Introduction

Menopause is a the naturally occurring decline of menstrual cycles in women in their early 50’s. Although many women experience different kinds of symptoms, such as hot flushes and mood swings, the process itself represents a natural part of the aging process.

Menopause is associated with a decrease in the production of the reproductive hormones, especially estradiol. This hormone controls not only ovulation and endometrial receptivity, but has a regulatory role in many other tissues, including skin, hair, bone, and connective tissue where estrogen receptor is expressed [1].

Herbal extracts provide a natural source of polyphenols that are known to counteract some menopause symptoms, by targeting estrogen receptors, but also have a range of other anti-aging mechanisms that act in different sites around the body, including skin. This article highlights the outcomes of a clinical trial that evaluated a combination herbal extract in menopausal women for its effects on facial skin.

Study Design

The study, published by in the Journal of Cosmetic Dermatology by Tumsutti et al. (2021) [2], presents the outcomes of a randomized, placebo-controlled clinical trial of a dry extract blend of soy isoflavones, black cohosh, chasteberry and evening primrose oil. The women involved (n= 110, aged 45-60 yrs), who showed post-menopausal symptoms and exhibited type II and III fine lines and wrinkles, were randomly given the intervention tablet product, or a placebo (soybean oil) tablet once daily for 12 weeks. Dermatologists measured a set of skin parameters at baseline, weeks 6 and 12, including the degree of wrinkling, skin texture, moisture and melanin in facial skin areas on the sides of both eyes. Blood samples were also taken to determine the level of glutathione (GSH) as an indicator of antioxidant production, and malonyldialdehyde (MDA), a marker of oxidative stress.

Outcomes  

After 6 weeks, the subjects who took the herbal formula showed significant improvements in skin roughness compared to placebo. At 12-weeks, the herbal formula group showed further improvements in skin elasticity, roughness, smoothness, scaliness and wrinkle density (Figures). In addition, the blood levels of MDA in test group subjects were significantly lower, while their GSH levels were elevated, indicating systemic improvement in oxidative stress status. There were no changes in trans-epithelial water loss (TEWL), melanin, skin gloss level or hydration levels between the two groups. When questioned about their skin outcomes, significantly more test participants perceived an improvement in the smoothness, moisture, elasticity and wrinkles, from six weeks after test product usage, compared to placebo users.

Implications of the study

The reviewed study is unique in that it shows how herbal formulas containing phytoestrogens can elicit progressive improvements in skin integrity and antioxidant status in aging women, alongside improvements in menopause symptoms.

These effects are specifically relevant to post-menopausal women, who no longer produce estradiol, an important regulator of skin turnover and integrity. Some of the underlying mechanisms by which the herbal ingredients in the blend may have induced these effects are through a combination of the estrogen receptor (ER) modulation, and the antioxidant effects of soy isoflavones [3] , the barrier promoting effects of evening primrose oil fatty acids [4], and the mixed antioxidant and cytoprotective effects of polyphenol compounds in chasteberry [5] and black cohosh [6].

The researchers suggested that the activation of ER-beta by the soy isoflavones may support collagen and elastin content. Possible secondary benefits of the herbs include the antibacterial and anti-inflammatory effects of the herb extracts, which relates to their clinical uses for conditions such as acne vulgaris and dermatitis. The antioxidant effects observed here are particularly relevant to natural aging processes because oxidative stress is intimately involved in degenerative changes not only in skin, being the largest organ in the body and exposed to aggressors that impact it from within, and externally. Oxidative skin damage is also related to elevated inflammatory states, and slower rates of repair and regeneration in ageing skin [7].

Conclusion

In summary, the outcomes reported Tumsutti et al (2021) [2] suggest that natural substances help to protect skin health and oxidative stress status in ageing, post-menopausal women. These findings are complementary to the improvements in menopause symptoms, cardiovascular risk and inflammatory status described for the same herb blend, in an earlier publication [8].

References

1. Sanchez, R., et al., Diversity in the mechanisms of gene regulation by estrogen receptors. Bioessays., 2002. 24(3): p. 244-54. doi: 10.1002/bies.10066.
2. Tumsutti, P., et al., Effects of a combination of botanical actives on skin health and antioxidant status in post-menopausal women: A randomized, double-blind, placebo-controlled clinical trial. J Cosmet Dermatol., 2022. 21(5): p. 2064-2072. doi: 10.1111/jocd.14345. Epub 2021 Jul 21.
3. Skovgaard, G.R., A.S. Jensen, and M.L. Sigler, Effect of a novel dietary supplement on skin aging in post-menopausal women. Eur J Clin Nutr., 2006. 60(10): p. 1201-6. doi: 10.1038/sj.ejcn.1602438. Epub 2006 May 3.
4. Schäfer, L. and K. Kragballe, Supplementation with evening primrose oil in atopic dermatitis: effect on fatty acids in neutrophils and epidermis. Lipids., 1991. 26(7): p. 557-60. doi: 10.1007/BF02536604.
5. Upton, R., Chaste tree fruit. American Herbal Pharmcopeia 2001: p. 1-30.
6. Burdette, J.E., et al., Black cohosh (Cimicifuga racemosa L.) protects against menadione-induced DNA damage through scavenging of reactive oxygen species: bioassay-directed isolation and characterization of active principles. J Agric Food Chem., 2002. 50(24): p. 7022-8. doi: 10.1021/jf020725h.
7. Petruk, G., et al., Antioxidants from Plants Protect against Skin Photoaging. Oxid Med Cell Longev., 2018. 2018:1454936.(doi): p. 10.1155/2018/1454936. eCollection 2018.
8. Rattanatantikul, T., et al., Efficacy and Safety of Nutraceutical on Menopausal Symptoms in Post-Menopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Diet Suppl, 2022. 19(2): p. 168-183. doi: 10.1080/19390211.2020.1853648. Epub 2020 Dec 17.

from an Expert Author

George Thouas

BSc, MRepSc, PhD – Biomedical Scientist

George has worked as a medical researcher for 17 years in the university sector, at both Monash University health institutes, and The University of Melbourne. He spent 12 of those years in reproductive health and fertility research, in roles such as Clinical Research Associate, Clinical Embryologist, Post-graduate Demonstrator, Lecturer, and later as a Senior Research Fellow and Lab Manager. His doctoral thesis investigated the effects of mitochondrial damage in the oocyte. He also worked on improving the nutrient and growth requirements for in vitro fertilization and embryo development.

George has authored and coauthored more than 50 publications, including 1 book, 5 book chapters, 30 peer-reviewed journal reports and reviews, 6 patents, international scientific conference proceedings and health practitioner journal articles.

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