"Why Hormones & Aesthetic Medicine are inextricably linked"
with Dr Elisabeth McCulloch
Aesthetic Doctor and Medical Director mSkin; General Practitioner with a Special Interest in Premenstrual Syndrome and Menopause;
33 Montefiore Road, Hove, BN3 1RD
92 Harley Street, London, W1G 7HU
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Dr McCulloch’s career started in Austria, where she graduated from Vienna University in 2001 and completed her medical degree with academic research in Ovarian and Breast Cancer. Dr. Liz McCulloch trained in Obstetrics and Gynaecology in the reputable Ignaz-Semmelweis Clinic in Vienna before moving to the UK, qualifying as a General Practitioner and working in Brighton since 2008. Dr McCulloch recognised the need for a holistic approach to women’s health and well-being, and opened her Aesthetic Clinic mSkin in 2013
Following extensive training Dr McCulloch was awarded the Certificate of Menopause Care by the Faculty of Sexual and Reproductive Health and works as an Associate at the International Centre for Hormonal Health, in London. Previous roles include Clinical Lead for Maternity and Children’s Services for Brighton and Hove Clinical Commissioning Group. Currently she is Deputy Chair of the East Sussex Local Medical Committee responsible for representing the views of GPs.
We know that both extrinsic and intrinsic factors contribute to the aging of the skin. Understanding how menopausal change impacts the aging process will support a holistic approach to aesthetic care.
As we age, we see a migration of the facial fat compartments and characteristic wrinkling of the skin. Oestrogen maintains epidermal thickness and the collagen in the dermis. Oestrogen deprivation can lead to skin changes such as atrophy and fine wrinkling which are often attributed to exogenous aging alone. Recognition of the wider effect of menopausal changes includes the impact of vulvovaginal atrophy (VVA), osteoporosis, low energy and libido on individual wellbeing.
Bone loss, especially around the mandibular area, will result in deep marionette lines, chin ptosis, pseudo jowls and mentalis hyperactivity. We can correct these with dermal fillers and botulinum toxin. Hormone replacement therapy (HRT) is known to improve bone health in menopausal women and prevent fractures later on in life but could facial bone loss also be prevented? Small studies indicate an increase in mandibular bone mass, but more research is needed.
Many perimenopausal women suffer from sleep deprivation and insomnia. Falling progesterone levels causing sleeping problems are often an early sign of the perimenopause. Sleep deprivation is an intrinsic factor contributing to the aging process as it can enhance inflammation, increase DNA damage and decrease DNA repair. Combined HRT containing micronised progesterone may alleviate the sleeping disturbances.
This presentation will focus on the menopause, the role of HRT and how these factors link to aesthetic medicine.
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