Estrogen ‘Up Here’ & ‘Down There’ Perimenopause & Beyond

If you're a woman in your 40s, 50s, and beyond, and you are dealing with changes, loss of moisture, and loss of elasticity (up here or down there), you’re probably beginning to wonder - What is happening?!

As a 61-year-old woman - who is on the other side of ‘the change’—I'm sharing what I experienced and what I wish I knew sooner to help you navigate your perimenopause and menopause years without losing having to suffer unnecessarily.

I’m going to talk about how and why doctors often overlook or misattribute symptoms in women 40+.

AND I'm going to give you a women’s health resource —not to replace in-person medical visits—but to complement and fill a gap to your current medical experience.

As a woman, you are privy to the female hormone Estrogen. It is a part of our life - all the ages and stages from adolescence, to childbearing, through perimenopause and menopause...

Here’s what happens over time:

• Low at birth and childhood

• Rises sharply during puberty (~ages 10-15)

• Peaks in reproductive years (~ages 20-30)

• Gradual decline in perimenopause (~40s)

• Sharp drop in menopause (~50s)

• Low, stable levels post-menopause (~60+)

Here's what happens beginning in your early 30s:

• Early 30s - gradual decline of estrogen – 10% loss compared to peak

• 40 – 50, perimenopause: more noticeable drop of estrogen - 25% loss compared to peak

• 50 – 60, menopause transition: sharp decline  - 90% loss compared to peak

• 60+ - Postmenopausal plateau, estrogen remains low.

*The first 5 years post-menopause, we experience up to 30% collagen loss due to this estrogen decline.

In your 40s, you may begin experiencing changes – thinner skin, dryness, wrinkles, and loss of elasticity- but you may NOT realize it’s due to estrogen loss, that you are perimenopausal. (I didn't consider it!)

As estrogen continues to plummet into and through your 50s, you lose skin moisture and elasticity, and it thins (and that’s your skin everywhere – if you know what I mean)!

Knowing that estrogen loss MAY be the root cause of these changes will not only help you when you present yourself and your issues to the doctor – but it helps them too – because here is something REALLY important you need to know.

What Happens ‘Down There’ in Perimenopause & Beyond?

As you can see, menopause doesn’t happen overnight—it’s a gradual shift that begins with perimenopause, typically in your 40s. One of the first places we feel this shift is down there.

So what’s happening?

• Estrogen levels start to fluctuate and decline.

• Vaginal tissues thin and lose elasticity (atrophy).

• Natural lubrication decreases.

• The urinary tract becomes more fragile, making infections more common.

Symptoms You Might Experience:

• Dryness & Irritation – Even if you never had issues before, you might suddenly notice discomfort.

• Frequent UTIs – Declining estrogen thins the vaginal walls, weakens the urinary tract, and makes infections more likely. Estrogen protects the urinary tract. When it declines, bacteria have an easier path to cause infections.

• Tearing & Sensitivity – Thinner tissue = increased likelihood of micro-tears, making intimacy uncomfortable.

• Yeast Infections – Antibiotics for UTIs can throw off the vaginal microbiome, leading to recurring yeast infections.

My Experience:

Looking back, the symptoms and issues I was facing started in perimenopause and escalated throughout my 50s. Finally, at age 58, a doctor said, “That’s menopause!” and recommended a estradiol vaginal cream. And she was like – wow, I’m so sorry no one connected the dots sooner.

"So how does this happen? How does no one connect the dots? I didn't know to think about estrogen decline, and the doctors didn't put it all together.

Have you ever heard of Occam’s Razor? It’s a principle in science (taught in medical school) that says, “the simplest explanation is usually the correct one”. In my case, when i started getting UTIs, the dr. prescribed antibiotics. Problem solved, right? Not really . . . 

While Occam’s Razor says the simplest explanation is often the right one, another medical principle, called Hickam’s Dictum, reminds us there’s no one-size-fits-all solution, and sometimes we need to treat multiple aspects of our health together. Especially when it comes to women 40 and beyond - when a myriad of symptoms and issues can all go back to a root cause: Changes in Estrogen.

Addressing my estrogen deficiency would have helped.

Sometimes, when your doctor treats each issue separately, instead of looking at the bigger.

picture: they miss the holistic diagnosis - they are getting a small piece of the puzzle and can't solve it. This isn't the best approach for aging women. 

This brings me to another major issue: medical training gaps. Despite women making up 50% of the population, menopause is barely covered in medical school.

But here's something I discovered - it's a certification that doctors can get in the area of ‘menopause’! So if you want to find a doctor who has this holistic approach to healthcare for women 40+, you may want to:

✔ Find a Menopause Society Certified Provider at Menopause.org

✔ Use the Menopause Society Directory to find a certified menopause practitioner.

✔ Consider Telehealth: Alloy Woman’s Health (not for annual checkup, which needs to be in person, but as a supplement for special needs . . . like estrogen cream for up here and down there!) Alloy provides care from Menopause Society-certified doctors – and I’ll talk more about that service next!

Now that you know all about estrogen ‘down there,’ let’s talk about estrogen ‘up here’!

It occurred to me that estrogen cream was helping ‘down there’ (since starting the estradiol cream at age 58 I havn't had any problems) so I thought, 'Wouldn’t it be great if I could use it up here?'.

And guess what, there's an estrogen cream that is now available, and it's formulated specifically for the face and body—how exciting is that?

I started researching and found that estrogen plays a huge role in collagen production, hydration, and skin thickness – and just like the ‘down there,’ our skin suffers from estrogen loss too.

✔ Sagging skin

✔ Crepiness

✔ Increased dryness

✔ Fine lines & wrinkles

✔ Loss of elasticity

✔ Thinning Skin

✔ Breakouts

✔Larger pores

I’ve done some research and found a telehealth service that is - you guessed it - has a Menopause Society designation - so that's where I'm getting my estrogen for my face!

Here's what I learned:

Alloy Women’s Health collaborates with healthcare professionals certified by The Menopause Society (formerly NAMS), ensuring that patients receive informed and specialized care. Their doctors prescribe FDA-approved medications and ship them directly to you—making it easy to get the support we deserve.

So what are the claims of Alloy’s M4 Estriol Face Cream:

✔ Less dry, better hydrated

✔Thicker skin

✔ Lifted skin

✔ Less noticeable pores

✔ Fewer lines and wrinkles

✔ Improved texture

✔ Improves sagging, elasticity, and crepiness.

✔ Helps with dryness and hormonal breakouts.

✔ Supports collagen production.

How I’ll Be Using It:

• Daily after cleansing and serums but before moisturizer (remember to use sunscreen too.

• Thin layer on my face, neck, chest and hands – a little goes a long way.

• Tracking results over 12 weeks.

  • I will continue my AM & PM skincare regimen, adding this one thing in and taking before and after photos.

Click to watch the video:

Visit Alloy Women's Health at MyAlloy.com - Use code ANNE90044 for $25 off M4 Estriol Cream

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