description.
What helps
Both cause hair loss, both are common at this age, and both are treatable. This comes before anything else.
The single most effective thing for skin aging, hormonal or otherwise. Photodamage compounds what estrogen loss starts.
The best-evidenced topical for collagen. Available over the counter at lower strength and on prescription at higher.
The best-evidenced topical for female pattern thinning. It takes four to six months and needs continuing to hold the gain.
Hormone therapy
Skin responds more predictably than hair, and a Los Angeles patient considering hormone therapy for appearance alone should know how modest the measured effect is. Studies do show improvements in skin thickness, collagen content and hydration with systemic estrogen, particularly when started close to menopause. The effect is measurable and it is modest.
For hair the evidence is thinner and the response less predictable. Some women see improvement, others do not. Treating hair loss is not on its own a sufficient reason to start hormone therapy, and it can be a welcome side effect of starting for other reasons. Worth reading next: brain fog and memory, low libido and weight gain. We would not start a Los Angeles patient on estrogen for hair alone, though where hot flashes are already on the list, the hair may improve alongside them.
Other symptoms
Most women have several of these at once. They share a cause, which is why they often shift together.
Common questions
What causes it, what to check first, and what treatment realistically does.
Patient reviews
I had been waking three or four times a night for two years and had been told it was just stress. The consultation actually went through my cycle history. Six weeks on a patch and I am sleeping through.
What I wanted was someone who would talk about the risks honestly rather than sell me something. They walked through the clot data and why a patch suited me better than tablets.
The brain fog was the part nobody warned me about. Having a clinician tell me it was a recognized symptom and not early dementia was worth the appointment on its own.
It took two dose changes before things settled, which they had told me upfront might happen. The three-month review was booked before I left the first appointment.
From the blog
Next step
Ferritin, thyroid and vitamin D account for a good share of hair loss at this age and all three are simple to test and straightforward to correct.
Consultations are by appointment. Prescriptions are issued only where clinically appropriate.