There are many factors influencing our skin's ageing process. Some of them are called intrinsic, or factors that are time related and independent of person's behavior. They include hydration, transepidermal water loss, oil secretion by sebum glands, gender, ethnicity, hormonal changes and some more. Factors that can be controlled to some extent by a person are called extrinsic. These include the effects of smoking on the skin, exposure to UV rays and others.
Intrinsic ageing in men is a smooth phenomenon: skin quality declines gradually and smoothly with time. It is not the case for women: there is a sharp increase in decline at around 50 to 60 years. This acceleration of decline corresponds to the passage from pre to postmenopause.
Female hormones have some important effects on the skin. Estrogen prevents or reverses skin atrophy, dryness, wrinkles associated with intrinsic ageing or photoageing (a process of skin ageing attributed to continuous long term exposure to UVA and UVB rays), enhances collagen synthesis, maintains skin thickness and moisture levels. Progesterone increases oil (sebum) secretion.
At an age of around 45 to 55 every woman experiences transition from a potentially reproductive to non-reproductive state. During menopause a woman's body slowly produces less of the hormones estrogen and progesterone which may negatively affect the skin.
Hormone replacement therapy (HRT) can help women deal with problems associated with menopause. Women are given estrogen or estrogen and progestin (synthetic progestogen that has effects similar to progesterone) to help alleviate the physical symptoms associated with the change of life. Women who begin HRT at the onset of menopause experience noticeable improvements; if a woman begins the therapy on average five years post-menopause, she experiences no significant improvement in her damaged skin.
Although HRT can improve skin's appearance if started early and has other positive impact on woman's life, it can also have negative effects such as increased risk of breast cancer or increased risk of thrombosis. If a woman is on HRT for less than two years, which is standard, increased risk of breast cancer has not been observed. Thrombosis is also a rare event, therefore, even if HRT increases the risk, its occurrence is still rare.