Dr. Ade
Welcome to the Modern Midlife Collective podcast, the place where we get unapologetically real about thriving in midlife health, hormones, and everything in between.
00:12
Dr. Jillian
I'm Dr. Jillian.
00:13
Dr. Ade
And I'm Dr. Aday.
00:14
Dr. Jillian
Together, we're your guides to navigating this powerful season with confidence, strength, and the wisdom you deserve.
00:24
Dr. Ade
Welcome back to the Modern Midlife Collective, the space where we get real about hormones, health, and how to stay radiant as we evolve. I'm Dr. Adeya Kendipe, family nurse practitioner. I help women navigate weight loss, hormone balance, and sustainable wellness so that they can reclaim their energy and confidence during a season that's often misunderstood. So I'm so excited today because I'm here with Dr. Jillian Woodruff, our co host, our midlife skin and aesthetics expertise. So today we are going to be talking about something that hits very deep for so many of us. What it really means to glow up as we age.
01:02
Dr. Jillian
I love that. I am also excited to have this conversation. I love talking about all things skin and aesthetics and beauty. It's always just been a fun thing for me to put on makeup and get nails done and all of that. So as I'm getting older and noticing that things are changing and I'm aging along with my friends and we're looking in the mirror, we're like, whoa, why do I look different? And not necessarily a bad difference. Something's very good, but other things just not the way we're used to seeing it. So today, let's just break it all down. The changes that happen to us as we age, what happens to our skin, our face, our hair, all of that.
01:46
Dr. Ade
So excited for this topic because I can definitely relate with that. It's one thing for people to come to you and talk about this and say, what's going on, but you start to notice it, too. So, yes, I can't wait for you to break it down for us and see how we can definitely make our skin much better as we age. Okay, so, Dr. Jill, let's kick it off with the most important thing. I hear often with my women when I'm coaching them, my skin just feels off dry. A lot of times they'll say it feels like their face is just changed overnight. They look in the mirror and they're looking different. So I always say, you know, it's not just about that serum. It's about doing something else.
02:22
Dr. Ade
But, you know, with, for me, I know that there's a holistic approach, nutrition and things like that, but please share with us what's really happening during this Time. It's really important for us to know that's right.
02:33
Dr. Jillian
Your skin is a reflection of your internal health. So what we put into our bodies, how we treat ourselves, that is going to reflect on the surface. And our skin is our largest organ. It's our barrier. It protects our bodies from. From toxins in the environment and from injury. So it is so important. And often when we're talking about aesthetics, we're usually just talking about our face. But all of our skin is important. And so things that you can have, issues happening on your face can also happen in other parts of your body. We can't really hide, and so we tend to think that's most important. But all of our skin is very important. And there's not just one thing that's leading to that dryness that we start to experience.
03:19
Dr. Jillian
It could be many things, but with that dryness, some of the things that happen in perimenopause and in menopause, which is what we really focus on, is that drop in estrogen that happens. And with that, and also the ratio of our estrogen to testosterone changes. So with that, our skin starts to lose collagen, it loses elastin. So if you want to stretch your skin out and it should bounce back, you know, you've seen in people as they get older that maybe they stretch it out, it stays there. It doesn't just bounce right back. So that's a loss of elastin, that's a loss of collagen, which is our largest protein. The loss of estrogen also causes some other than dryness, causes itching. We start to be really itchy in perimenopause, all over our bodies. And oftentimes we don't associate that with vilossovar estrogen and progesterone.
04:13
Dr. Jillian
But that is another thing that occurs also, if we live in a dry environment, then our symptoms may be very exacerbated. And if our thyroid's off, also, that can lead to dryness of our skin. So hormones certainly plays a huge role in what's happening with our skin. But then the other things are, like what you said, paying attention holistically to what we're doing to our body. So if it's just dry, then we need to make sure we're hydrating ourselves right, and drinking a lot of water. We have to be careful with even how we are sleeping at night, making sure we are sleeping, and then how we're sleeping. So they have these pillows called beauty pillows. I don't know. Dr. Day, do you use a Beauty pillow. Oh, my goodness. So the beauty pillow serves a couple purposes.
05:03
Dr. Jillian
One of them is to make it so you're sleeping on your back. One of the things, if you sleep, I usually can tell which side somebody sleeps on. If they sleep on their side because they will have more loss of their fat pads over, like in their cheek area, they may have more wrinkles around the eye one side over the other side. And so you want to try to sleep on your back. But a beauty pillow is one that should you turn to your side, it will kind of cup your face on the bones of your chin and of your skull. And so you're not going to be smushing the soft parts of your face. The other part of the beauty pillow is the pillowcase.
05:41
Dr. Jillian
It's like a satin or silk pillowcase, which is nice for your skin, and it's white so that you're not introducing dyes and things that are on some linens onto your face. So you want a nice soft in that. Satin or silk is nice for your hair, too. If you don't sleep with a hair cap, I put a hair cap on. But for those who don't, then that's how pillow could be very nice. And that's for people with all hair types so that it's not rubbing and pulling against your other sheets.
06:10
Dr. Ade
That is a lot of information, Dr. Shel, but thank you so much for sharing that. No, I have never heard of a beauty pillow. But it's interesting that you can see the differences just by the position of how someone is sleeping. So it's very obvious that a lot really does happen with women as they age with the skin. And, you know, first thing you mentioned is that the hormones start to change. You can remember when you're in your 20s and 30s, that plumpness that you get, you just put on very little makeup, not even. And then you have now you may have to mask the wrinkles or the dryness, things like that. Those days are long gone. So it's very obvious that skin care is very important. Often they would say, you know, my moisturizer doesn't work anymore.
06:58
Dr. Ade
I actually attended one conference where it really focused on even figuring out what kind of moisturizer is good at this age. So, yes, you might have to splurge a little bit on the right kinds of products. It sounds like. So what else would you say would be missing? Like, we're hydrating every day. Women are drinking lots of water. They're eating the right foods to try to help their skin glow. They're Sleeping enough. But they're not really seeing the results that they want. I try to picture myself with someone. You know, when you look at someone and you're saying, well, they look beautiful, I think you look beautiful. But you're not really seeing the results that you want, whether it's the wrinkles on the sides of the eyes or the frowning look on the forehead.
07:43
Dr. Ade
Can you share some insights on what are the possibilities out there? What else can you do before even, maybe even looking at aesthetics? And maybe we can talk about some aesthetic things later.
07:53
Dr. Jillian
Okay, well, I think I do probably have to go a little deeper with the explanation of some other things that change, because there's quite a bit more other than the hormone. Another aspect that changes is just our cell turnover. As we get older, our cell turnover changes. Yes. And so it is just as important to have proper cell turnover in our organ systems, including our skin. Skin. And so aesthetically, the things that we notice when our skin isn't turned over or turning over, changing, we're not shedding our dead skin cells is. You notice duller skin because you're not lifting off that older area, the older layer of skin. So it's not only is it dry, but then it is dull. We want that glow. We don't have that glow.
08:43
Dr. Jillian
Testosterone levels start to go down, we know, in our mid-30s, and they continue to decline. And testosterone is what makes our skin oily. And so when we have that oil, the problem is in some, when they have that oil and you do not have the shedding of your old skin cells, you don't have the renewal of skin cells, then what happens with that oily ness, then it can get infected or in the pore. Bacteria concentrates in our pores and we have acne again. So not just in puberty, but again at midlife. How terrible is that? So, and we don't even have high testosterone levels. We just have an imbalance of our testosterone to our estrogen levels. So we're not shedding those skin cells. So then exfoliation is very important.
09:34
Dr. Jillian
Another thing is the skin in some areas is thinner and in other areas is a thicker skin. Thicker because you have all of this keratin, this old skin layers on top of each other. So we need to do ways of clearing the dead skin cells, exfoliating our face and things that encourage cell turnover. So again, this is going to take us back to things to keep our internal system healthy. So when does our skin and our. And our cells turn over? During sleep. So we have to sleep so that Our bodies can regenerate. There's no substitute for this.
10:11
Dr. Ade
You can't stay up till 3am and expect perfect skin. You just can't. Right? Yeah. And stress. You had mentioned oil. Okay, so this is one thing I want to clear up because I was known to have really beautiful skin. Well, it doesn't come easy. I tell you, one of the things I noticed after I turned 40 was the acne. It's like these breakouts were coming out of nowhere. It's like being, you know, the teenager. Even though I didn't have that experience growing up, I had great skin. But it's the norm to think that this is a teenage thing. So from a functional health standpoint, I think, you know, obviously gut health, making sure that your pathways of metabolizing what you're eating, your blood sugars and all of those things are important, but what can you share from the hormonal standpoint?
10:57
Dr. Ade
What is happening during this time when you start to have breakouts in your mid-40s?
11:02
Dr. Jillian
Oh, yes. I mean, this is really just detrimental to people's self esteem that they're finally understanding themselves and they're stepping into their power and then they have pimples like they're 15 again. It is terrible. I think the things that you mentioned really are very important and all play a role in acne. So the gut health, your liver health, that is important because your hormones are metabolized there. And so what can happen is the balance of your hormones changes if you're not getting out the metabolites. And so as a hormone breaks down, you need to clear the byproducts. And this becomes increasingly less efficient as we get older. So there are certain vitamins that I recommend for people to increase their liver health and also to increase those metabolic pathways. I know one of them you're extremely familiar with, which is dim.
12:01
Dr. Jillian
That helps our estrogen metabolism. So whether you're on hormone supplements or we're just helping your regular hormones, these things are very important to be taking, especially as we're in times of transition. Blood sugar, diabetes, insulin resistance, those are all extremely inflammatory issues that people have that also increase your risk of showing up on your skin. Your skin is just showing you what's going on the inside. And so we do have to decrease processed food. In my case, I did have that same situation where I started to have breakouts. And it was dietary things that I could eat before. Now I realize that I can eat it, but I'm going to have a pimple. Do I want that?
12:51
Dr. Jillian
Maybe I'M okay with that around, you know, Thanksgiving, I'm going to have my dessert and my gluten in my dairy, but the majority of the other time, I'm not having dairy because I don't want that to happen. So it's just decisions that we have to make in our life based off of what's important to us. For me, dairy is inflammatory. I don't have any GI issues with dairy, but I break out. And also sugar. Sugar is inflammatory for me. So if I'm eating a lot of desserts and carbs, then I may break out. Otherwise, if I eat grape, I do not have a problem. And so I think even in midlife, it's not just the hormone issue, it's just exacerbating these other things.
13:32
Dr. Jillian
So, you know, maybe you were okay with the sugar and okay with the dairy, but then the hormone dysfunction really was the last insult, and then you had an issue. So, as we know, your estrogen levels, we discussed with perimenopause, they fluctuate wildly. They're going up and down and up and down. And then progesterone, and I should say fluctuation. That's what happens to women after puberty. You have cycles, you're supposed to have this kind of a smaller cosine, I guess, wave, right? But in perimenopause, it's like high roller coaster. And, you know, I don't like roller coasters. The steepest roller coaster. So that estrogen, it's going up and down, your progesterone is really just declining. And it's the estrogen and progesterone together that affect things in our skin, like pigmentation.
14:23
Dr. Jillian
So when they're off, we may have more pigmentation, and this may show up more on some people than other people, or on some skin tones, it may show up brown, and others, it may show up red. Your testosterone levels do decrease. They shouldn't ever go away because we make testosterone outside of our ovaries as well. But they do decrease. And then with that fluctuation of estrogen, the ratio of estrogen to testosterone just changes a lot. And so your testosterone level, you may have signs of high testosterone in some places, like hair growth on your face, on your chin. That's something that people notice in midlife. But then we check levels and their levels are low, and so they're surprised. But it's because that ratio of the estrogen to testosterone has changed.
15:12
Dr. Ade
And.
15:13
Dr. Jillian
And so there's so many signs of high testosterone, even when your overall testosterone is low. So people are Surprised when you're like, you need some testosterone. They're like, no, I don't. But yes, they do in some situations. And then I would also say that with your face, the whole shape can change as we get older. So it starts off your lower face is like a nice V, you know, comes to a point at your chin, and then it goes outward at your cheeks. So. So when you look, you see a V. In midlife and beyond, that starts to change. And that's where people start noticing those jowls. The face kind of falls and becomes an A. And so your narrow point is up at your bridge of your nose, and then it's wider down at your jawline.
16:00
Dr. Jillian
And so this is not typically something that people want in their faces. They don't want it to feel like it's sagging. But we have changes in your bones that happen. You have bone resorption as you get older. So I don't know if we talk about osteoporosis yet, but that will be a hole. We will talk about that on this podcast. But with osteoporosis, low bone density, we're thinking low bone density of our hip and our legs. It also happens all the other places we have bones. So in our faces, that also happens. We have bone resorption. And the eye sockets, they get wider, and so that changes our look. Our cheeks get. They drop in. The fat that sits on top of our cheekbones also starts to fall. So gravity basically starts to fall downwards, and so then it accumulates at our jawline.
16:56
Dr. Jillian
So this is where they've developed so many assistants, anesthetic treatments. But what can we do to prevent that is things that will strengthen our bone structure. And so that would be things like we can't really do forced exercise, like exercises with force on our face. Right. But we can look at our protein intake. That would be very important, make sure that we are maybe supplementing with collagen, having vitamins that build bone, you know, like calcium, vitamin D, that sort of thing. And then our overall bone health will be reflected in our face as well. So definitely. So important just to our inner health. Inner health is so important. So if we want to reflect that beauty on the outside, we really have to have that beauty on the inside. Right. It's just like dressing up. Right.
17:49
Dr. Ade
It's a whole package thing. And I think it's important to have this conversation for women who are. The end of the day, it sounds like there's no quick fix.
17:57
Dr. Jillian
Right.
17:58
Dr. Ade
You can't just skip everything else and try to do Just the outward appearance. And I think I gave an example one time one of my social media posts. A woman that came in and she looked beautiful, like she had the lashes and she had all, you know, the Botox and she looked amazing. And I had to. And she walked in the room and I had to just give her a compliment and said, you look amazing, absolutely beautiful. And I think you know that confidence is there when you feel great, you look great, you can show up in the room and want to conquer the day.
18:32
Dr. Ade
Unfortunately for that same woman, I had to also tell her that she had an A1C, which is what shows how high blood sugars are, was really high, she was type 2 diabetic, her blood pressure was really high, she was really stressed. And these are one of the things that brought her in. And it's like, you look great, but how are you feeling on the inside? So everything has to make sense. It's like you don't want to just look really beautiful, but then we want to make sure that holistic approach is taken. Like Dr. Jill just said, making sure that you are sleeping, you're getting the foods that are going to nourish your body, collagen, and all these things are building blocks to get you feeling younger.
19:17
Dr. Ade
You want to be that 60, 70, 80 year old woman that's able to get up and not having to use if unless you have to, obviously, but having to get up and have somebody carry you or will you somewhere. So it's longevity, it's bone health, muscle health, and then all those things on the outside. Whether you want to take up some, you know, aesthetics with Dr. Joe and get those things modified, you deserve to look your absolute best. Absolutely. So now let's get into the hairline. Okay, so this is something that for me hit really hard. There's some genetic components to that for me, but there's also aging. So women tell me I'm shedding hair like crazy. Of course there's many reasons this could happen, you know, hormonal things and. But what are your thoughts on what women should do?
20:07
Dr. Ade
Where do they start to discover where to even start when they start to notice this?
20:11
Dr. Jillian
Great question. And very similar to the skin multifactorial for sure. The first thing I would do is really get a hormone evaluation of your nutrient status. Always look to see with women when they are experiencing hair loss. I check their thyroid. Typically I see an underactive thyroid. And when we optimize that, then it can stimulate hair growth. I look at their iron and their ferritin levels. So Their iron and their storage form of iron, and I make sure those are optimal. Just having levels that are okay for survival may not be enough for your hair. Right. Because you're thinking about survival and what you need for that. There are basic things we need for survival. And when we are basically surviving, our bodies do not care that our hair looks nice or we don't have bags under our eyes. Right.
21:04
Dr. Jillian
Our buddies are just trying to let me see how I can store fat for the future because we're in this stressful situation. Let me make sure I have what I need to survive the day. So you're not going to be have beautiful glowy skin. You're going to be just surviving. So we want reserves so that we can take our reserves and do fun things, Right. So the thyroid, the iron, you're going to look at vitamin supplements. I'm going to look at. I typically don't look at biotin levels, but I look at our vitamin D, which we know is a vitamin but also a hormone. Hormones are body's messengers. They send information to other body parts to tell them how they should function, how your organs should function. They have to get these messages.
21:47
Dr. Jillian
So if we have low hormone levels, these messages are not being delivered and then the function that it's supposed to be doing isn't being carried out. So I check my sex hormones, I'm going to check my estrogen, I'm going to check progesterone. I'm going to check testosterone. I'm going to check free testosterone. Sometimes people may have a low total testosterone, but their free testosterone is high and they often have more aesthetic changes like hair loss on the growth of hair on the face and acne. So we'll check these hormone levels. Progesterone, I would also go back to say, is that progesterone is a hormone and it is not just important for people with a uterus. There's many. Right? And I know that you hear this too.
22:32
Dr. Jillian
Oh, I don't have progesterone because I had a history hysterectomy and so I don't need progesterone when I'm taking estrogen. So typically, if you have a uterus, progesterone, because we want to prevent estrogen from stimulating too much growth of your uterus and leading to bleeding after menopause. And so progesterone counteracts that and keeps that lining thin and prevents the bleeding. However, we know that even if you don't have a uterus, I mean, progesterone was not created just for your uterus, there's many other things that progesterone does, and one of those is regulating the cells that make pigment in our skin. And so we need progesterone to regulate that, otherwise it goes haywire. And then we have age spots and post inflammatory hyperpigmentation and melasma. So we have to regulate that hormone just like we do the other hormones.
23:25
Dr. Jillian
And then things like zinc and reducing stress levels. And I said vitamin D. I said vitamin B12. Check those things. Those things are very important. What else is there? The other thing to look at is your eyebrows. If you're noticing that the lateral aspect of your eyebrows are thinning, then that's typically a thyroid issue. So we want to not just make it okay for survival, but optimize it. And I know we both do that. A lot of times as we're transitioning into perimenopause and menopause, our hairline starts to move backwards on our head and then the temples start to have shedding. There's a lot of increased shedding during this time. People are having areas where they have balding. I like them to see. I usually send them to a dermatologist and have them do a biopsy.
24:15
Dr. Jillian
You can look to see if you have hair follicles that are sensitive to dht. It's a powerful metabolite or breakdown product from testosterone. But DHT leads to hair shedding, hair thinning of follicles, and hair loss. If your hair follicles, and that's usually the follicles, the hair in the front of your head that is more likely to be sensitive to dht. But if your follicles are sensitive to that, then you may experience this sort of hair loss due to your own hormones or when you're supplementing to testosterone. And there's really no level that we've found of this is the level where it causes this problem. So we try to counteract that with medications that would prevent or decrease the conversion of testosterone to this very powerful metabolite.
25:05
Dr. Ade
Wow. It is so much that's changing. Ladies, please don't lose hope. I feel like we're going to need more than just this episode. There's so much packed in here, so we're going to need to break it down some more because this is really interesting stuff. It's good to really be informed about what's happening so that when it's happening, you're not like, oh, my goodness, what's wrong with me? Am I sick? Even be put on medications that you don't need because maybe you were misdiagnosed. So this is really great. So, okay, Dr. Jill, I know we covered a lot, but let's give our listeners hope. What can women actually do? Short run? They want to feel better, they want to see some changes. What are some things that they can do right now to get started?
25:47
Dr. Jillian
Well, aside from seeing one of us or a hormone specialist like us at home, of course, think about your lifestyle. That's very important. But I think even when it comes to skincare products, you do not have to spend a lot of money on your products. But you definitely, you want to cleanse your skin twice a day. And I would choose my sort of cleanser based off of the type of skin I have, if it's more oily, if it's more dry, if it's acne prone. And there are great products at your local drugstore that you can get and you can cleanse your face. If you wear makeup in the evening, I would cleanse it twice. I would remove the makeup and then cleanse your face again.
26:31
Dr. Jillian
And there's so many serums that we can get into depending on what we need, you know, so like daytime, I usually use something that protects my skin from toxins, like a vitamin C with a vitamin E probably. And then in the evening, my serum would be retinol or tretinoin or retin A or vitamin A. Those are all the same derivatives. They have non prescription types and they have prescription types. But the reason why this one is so important is because it helps your skin turnover. So, so it's going to help prevent acne, going to help treat acne. But it can be tough to use, especially if you jump in there and you get a high level of this product.
27:14
Dr. Jillian
So I would start at the lowest level because you may have some peeling and dryness, which you should get over as you start to shed. And if you don't, then that's something really to talk about with your aesthetic provider because you may have to go down a different path. And then I would in the daytime and in the nighttime, moisturize my face. I'm going to moisturize whether it's dry or oily. But the type of moisturizer will depend on if it's dry or oily. But we need to put ceramides, proteins, things that protect our skin barrier, because that's what this is, back onto our body. And in the daytime, number one thing, sunscreen. I use SPF 50. Sunscreen is so important, we have to put it on and continue to Apply throughout the day. Dr. Day.
28:01
Dr. Jillian
We probably don't have to apply that often until it gets to our summer months. But if I live somewhere else, you know, where I had sunshine, then I would be applying all through the day because what happens when you're not using your sunscreen? You're having skin aging at rapid rates and increased wrinkles, dryness, and falling skin. Sunscreen. Sunscreen. Sunscreen.
28:25
Dr. Ade
Yeah. It boils down to having the right fit for you, whether it's starting with hormone specialist, a dermatologist, if needed. You talked about maybe even looking at the hair follicles to see if there's some sensitivity turning over, shifting your hormones from testosterone. It's converting into dht. That can be very harmful and, of course, cause hair shedding. So I'm so happy that we. We had this conversation because it's important for women to really feel empowered and not panic. But there's so much we can do, right? There's tools, there's technology. We now understand hormones better than we did. Hormones aren't the problem. People have that bias against it. But you don't have to just accept things as they are. If it's a bother, seek consultation. Get someone that really is listening to you and gives you personalized and holistic advice. All right, Dr.
29:21
Dr. Ade
Jill, leave it over to you. Help us summarize this podcast.
29:24
Dr. Jillian
Yeah, I think you did a great job. I think if you do not like what you're seeing in the mirror and you want to change, you can. You don't have to live with it. You know, I always say I am constantly reinventing myself, and I enjoy that. So if that is you, there are things you can do. There are so many things. Now. We're living in a time where anything is possible from very minimal to extreme, right? And you can do things that are completely natural, and you can do things that really only depend on you in your lifestyle. And that's it. You get to choose. So if you want a gentle refresh, you can choose that. If you want a full treatment plan with aesthetics and procedures, you can choose that. You have all of the options.
30:09
Dr. Jillian
You decide what feels good for you, but most importantly, it's going to be what's in here, what's on the inside. And we want to get that as healthy as we can. So we're hoping that you're going to come along with us, and we're going to be practicing what we preach as much as we can so that we also can benefit from the things that we have been learning along the way. And sharing with our patients in our offices.
30:38
Dr. Ade
So this is not the end of this conversation. We are going to be talking about this, but I'm sure we're going to have more episodes that are going to break things down a little bit more. So let's keep this conversation going. Tag us on Instagram oddernmidlifecollective and drop your biggest glow up question. Let us know what you want to hear more about and that'll let us know what we can talk about at the next episodes. Midlife isn't when you fade out. Ladies, ladies, you really need to elevate yourself during this time and you just need to know what's the right fit for you.
31:08
Dr. Jillian
That's right. We'll see you next time. Thank you so much for listening.
31:12
Dr. Ade
Thank you for tuning in to the Modern Midlife Collective podcast. We hope today's episode has inspired you to take bold steps towards thriving in midlife.
31:21
Dr. Jillian
If you loved what you heard, please leave us a review and share this episode with a friend who's ready to step into their power.
31:28
Dr. Ade
We'll be back next week with more insights, strategies and real talk to help you live your best life at any age.
31:36
Dr. Jillian
Until then, remember, thriving at 40 and beyond isn't just possible, it's your birthright. We'll see you next time.