Raphaela Paes

Menopause marks the end of a woman’s reproductive life. It is well-known that skin aging is accelerated during this period, as declining estrogen detrimentally impacts the skin’s extracellular matrix (ECM) which is the provider of strength and elasticity. Menopause also affects scalp hair, reducing hair diameter and leading to shorter hair growth. Objective: To evaluate the main dermatological complaints of Brazilian women during this period, comparing the compatibility of these complaints with similar studies that evaluated skin health at menopause. Methods: This study interviewed 463 postmenopausal women between 42 and 83 years old through a public electronic questionnaire in the SurveyMonkey app about their perception of the changes noticed in their hair and skin after menopause. All statistical analyses were performed in R v. 3.6.1. Results with p-values < 0.05 were considered significant. Results: Dermatological health in menopausal women, especially the quality of the skin, nails and hair may deteriorate with estrogen deficits. As life expectancy increases and hormone replacement therapy (HRT) becomes more common, a greater understanding of their dermatological effects in menopause is needed. Conclusions: Menopause strongly impacts skin quality and worsens women’s self-esteem and quality of life. There is still a lack of knowledge about HRT and specific treatments for improving skin, hair and nails.

Segesterone acetate (SA) or Nestorone, a fourth-generation progestogen, is a synthetic compound with high progestational activity and no androgenic, glucocorticoid, or anabolic effects. However, due to its oral inactivity, SA must be used by other routes, such as subcutaneous. Thus, considering its peculiar properties, the SA subdermal implant is successfully used in female contraception and postmenopausal hormone replacement therapy (HRT). In recent years, its potential uses in endometriosis, polycystic ovaries syndrome (PCOS), and a new therapeutic possibility for neuroprotection have made this treatment extremely interesting. However, the absence of a standardized dose and the long-term safety of SA implant therapy in women is still controversial. Here, we present the possible indications, doses, limitations, and side effects of SA implant therapy.

Introduction: Vitamin D has been primarily studied as an important factor influencing bone and calcium metabolism. Metabolites of vitamin D are essential for whole-body calcium homeostasis, maintaining serum calcium levels within a narrow range by regulating this process in the bones and gut. Nevertheless, its deficiency is also related to increased risk of type 2 diabetes mellitus (T2DM), metabolic syndrome (MS), and cardiovascular disease (CVD)—with increased visceral adipose tissue and body mass index (BMI), as well as the frequently associated hypercholesterolemia. It has been reported that vitamin D levels are inversely related to cardiovascular (CV) risk in men and women. However, the effects of vitamin D on distinct outcomes in women and the dose of supplementation needed to improve clinical endpoints have not been established. 25-Hydroxyvitamin D [25(OH)D] reduces systemic inflammatory mediators in CVD and favors the release of anti-inflammatory cytokines from the immune system. In addition, 25(OH)D can be primarily converted into calcitriol (1,25-dihydroxycholecalciferol [1,25(OH)2D]) in the kidneys through the action of the 1-α-hydroxylase enzyme. Calcitriol, through the downregulation mechanism of renin expression, renin–angiotensin–aldosterone system (RAAS) activity, and its interaction with the vitamin D receptor, can bring CV benefits. The calcitriol form also lowers parathyroid hormone (PTH) levels by indirectly causing a reduction in aldosterone and mineralocorticoid synthesis. Elevated plasma aldosterone is related to endothelial dysfunction and CVD in hypovitaminosis D status. Conclusion: Vitamin D supplementation may benefit certain risk groups, as it improves metabolic variables, reducing oxidative stress and CV outcomes. More studies are needed to define interventions with vitamin D in men and women.