October 2003
Dear Paula,
I just had to comment on your statements about estrogen use and young-looking skin. You might want to read Dr. Susan Love's The Hormone Book. Dr. Love is a leading breast surgeon who is very against using long-term estrogen therapy, and in her book she talks about the false data about estrogen supplements and their benefit to skin. According to Dr. Love, the measurable difference between estrogen-supplemented skin and nonsupplemented skin is very minuscule. You make it sound like women will get all wrinkly without estrogen use despite staying out of the sun and not smoking as you advocate in your book.

Judy, via email

Dear Judy,
I have the deepest respect for Dr. Love's work. Her research and books have provided invaluable insights and support when my sister and other friends struggled with and, thankfully, survived breast cancer. Her information and contribution to the issues involving women's health is significant. There are, however, those who disagree with her (and not just the companies that sell hormone replacement therapy, HRT). The research on how the lack of estrogen affects skin is not random or unsubstantiated (Sources: Plastic and Reconstructive Surgery, February 2003, pages 935-938; American Journal of Clinical Dermatology, 2001, volume 4, number 3, pages 143-150, and 2003, volume 4, number 6, pages 371-378; Clinical Geriatric Medicine, November 2001, pages 661-672; and Gynecological Endocrinology, December 2002, pages 431-441).

Many factors contribute to the wrinkling and aging of skin. Sun is a major factor, but so are free-radical damage, cigarette smoking, muscle movement, skin-cell senescence (that occurs when skin-cell renewal is slowed or stops), and loss of estrogen. Whether or not Dr. Love agrees with this, I merely reported the research that exists on what is available. There are lots of controversies involved with HRT regarding breast cancer risk, and possible heart disease issues. Other than Dr. Love's comments about hormones and skin, though, I haven't seen any information suggesting that loss of estrogen has anything but a negative effect on skin.

I am in no way advocating or discouraging the use of HRT. My intent is only to help women understand what is taking place in their skin as they age so they are better able to see why a wrinkle cream can't possibly be the answer to the wrinkling and sagging they see showing up in the mirror.

For those of you interested in Dr. Love's approach to hormone replacement therapy, consider her new book Dr. Susan Love's Menopause Book: Making Informed Choices, by Susan Love, MD, (January 2003, Three Rivers Press, $15.95).