The Hormone Shift: How Beauty Changes in Perimenopause and Menopause

There was a word in my house growing up that teetered between a fact and an insult. Menopause.

My mom would complain about “hot flashes” and utter the word sometimes in a matter-of-fact way, but many times with grief. So I avoided it like I avoided other words that people find offensive. And as I grew up, I realized I was not alone. The word, and this very real and very normal life stage of women, felt unsettling. And you know what happens with natural things we avoid naming or talking about: they don’t cease to exist. We just face them unprepared. 

I interviewed two doctors who see Filipina women navigate this shift every day: Dr. Trixie Valle-Tin, a board-certified dermatologist and functional medicine practitioner, and Dr. Lizzette Caro-Alquiros, an obstetrician-gynecologist and maternal-fetal medicine subspecialist. Turns out, the thing I was dreading is not, well, dreadful. It has its challenges, but like most challenges, it has opportunities.

Meet the experts

Dr. Trixie Valle-Tin is a board-certified dermatologist, certified integrative dermatologist, and functional medicine practitioner at The Core Clinic at Centuria Medical Makati and Makati Medical Center. She also runs the Integrative Skin Health (ISH) program virtually and in her private clinic in Quezon City.

Dr. Lizzette Caro-Alquiros, MD, MBA, FPOGS, FPSMFM, is an obstetrician-gynecologist and maternal-fetal medicine subspecialist.

What happens to your body—and skin

“Menopause has a clinical definition,” says Dr. Caro-Alquiros: twelve consecutive months without a menstrual period, typically arriving somewhere between the ages of 45 and 55. 

The stage before menopause, while less defined, is a very important one. “Perimenopause can begin anywhere from 2 to 10 years before that twelve-month mark,” she explains, “and there is no clean starting line.” 

“Perimenopause is like a roller coaster,” says Dr. Trixie Valle-Tin. By this she means that hormones fluctuate wildly rather than declining in a straight line, which is what makes this stage feel so disorienting. One week you are fine. Next, you cannot sleep and you are crying without knowing why. Women often look for a single cause when the reality is more tangled. “We don’t get to blame only the estrogen or progesterone. Your cortisol, your thyroid, these will all play a role in how easy menopause will be. The enemy is not menopause. What matters is what you bring into this period.”

On the skin, the effects are tangible. Estrogen supports the skin barrier. When it starts to fluctuate and eventually decline, that barrier gets compromised. Dr. Valle-Tin sees it in her patients as dryness, sensitivity, redness, adult-onset acne, and hair thinning, as well as fine lines, sagging skin, eyebags, and pigmentation. “Collagen and elastin become degraded faster than they are made,” she explains, made worse by what she calls inflammaging—the cumulative damage from prolonged UV exposure, poor nutrition, chronic stress, and disrupted sleep. 

None of this happens overnight. This is why the timing of awareness matters.

The window you don’t want to miss

If perimenopause can start in your early 40s, and sometimes as early as the late 30s, then the most useful thing any woman can do is start treating that decade as a golden window for health investment. The good news is that there are ways to get a sense of your own timeline before symptoms arrive. 

One starting point is surprisingly simple: ask your mom when she hit menopause. Dr. Caro-Alquiros says it is one of the strongest indicators of your own timeline, typically falling within a year or two of hers. Other factors like smoking, procedures on the reproductive organs, or radiation in the pelvic area can also influence it, but your mother’s experience is your most accessible reference point.

Beyond that, Dr. Caro-Alquiros is specific and practical about what a proper check-in should look like. Beyond the standard transvaginal ultrasound and pap smear, she points to something most women overlook: tracking their own cycle. “Most of my patients, when you ask about the menstrual cycle, they don’t know. It’s just an estimate.” Irregular cycles, especially for those who have always been regular, are often the first signal that something is shifting, and that is information a doctor can use.

A hormonal panel, metabolic blood work covering sugar levels and lipid profile, and bone density checks become relevant as you enter your 40s. What labs you need depends on your doctor’s assessment. But the point, Dr. Caro-Alquiros says, is not to wait until symptoms force the conversation. “This is the stage to take care of yourself. If you are able to focus on that during perimenopause, you can be more functional and happier during your menopausal years.”

Skin care that makes sense at this stage

During this life season, beauty and skin care can feel overwhelming. Dr. Valle-Tin cuts through it with a framework she calls the 5 S’s: sun, stress, sleeplessness, excess sugar, and sedentary lifestyle. You don’t have to perfectly manage all five at once. Pick your anchor, she says, and build from there. Pair that with her daily mantra: Move. Nourish. Recover. Repeat. 

For skin care specifically, her advice is simple and practical. Start with a barrier-supporting product line, then consistent sun protection with antioxidants. Vitamin C serum, retinoids, and other antioxidants are worth adding. “You want to support your collagen, epidermis, and slow down the things that speed up the breakdown.” 

Nutrition is also crucial. What goes inside the body affects what shows on the outside. Phytonutrient-rich foods, the oranges, reds, and yellows from produce, support skin from the inside. Omega-3s, vitamin D, zinc, and coenzyme Q10 are worth checking for deficiency, particularly if a food-first approach is not covering gaps. And gut health matters more than most women expect. “There is a gut-skin-brain connection,” Dr. Valle-Tin explains. “How you nourish your gut affects your skin and your brain.” 

For in-clinic options, she points to regenerative aesthetics: treatments that build rather than just correct, including skin boosters with amino acids and procedures that support collagen production, blood flow, and skin healing. “That is what slowing down aging looks like.” Lasers and chemical peels for pigmentation, scars, and wrinkles exist and work, but those are best left to trained doctors who know your skin’s current state.

She leaves women with this: “I wish more women enter this stage empowered rather than disheartened. We need not suffer in silence. There are doctors who can help you navigate this tender but beautiful season. Looking and feeling beautiful may seem costly, but radiant confidence is free. It needs time, energy, and space, but it is available if you seek it. No one has regretted seeking holistic, medical care early.”

On hormones, HRT, and the conversation Filipino women need to have

Hormone replacement therapy used to carry a heavy stigma, much of it stemming from older studies that have since been reexamined and contextualized. The conversation has shifted.

“Before, there was this fear: it’s risky,” says Dr. Caro-Alquiros. “But now it is shifting toward: yes, there are risks, but you have to weigh the benefits. And you have to be screened.” HRT requires proper assessment: your medical history, the conditions that may make it unsuitable, the right dosage, and the right administration route.

There is also a window of opportunity worth knowing about. Starting hormone therapy after a certain period post-menopause becomes more complicated. So if hot flashes, night sweats, sleep disturbances, and vaginal dryness are entering your life, that is the time to raise it with your OB-GYN, not years later when you have simply adapted to being uncomfortable.

Non-hormonal options also exist, including some herbal supplements with varying levels of clinical backing. Transparency about evidence strength matters here. Dr. Caro-Alquiros is clear that the conversation should include which options are FDA-approved, which have strong studies, and which have mixed results. Lifestyle, still, is non-negotiable underneath all of it: a balanced diet, consistent movement, low-impact strengthening exercise.

A beautiful life for your 40s, 50s…and beyond

Both doctors, across different specialties, arrived at the same place.

“Women’s vitality is multifactorial,” says Dr. Caro-Alquiros. “We can control what we can control. There are solutions during perimenopause and solutions during menopause. It is a life stage, and we have to come prepared.” 

Dr. Valle-Tin puts it more personally: “The most attractive women I see in their 40s or 50s are those who come in knowing that they are wiser, stronger, invested in overall health. They come to live a life of purpose.”

She is direct about what holds Filipinas back from getting there. “As Filipinas, we tend to take care of others before ourselves. We are afraid that some people might judge. But the best gift you can give your family is a stronger, healthier mom, sister, or daughter.”

Menopause is a life stage, not the end of it. There will be changes and challenges, but we are built for this. The women who wear this season well are the ones who sought to understand it, cared for themselves consistently, and refused to face it alone.

I thought about my mom a lot during these interviews. She faced menopause the way many Filipinas do: quietly, and alone, without the language or the community to make it easier. These did not exist for her during her time, but we get to choose differently. 

May we be the generation that talks about this openly, prepares well, and arrives at this season ready.