WHAT IS COLLAGEN AND WHY IS IT SO IMPORTANT IN MENOPAUSE?

Collagen is a protien tissue, found in the human body, giving elasticity to the tissues.

WHAT ARE THE EFFECTS OF OESTROGEN-DEPENDENT LOSS OF COLLAGEN?

Collagen from the skin is lost due to oestrogen deficiency, resulting in skin thinning. Loss of collagen from around the Urethra and within the bladder predisposes to urinary dysfunction. The muscular aches and pains which many postmenopausal women complain may be related to a loss of collagen from ligaments and other soft tissues.

WHAT ARE THE EFFECTS OF OESTROGEN DEFICIENCY ON THE SKIN?

Oestrogen deficiency accounts for the dry skin experienced by many premenopausal women, which improves with oestrogen replacement therapy.
There is a loss of collagen after the menopause. Approximately 30% of collagen is lost during the first 5 years after menopause.

Complaints of thinning and dryness of the skin can be accompanied by increased bruising and itching. Very occasionally, 'crawling' sensations are experienced just underneath or on top of the skin. Women complain that they feel that 'ants are crawling over them'. This appears to be due, most likely, to changes in the nerves rather than the result of changes in the skin.

WHAT OTHER TISSUES ARE AFFECTED BY OESTROGEN DEFICIENCY?

Oestrogen being the female sex hormone, its target organs include the breast, uterus, fallopian tubes, ovaries, vagina and vulva as well as the urethra. Atrophic changes in oestrogen-dependent tissues, is the rule rather than exception, after menopause although the severity of symptoms vary greatly.

Following menopause, the vulva gradually undergoes atrophy with progressive loss of pubic hair and the skin becomes thinner. The subcutaneous fat all but disappears and the labia shrink, contributing to dyspareunia.

During this period, the uterus becomes smaller with its walls becoming thinner. The cervix is reduced in size. The endometrium (see pic) becomes thin, but, importantly, always retains the ability to respond to oestrogenic stimulation.
The tissues of the pelvic floor (see pic) appear to lose tone and this may contribute to prolapse & stress incontinence.

Changes are not limited to vagina, certain other membranes also appear to be sensitive to ovarian function. For example, dryness of the mouth and eye has been described as a menopausal disorder.

Breast involution follows loss of ovarian function. There is a reduction in the amount of glandular tissue with an increase in fat deposition.

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