Article - Sator, Schmidt, Rabe, Zouboulis: https://www.tandfonline.com/doi/abs/10.1080/136971...

What the researchers found

Skin is a hormone-responsive organ. It contains receptors for estrogen, progesterone, and androgens, which means these hormones directly influence how skin cells function. Estrogen plays the biggest role; It helps regulate collagen production, which is the protein that keeps skin firm and structured. It also supports hydration by increasing substances like hyaluronic acid that hold water in the skin.

What happens in menopause

As estrogen levels decline, several structural changes occur in the skin. Collagen production drops. Skin becomes thinner. Elasticity decreases. Hydration is reduced. Sebum production also declines, which contributes to dryness. These changes are not just cosmetic. They reflect measurable biological changes in the skin’s structure and function. Some studies cited in this review suggest that women can lose up to 30 percent of their skin collagen in the first few years after menopause!

What they found about hormone therapy

The authors reviewed studies where women used systemic hormone replacement therapy or topical estrogen. Across many of these studies, hormone therapy was associated with:

Increased collagen content
Improved skin thickness
Better elasticity
Increased hydration

Some studies also showed a reduction in wrinkle depth, although results were not consistent across all trials. These findings came from objective measurements such as skin biopsies, ultrasound imaging, and mechanical testing of skin elasticity.

The role of other hormones

Androgens may also play a role in skin health, particularly in oil production and possibly collagen support, although their effects are less clearly defined. Progesterone’s role is not well established in this context. The paper also discusses phytoestrogens, which are plant-derived compounds that can weakly mimic estrogen, but their effects are significantly less potent than pharmaceutical hormone therapy.

What this means in menopause

The decline in estrogen during menopause is a key driver of skin aging in women. This is not just about time or sun exposure. It is a hormonally driven process that affects the structure and function of the skin at a cellular level. Hormone therapy can improve several of these changes, particularly collagen content and skin thickness, but results vary and are not universal.

Skin aging in women is strongly influenced by hormonal changes, especially the loss of estrogen. Hormone replacement therapy can improve some measurable aspects of skin health, but it should not be used solely for cosmetic purposes. Its role is broader, and any skin benefits are part of a larger systemic effect.