Would YOU use vaginal HRT gel on your face?

It’s suddenly the hottest topic for menopausal women. Could you – and should you – use vaginal HRT gel, aka oestrogen gel, on your face to revive ageing skin?

Excuse me, but what on earth is this all about?

As women go through menopause, our oestrogen levels decline, which has a predictable and dramatic effect on our skin. Losing oestrogen means our skin can’t create collagen so well, can’t hold onto hydration as effectively, nor defend itself from the environment. Cue skin that looks drier, more fragile and more wrinkly. So why not put an oestrogen gel straight onto the skin? This has become a huge trend in the States, with women raving about the glowing skin they get after doing this, and it’s already flashing up here in the UK too.

Sounds amazing – but is it safe to do this?

Up to a point. Facial skin is more sensitive than vaginal tissue, so if you use a gel that has been formulated for vaginal use directly on the face it could well cause irritation or an allergic reaction.

Why use vaginal oestrogen?

Vaginal oestrogen gel is prescribed for helping reduce the dryness and vaginal atrophy that comes on with menopause and which can be uncomfortable in itself as well as making sex painful. The oestrogen gel is designed to revive and plump up the vaginal tissue. So, it follows, that it could do the same for the skin on your face.

Aren’t there any oestrogen face creams?

‘Using oestrogen as a face cream isn’t new, it just hasn’t been common practice,” says hormone expert Dr Sohère Roked. ‘In the laboratories I use to compound hormones, I have been making face creams with oestrogen (and often progesterone, too) for years, to help with fine lines and other signs of ageing. I understand the concept of using the vaginal product on your face and it probably won’t do harm. The formulation is not designed for facial skin, but the hormone in it, the estriol, would be of benefit, that’s what I would put in a facial cream if I’m having it compounded.”

Some doctors say: have great caution.

Many UK menopause doctors don’t recommend doing this, because it is an off-label use of a prescription medicine (although there are two types of vaginal oestrogen, Ovesse and Gina, that can be bought at pharmacies). Nor does Dr Jennifer Pearlman, who I bumped into at an aesthetic conference in Paris last week. Biohacking and menopause advice are two of her key offerings at her aesthetic clinic in Toronto.

“There’s a lot of buzz right now about using oestrogen on the skin,” says Dr Pearlman. “I’d say ‘have great caution’ with that because vaginal oestrogen products are a local estradiol that’s intended for vaginal atrophy or a condition referred to as GSM, the genital urinary syndrome of menopause. They are not meant for, and are not appropriate for, treatment on the face where you could have high absorption and a systemic effect [an effect that impacts the entire body, rather than just a localised area].”

What else could you use?

Dr Pearlman suggests trying an approved product that has been developed as a non-estrogen receptor agonist or NERA. “This is an oestrogen product that is fully metabolised in the skin, has no systemic effect, and all the health, aesthetic and ageing benefits we want for oestrogen-depleted skin,” she says.

Is there a non-medical equivalent or alternative?

There is one cosmetic product which has an oestrogen-like effect on the skin. It is one of these NERAs that Dr Pearlman mentioned. It’s called Empelle, and it basically tricks the skin into thinking it has received a dose of oestrogen, so it responds accordingly.

So – how else do you get oestrogen back into the skin?

If you take oestrogen as part of a hormone replacement therapy regime, that will be absorbed into your system, and that will largely provide what your skin needs.

If you’re already on HRT, does topical oestrogen have any benefits?

“Yes,” says Dr Roked. “Even if you’re already taking HRT an oestrogen cream could still be of benefit because your skin is an ‘end organ’ [the last organ the oestrogen will end up at]. The oestrogen you are using, whether it’s a patch, a lozenge or a gel, is getting into your body, it’s in your system, but because skin is an end organ you might not get the full benefit of what you need. That’s why lots of women on HRT still need the vaginal oestrogen. They’ll be getting oestrogen systemically which helps with their hot flushes, their mood, their concentration, but perhaps it’s not quite helping with vaginal dryness, so there can be a benefit of using something additional.

“You could use the two things together,” continues Dr Roked. “A lot of my patients find that once their HRT is really optimised, they don’t need to use extra oestrogen vaginally, but some do –  we’re all different. The same could apply to the skin. It’s definitely an interesting area to explore further.”

Am I going to be trying this?

No. Well. Maybe. Until I spoke with Dr Roked, I’d have said no. I’m tanked up on replacement hormones and they, along with the high-tech skincare I use, with its retinoids and vitamin C, and the collagen and vitamin C supplements that I scoff, seem to be doing a good job of keeping my skin functioning much as it used to. But in the future? If it was a specific oestrogen cream designed to be used on the face? I’d certainly be open to that.

Find more skincare solutions for all your main concerns, over at the TTG skincare shop.