Collagen As We Age

Podcast Episode 16 transcript.

Listen to Apple, Spotify, and our website - or wherever you get your podcasts!

Today, I’m talking about Collagen and Ageing.

Collagen provides strength and elasticity to the skin. Research has identified around 28 types of collagen in the human body, grouped into five types. Collagen 1 makes up 90% of your body’s collagen. It is densely packed and provides structure to your skin, bone, tendons, and ligaments. We are mainly talking about Collagen 1 in this podcast because it relates to skin. 

Skin is the largest organ in the body, mainly collagen fibres and hyaluronic acid.

Proteins are long chains made up of smaller building blocks called amino acids. Collagen is a protein comprising three amino acids: glycine, proline, and hydroxyproline. The body also needs the right amount of Vitamin C, zinc, copper, and manganese to build collagen.

We naturally start losing collagen between the ages of 18 and 29. After we hit 40, the human body loses around 1% a year. During the first five years of menopause, the skin loses about 30% collagen. After that, women lose about 2% collagen annually for at least 20 years.

As collagen is lost, our skin loses firmness and begins to sag. Jowls suddenly appear out of nowhere; permanent lines run from the tip of the nose to the corners of the mouth, together with permanent wrinkles. You may notice pouches under the eyes; pores might seem larger, and even the tip of the nose can dip! Isn’t ageing just lovely?

So, how can we preserve and build our collagen stores?

It would be ideal to start naturally banking your collagen from a young age—so young people take note! It is never too late for the rest of us to take action!

Here are some suggestions:

1. Stay out of the sun - exposure to UVA is the leading cause of photoaging because it causes collagen in the skin to break down quicker than it should

2. Quit smoking and reduce your alcohol intake

3. Reduce the amount of sugar and processed food

4. Drink more water - it will automatically plump the skin

5. Eat a diet rich in vegetables, whole grains, nuts and fruits with a moderate amount of seafood, meat, dairy and eggs

6. Pay particular attention to foods rich in collagen building blocks or make collagen production faster. Here are some examples:

   1. Vitamin C - we all know it’s in citrus fruits, but it’s also found in strawberries, bell peppers, broccoli and potatoes

   2. Proline is found in mushrooms, cabbage, asparagus, peanuts, fish, egg whites and meat

   3. Glycine is found in meat, peanuts and granola

   4. Copper is found in shiitake mushrooms, nuts and seeds, leafy greens, tofu and dark chocolate

   5. Zinc is found in meat, beans, chickpeas, nuts, broccoli, green leafy vegetables, whole grains and dairy products.

7. Treat yourself to Regular Peels, Light Therapy, Laser treatment, and Microneedling. This can start in your 20s. If you’re older, make sure that the person treating you has experience with menopausal skin, which tends to be drier and thinner and needs to be treated differently from younger skin.

8. Use retinol and peptide-rich skincare - again, choose skincare that is personalised to you. Skincare with active ingredients needs to be used with care. Please don’t just buy any retinol serum bottle without knowing how to use it. This can cause dryness and irritation - and happens so often that it also has a name: retinoid-induced dermatitis. So make sure you speak to someone who can tell you exactly how to use this skincare before they sell it to you.

9. Hormone Replacement Therapy can reverse the effects of ageing on the skin and has been shown to increase hydration, elasticity, skin thickness, and the quality of collagen while reducing wrinkles.

10. Supplements: Most collagen is extracted from animals. I’ll spare you the details as it’s not pretty, and recently, it was extracted from algae, which is excellent for vegans and vegetarians. There are loads of collagen supplements, all claiming to be the best. But, when we eat collagen-rich food or supplements, our digestive system breaks down the long protein chains into smaller amino acid-building blockers. There is no way for us to consciously direct those building blocks to go straight into our skin. The body decides to use those blocks wherever needed - from ligaments to bones to muscles. We also know that it usually takes 10-12 weeks for supplements or a change in nutrition to show any effect. So be weary of whoever tries to sell you a quick fix because it cannot happen with everything we’ve listed until now.

But people sometimes like a quick fix, which is why Botox and fillers have become more prevalent in recent years. 

I was against offering these treatments when we started our skin clinic, possibly because social media is currently promoting the misuse of these products. 

However, seeing these treatments expertly and elegantly administered by my healthcare colleagues has convinced me there is also a place for them. I cannot stress enough how important it is to have a healthcare professional administer these treatments, and I fail to understand why anyone would want just anybody injecting their face. Using good quality skincare and good nutrition with these treatments, which could also include laser and light therapy, is essential, as everything will work together to build and maintain collagen in your skin.

Mood Swings and tips to cope

Podcast Episode 16 transcript.

Listen to Apple, Spotify, and our website - or wherever you get your podcasts!

Today, I’m going to talk about mood swings.

Around 40% of women have mood symptoms during menopause that are similar to premenstrual syndrome. Women describe irritability, low energy, difficulty concentrating, tearfulness, and moodiness. However, unlike Premenstrual Symptoms, menopausal mood swings are unpredictable and may occur at any time without a reason or pattern.

Menopause also hits us at a time when we are dealing with a lot of life pressures. You might juggle young or older children leaving for college or university, depending on your situation. You might be struggling with the loss of loved ones, going through separations and divorces, maintaining relationships with partners and friends, demanding jobs, making ends meet, or looking after ageing parents. Even exciting times like career progression or re-inventing yourself are stressful! Menopause also comes when we start noticing changes in our skin and how we look; in a way, it is a time when we begin to feel mortal and possibly think about ageing and a bit more about the future. These things might be happening all at once, and it’s normal to feel like we’re being pulled in every direction while we try to do our best, which sometimes doesn’t feel enough!

There is evidence linking hormonal swings to both anxiety and depression, Most women report various levels of anxiety symptoms, that in some cases, affect daily life. Symptoms include muscle tension, nausea or sweating.

Symptoms of depression include crying a lot, feeling hopeless or worthless, feeling numb, losing interest in activities and personal care, and isolating yourself.

If you are feeling this way, although there is a chance that your feelings could be related to menopause, please do not just assume it is; speak to someone. There are a lot of other causes for both anxiety and depression, especially if you’ve struggled with these symptoms throughout your life.

Here are some Coping strategies to help you with mood swings

1. Awareness and acknowledging your feelings is important and is the first step towards empowering yourself to take action.

2. Stop feeling guilty! Be kind to yourself! This is not your fault—stop apologising. Use this energy to do something positive for you. It’s okay to look after yourself!

3. Seek help and support from people you can open yourself up to, such as family members or good friends. I would like to give a shout out to my friends; to me, you are the sisters I never had.

4. Self-refer to talking therapies, which can be accessed for free on the NHS in the UK. Go and speak to your doctors; they can also refer you to other services in your area.

5. Self-care is not a luxury - it is a necessity. Time spent looking after ourselves means the body and mind have time to recalibrate. Self-care can be going for a run, walk, or bath. Sitting silently for a few minutes, maybe listening to a relaxing podcast or music, also counts. Vary these activities, and schedule them into your routine. They are as important as going to a food shop or doing other chores!

6. Eat food that actually nourishes both your brain and body. If your appetite is not the best at the moment, try to look at food as if it were medication.

7. I heard someone describe motivation as non-existent because motivation is most often not there when you actually need it. Make little changes, a step at a time, and set yourself up for success. Trying to do too much too soon can put too much pressure on you.

8. Last but not least, medication. The use of Antidepressants during menopause has been demonised over the past few years. I do believe that medication is there to use it when it is needed. Find a doctor you can talk to, one you can sit down with and make a plan. Depending on the severity of your mood swings and mental well-being symptoms, you might want to try HRT first and then review how you feel in a few weeks’ time, or you might opt to try antidepressants or have both HRT and antidepressants together. Remember, what works for others might not be right for you because you are unique. If what works for your friend does not work for you, you are not a failure - you are biologically different from anyone else. If you choose to try medication, whatever it is - please be aware that the other things we mentioned, like nutrition and self-care, will still be a very important part of your mental well-being plan.

Useful links:

NHS talking therapies for anxiety and depression

#radiomenopause

Hormonal Acne in Menopause

Podcast Episode 15 transcript.

Listen to Apple, Spotify, and our website - or wherever you get your podcasts!

Androgens are a group of hormones, including testosterone, usually associated with male characteristics. However, androgens are reproductive and growth hormones produced in male and female bodies in different quantities. In women, androgens are made in the ovaries, adrenal glands, and peripheral tissues like the skin.

It is thought that in post-menopausal women, ovaries remain producing androgens up to around ten years after menopause. 

While oestrogen concentration decreases abruptly to undetectable levels, androgen concentration decreases gradually. This may lead to symptoms like acne, increased facial hair growth, like those dreaded chin hairs, and worsening scalp hair loss.

Adult acne tends to happen mainly around the jaw, chin and sometimes around the mouth.

Acne lesions produce post-inflammatory redness, pigmentation, and sometimes scarring, so avoid squeezing or picking your face.

1. There are four stages in the formation of a spot:

2. First, there is Excess and unbalanced sebum production under the control of androgens

3. Then, the skin over the spot thickens a process called hyperkeratosis. This is followed by a particular strain of bacteria called C. Acnes entering the follicle.

4. Lastly, the body fights this infection, producing chronic inflammation.

We know that androgens play a significant role in acne flare-ups in perimenopausal and menopausal women. It's not the number of androgens that causes acne but that the sebaceous glands in some women are hypersensitive to androgens. As we have discussed, this causes their sebaceous glands to enlarge and overproduce sebum, which starts the formation of acne lesions.

Managing Hormonal Acne is an ongoing process that requires patience—and a lot of it. Acne is a very frustrating condition and quite distressing for many women. Whatever treatments you choose to trial, medical or not, managing acne will take time, and it's usually around 12 weeks before you see if what you are trying is having an effect. There is no overnight treatment for acne.

So now, for the best bit, how do you manage hormonal acne?

Treatment is not a one-size-fits-all and usually depends on the severity of acne and skin type. Consistency is key.

Medical Management might include spironolactone, which blocks androgens, hormonal therapy, antibiotics, and isotretinoin. All these medications can be very effective, but they come with contraindications and risks that are not to be taken lightly, so it's important to have these discussions with your doctor or dermatologist.

Again, topical medical treatments can be very effective. However, they must be chosen carefully during menopause and used sparingly, as they cause dryness and irritation. Menopausal skin already tends to be more sensitive and dry.

Some women decide not to go down the medical route and manage their acne using skincare, supplements and treatments.

Skincare is very important whether you are using medical treatment or not. A good consultant routine must be carefully selected to avoid irritation and dryness. 

Physical scrubs should be avoided, as they can spread infection and irritate the skin. Tanning should also be avoided, as it can cause hyperpigmentation. Heavy, oil-based foundations should be avoided and replaced with water-based cosmetics.

Ingredients like salicylic acid, Niacinamide, and retinol can be carefully included in your routine while maintaining hydration and preventing dryness. Adding ingredients like hyaluronic acid and monitoring your skin daily can also maintain hydration and prevent dryness. Using an SPF daily, morning and night, is also essential.

Supplements like zinc and probiotics have been shown to improve the skin barrier and acne. The diet also plays a role in blemish balance. Consider adopting an anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids. Hydration is vital, too—water helps flush out toxins and keeps your skin looking radiant.

Several studies show that weight loss, exercise, getting enough sleep, smoking cessation, a healthy diet with low sugar content, and avoiding milk can all help to reduce acne. Stress management plays a pivotal role in hormonal balance. Incorporate relaxation techniques into your daily routine, whether meditation, yoga, or a simple walk in nature.

We must stress the importance of seeking professional advice if you are struggling or unsure what to do about your acne.

Remember that you're not alone in this journey. Many women are navigating the same challenges, and with the right approach, you can continue to improve your skin and keep it in the best condition.

Links:

Acne treatments and products at Chemist & Co

Changes of androgens levels in menopausal women

The effect of probiotics on immune regulation, acne, and photoaging