Menopause and Skin Aging in Primary Health Care: The Impact of Hormone Therapy on Skin Health and the Role of the Family and Community Doctor

Abstract

Introduction: Menopause is a physiological process characterized by the permanent cessation of ovarian function and a reduction in estrogen production, triggering structural and functional changes that accelerate skin aging. Among the main manifestations are reduced dermal thickness, loss of collagen, decreased elasticity, dryness, impaired barrier function, and delayed wound healing, all of which negatively impact women’s quality of life. In this context, hormone therapy has been investigated as a strategy to minimize these changes and preserve skin health. Objective: To critically analyze the available scientific evidence regarding the impact of hormone therapy on skin health during menopause, emphasizing its effects on skin aging, the pathophysiological mechanisms involved, clinical benefits, limitations, and therapeutic prospects. Methods: A systematic literature review was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). Searches were conducted in the PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, LILACS, SciELO, and Virtual Health Library databases, using controlled descriptors from the MeSH and DeCS systems combined with Boolean operators. After applying eligibility criteria and conducting a methodological assessment of the studies, 36 publications were included in the qualitative synthesis. Results: The evidence demonstrated that estrogen deficiency is one of the main factors responsible for accelerating skin aging during menopause, leading to changes in the extracellular matrix, increased oxidative stress, activation of inflammatory processes, and reduced synthesis of collagen, elastin, and hyaluronic acid. Hormone therapy showed consistent benefits in improving hydration, elasticity, dermal thickness, barrier function, wound healing, and overall skin quality, especially when initiated during the window of opportunity. However, heterogeneity was observed among the studies regarding therapeutic protocols, routes of administration, duration of treatment, and dermatological assessment methods. Conclusion: Hormone therapy represents an important strategy for preserving skin health in postmenopausal women, offering significant clinical benefits when prescribed on an individualized and evidence-based basis. However, new multicenter clinical trials with greater methodological standardization and prolonged follow-up are needed to establish more robust recommendations regarding the efficacy and safety of the different therapeutic modalities.