Perimenopause and menopause bring far more than hot flashes and mood changes they can dramatically impact the skin, facial structure, and the way women see themselves. In this episode of The Beauty Equation, hosts Dr. Christelle Oliver-Dussault, Dr. Harpreet Lotay, and Amanda Manholt are joined by Dr. Amber Bocknek, physician, medical aesthetics expert, and author of Hot Flash to Hot Damn, to explore the powerful connection between hormones, skin health, and confidence.

Together, they discuss why collagen loss accelerates during menopause, how declining estrogen affects the skin, and why so many women feel like their appearance suddenly no longer reflects how they feel inside. Dr. Bocknek shares her "inside-out" philosophy of care, explaining why treating hormone health and aesthetic concerns together can help women feel healthier, stronger, and more like themselves again.

The conversation also dives into hormone replacement therapy, the lasting impact of the Women's Health Initiative on women's healthcare, and the growing evidence supporting individualized hormone treatment. The hosts explore the emotional side of aging, the concept of "image alignment," and how aesthetic treatments can restore confidence by helping the outside better reflect the person within.

Finally, they tackle one of today's trending skincare topics—using estrogen in facial skincare—and discuss the current evidence, practical considerations, and why personalized care is essential. Whether you're navigating perimenopause yourself or simply want to better understand how hormones influence healthy aging, this episode offers compassionate advice, practical insights, and evidence-based guidance for looking and feeling your best.

What You'll Learn:

• Why menopause can rapidly accelerate skin aging and collagen loss
• The role estrogen plays in skin health and facial aging
• How hormone replacement therapy may complement aesthetic treatments
• Why feeling "like yourself again" matters more than looking younger
• The importance of treating the whole person—not just the skin
• What the Women's Health Initiative got wrong and how menopause care has evolved
• Whether estrogen creams belong in your skincare routine
• How stress, hormones, and lifestyle all work together to influence aging
• Why individualized treatment plans are key to successful outcomes

Free Gift:

https://learn.precisionlongevity.life/hot-flash-to-hot-damn-get-workbook-lp

Precision Hormone Program™ Workbook. Take the guesswork out of your hormone health journey with this free printable workbook designed to help you implement the Precision Hormone Program™ step by step. This resource guides you through the process of understanding your unique biology, creating a personalized approach, and focusing on the right strategies in the right order to support your hormone health.

No purchase is required.

How to get in contact with Dr. Amber Bocknek:

• Website https://thriveaurora.com/
• Instagram https://www.instagram.com/dramberbocknekmd/
• Facebook https://www.facebook.com/people/Amber-Bocknek-MD/100058955573515/?ref=NONE_xav_ig_profile_page_web#
• Her Podcast Longevanity https://www.youtube.com/@Longevanity
• Her Book - Hot Flash to Hot Damn www.hotflashtohotdamnbook.com
• Amazon Purchase Link https://www.amazon.ca/HOT-Flash-DAMN-Precision-Perimenopause/dp/1067563814/ref=sr_1_1?crid=2ZZ7WNH3MV2KD&dib=eyJ2IjoiMSJ9.kwiRftdrTcqF3V117U20mgzvtn8Ta11fFWmX48RZQfNzTo_CSt1PQtt7_St1Pp6O9QGabXCTReJ9FEn2bIqq6OHzzZNAWQCR9k1parUOwq6VpENuXaoFdjPVMOdnHw-xIC8bizL22Z9muTS8WwnAEyszc2-U9YXEHpGM46x_LJW1r10mEoIBL75CBBFP33iDNSF-Dtvq63rbOf4jP_pmCzkZeMhhkJtdvXCCZd9nHLECteCDiz4goGf8eA4ioAH2T3d8Hqk1WNWEDlFfqeLsBXIv7J6uekoV94QN5WEfrF8.VV6fJqwTEIj3mLxydrgH_5dXgOk6HYWmZhAXMax3j7k&dib_tag=se&keywords=hot+flash+to+hot+damn+book&qid=1784742406&sprefix=hot+flash+to+hot+dam%2Caps%2C125&sr=8-1

About the Hosts:

Dr. Harpreet Lotay is a family physician specializing in aesthetic medicine. She is the founder of Sona MD in Kamloops, BC, and serves as Chief Medical Officer at Bios Wellness Clinics. Known for her artistic approach and comprehensive non-surgical treatments, Dr. Lotay combines medical expertise with an eye for natural results. She is also an educator, a national trainer and holds academic appointments where she shares her knowledge in clinical dermatology and aesthetics. You can get in touch with her on Instagram @hlotaymd

Dr. Christelle Oliver-Dussault is a family physician specializing in aesthetic medicine, women’s health, and psycho-education. She brings a holistic, whole-person perspective to her clinical work, blending science with a deep understanding of the mind-body connection.

She is also the founder of Reclaim The Pink Within, a movement that empowers women to rediscover themselves during life’s most transformative stages. In addition, she is passionate about medical education and mentors the next generation of family physicians through her work with the department of Family Medicine at the University of British Columbia.

You can connect with her on Instagram @drchristellemd

Amanda Manholt is a clinic manager, patient consultant, and co-host of The Beauty Equation Podcast. With over 30 years of experience in beauty, aesthetics, and leadership, she has guided patients and teams alike toward confidence, growth, and empowerment. Known for her ability to connect with people and simplify the often-overwhelming world of aesthetics, Amanda brings a warm, practical, and relatable perspective to every conversation. You can find her on Instagram @crowsfeetandconfidence.

Websites

https://sonamd.ca/

https://www.getyourpinkbackproject.com/

Disclaimer: The Beauty Equation is for informational purposes only and not medical advice. This podcast does not create a doctor–patient relationship. Always consult a qualified healthcare provider before making medical or aesthetic decisions. Information may change as the field evolves.

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That's one of the parts I find so gratifying is when I start to see

people back who go and engage on this journey is that

moment of, oh my goodness, like here I am again.

I feel like myself. I've got my life back. I've got my

relationship back. I don't wanna murder my husband and my coworker

and my children. I actually love them. You know, it's like, it's kind of

like we kind of laugh about it, but it's like, yeah, I was feeling a

little murdery. Did you not see the crazy that was there? 'Cause it was right

below the surface. And I'm like, yeah girl, but you look good now. Like I,

Feel good, but it can really be a game changer. And again, it's like

quality of life, like, right? That's been lost. Our moms

missed out on this. We have a whole generation of women who did

not have this offered because of the Women's Health Initiative. Welcome

back to The Beauty Equation, where we have real

conversations about real issues in medical aesthetics to help

keep you informed about what is going on in our world. I

am Dr. Harpreet Lotte. And I'm Dr. Christelle

Oliver-Dusseau. And I'm Amanda Manholdt. And I'm

very excited about today's episode because we have a special

guest. Her name is Dr. Amber Bocknek, who I met in

Puerto Rico during a trip where we were learning about

bioregenerative treatments, specifically Radiesse, and we just

hit it off. She is the owner of Thrive Med Aesthetics in Aurora,

Ontario, and she has a YouTube channel called Longed

Vanity where she talks about aesthetics, menopause,

all things that many of our listeners would be very interested in.

And she has a book which I just love the title of called Hot

Flash to Hot Damn. So welcome,

Dr. Brockneck. Thank you. I'm so glad to be here today.

Thank you for the invite. Of course. We have

lots and lots of questions for you. Perimenopause and

menopause is a stage that is marked

by a lot of changes. You know, a lot of people will talk about hot

flashes, sleep issues, general change in mood and

anxiety, but from an aesthetics perspective, there are also some

changes that are, are quite, uh, quite, quite stunning,

shall we say? So I'd love to hear what you see in your

patients. What are some common concerns? We'd love to chat about that.

Absolutely. So as you rightly identified, the

hallmark of that time of life, as we're all kind of going

through it, is, is change. And so

with the decline of the hormones, You really

do see changes in the skin as well too. So, uh, you

sometimes you see accelerated skin aging at that point. The skin looks

thinner, drier, it's more irritable.

It starts to become crepey in all those areas that you never

knew could become crepey. It's so funny. I think I

represent my own patient population. Just this weekend, I'm sitting on the

sofa with my husband with my one ankle crossed over the other. I

look down at my legs in horror and I'm like, oh my God, I have

like Creepy old woman skin. When did this happen, and

how have I not managed this? It's like, oh,

me too. But yeah, so again, there can be quite a bit of of change.

So the hormones again, I think it comes a bit of a surprise to

some of my patients. I don't know if you've had these conversations in your respective

offices—is that estrogen receptors aren't just in

breasts and uteruses; they're everywhere,

including the brain, the bone, and the skin. So we

do see absolute visual. signs of aging

with fluctuation and loss of hormone. I don't know what you guys hear in your

office, but for sure the struggle is real.

Hmm. Yeah, we do notice that quite a lot. It's, you know,

it's, it's a slow decline in the 40s. And then oftentimes we'll get

women who'd never sought any form of aesthetic care

and around menopause in their early 50s. And the common line we'll

hear is, I feel like my face just dropped overnight. I think that's,

that's the big thing, you know, and We do this all day and we

look at faces all day. So at first I thought

it was really interesting when someone said to me, I didn't look like this

last year, but then I hear it over and over

and over again. It's, I don't know what happened. It's a huge

rapid decline. I think it's something like 30% in the first 5

years collagen loss. So it's,

it's startling. Right. And you can tolerate a little bit of

loss, just like as if you're sort of going, going down a bit of a

slide, but then And you hit this sort of

breakpoint where it's like falling off of a cliff. It's like huge in

terms of the impact. And we do see a lot of people who

are not your typical aesthetic person or not someone who gets

Botox, but it becomes so distressing for

people because what they see in the mirror just doesn't really match how they feel

inside. And I often say that by the time you

hit perimenopause, menopause, you're sort of good in your career.

You feel like you're at the top of things as far as that's concerned. You

feel confident about many things. And then the reflection

doesn't match how you're doing inside in terms of that mastery of

other aspects of your life. It's super distressing.

And, you know, it's like one step forward and you've got this thing

dragging you back and also the physical changes that happen, right?

Absolutely. I think image alignment, really, you hit the nail right on

the head. It just doesn't align anymore. And I think

For some people, it's even one step further where all

of a sudden you look in the mirror and you see this different face

looking back at you, which is older. And it reminds you that there's

only so much sand in the hourglass. And that

again, we're on the second half of

the game. So it can be a little bit distressing

that way as well too. It creates a sense of urgency. Yeah. A sense

of not being aligned with It can be frightening.

Yeah, it's, it's a lot of emotions I think that come with it. It's not

about vanity. It's about all these other messages that it

gives. Yeah. So how do you approach

it? What's your first step when somebody comes in and you know they're

perimenopause, menopausal, their hormones are impacting

their aesthetics? Do you kind of do both at the same? Do you

address their aesthetic concerns first? What's your general

approach? Love to hear that. So I like to

meet, especially a newer patient to me, I think it depends

too how established of a relationship I have with them. I

really find a, a newer patient to the practice,

it's just from my perspective, it's so important to meet them where they're

at. So it's that whole patient-focused

care approach. Well, what do you see and what's concerning you? And so we

sort of start from there and then it's like the onion where you peel

off the layers. And so we may start where the

original item or problem was that they noticed.

But then part of the natural discussion about that issue

sometimes gets to root causes. Well, what's actually

driving this? Because at the end of the day, to be most

successful in meeting that specific need that they came in with, we

sometimes have to actually identify that it's, it's actually due to

alternate things. And then we have to kind of address education and

treatment targeting around that. So that seems to be how we go. A patient who's

like a longer-term patient who's been with us a long, long time, sometimes

it just sort of naturally comes up as part of process. So I think it

depends on whether they're new and we have an established relation or versus an

established relationship with them. What about you guys? Because again, it's a complex

question. So Christelle might have

access to a different approach because although I'm family practice, my

main focus is aesthetics. So

When a patient comes in, as you say, we're going to meet them where they're

at. So if they're worried about their 11s or their crepey skin, we're

going to use modalities that impact that. But all of us know

that there's also those hormonal changes underneath underlying

that, that are contributing to that. So

yeah, we're going to address the root cause if it's the 11s or lines

by using neuromodulators or muscle relaxers,

but at some point, You know, you are looking at the whole

person and you're thinking this person really could use some hormone

replacement. We don't have a huge amount

of data around how that replacement impacts skin.

However, it makes a lot of sense. And now people are

using different estrogen creams and things

like that. But ideally, you'd want to partner with someone who

could also support their hormonal health. And, you know, it's nice

that in your clinic you have— Yeah. Both options. Yeah.

I'd love to hear more about that. 'Cause the way my, the way it works

for us now is that I'll have these conversations inadvertently

hormone placement comes up in its various forms and the

changes that they're noticing. And it's not uncommon that I will say to

them, or I will take their details and I'll link them in through the

clinic that I run with family medicine residents because of the

community we live in. Most people don't have a family doctor, so they

can access a family doctor who may. Yeah. Do hormonal replacement,

or they don't even have someone to refer them to,

someone who would provide those type of services. So that's something that kind of comes

up almost on a backdoor conversation, being like, well, I can— we can address in

this setting the— what you're noticing is happening in the skin.

But from everything else that you've mentioned in our conversation, we shouldn't ignore that. And

this needs to be— sometimes it needs to be investigated. We need to really look

at the whole picture and

let's link you in, in that direction to do that. So how do you marry

that in your current practice where you offer both

services? Yeah, I know it seems like a kind of a

quirky little twist, but when you look at it the

opposite way, for me, it's very much

inside-out anti-aging. So addressing the

hormonal things that are happening is actually

addressing the aesthetic things that are happening. And it's, you

know, like, again, it's an interesting transition for me because I have a family

practice background as well. Originally did a lot of work with

women. I'm a 1996 grad, so

I'm dating myself a little. But the important thing was it was

pre-Women's Health Initiative, and I was

extremely pro hormone replacement back then for

the cardiovascular, the bone, the cognitive, all the things we believed.

I actually spent time when I decorated my first

office on one wall in each room. I had a wall just

dedicated to hormone replacement. investment benefits, all the different reasons to

consider it. And, you know, when the

Women's Health Initiative hit, it hit hard and it

created so much fear and we yanked everybody off.

And at that same time, I was doing a little bit of a cosmetic practice,

but I was so, you know, chronologically young back

then. I was like in my late 20s, not really experiencing

any of this firsthand. You know, I was more concerned at that point

from my personal use and interest. All of these things have come from personal

things, the cosmetic stuff, a little of the neurotoxins, some

laser, you know, that kind of thing. I never really put two and two together.

As I've gotten older and these things have been happening, it's kind of like my

old lady skin moment on the couch where I'm like, oh my God, what is

this? You know? So it's one thing to see people as patients, but it's another

thing to kind of experience it and go, holy, like I thought I

was sympathetic before, but I really didn't fully understand the

magnitude of this. And now that I have that, I've become a

lot more interested in the whole hormone story again,

especially as there's been so much emerging data

around the flaws in the interpretation of the Women's Health Initiative that

led to all the fear and the abrupt withdrawal and me taking all of that

educational stuff off my walls to now where again,

we're very strongly in support of it in broader

circumstances than we were before when we do it

appropriately with best practices. So that has kind of

become like my own aging journey along with the

evolution of the medicine. All of these things have kind of coincided.

And so now my priority, as my sand is leaving my

hourglass, is I want to slow that down

physically. I want to feel young and I want to look young, and I want

that full image alignment experience. So

again, when I look at my hybrid practice of both, I

don't even think of it as a hybrid anymore. I just think of it as

a continuum. So the outside is just a continuum of

good health on the inside. And when we take care of ourselves from a

hormonal, a metabolic, a cardiovascular point of view, we

have all-round better function, better, healthier skin. We look

better, we have more muscle mass, all these different things. So the outside

manifestation of us is more aligned with the

inside. So again, this whole inside-out alignment, I

think now fully fits with my truly non-hybrid, but now more

continuum practice of both. So I think this is how I've kind of

philosophically reconciled it, but I wish I could say had the

foresight to understand it prior to

experiencing it, but really it was the experience myself that made

me much more sensitive and much more aware.

But again, I'm trying to do something with the awareness. So that's how

I kind of marry it in my own office, if that makes sense. Yeah, it

makes, makes a lot of sense inside out. And I think as family practice

physicians, that comes very naturally to us. But there are

challenges when, just as you mentioned when

you have a study

that made such an impact and really did stop the

progression of women's health, even though its intention was the opposite.

It's just a tragedy, really, an absolute tragedy.

So we're lucky that some of that is reversing and now just in

time for our transition, we have access to these things,

but, you know, yeah. I want a personal— I was

mentioning to these guys earlier, I'm on a personal crusade for

anybody I know to any friends or

acquaintances, are you on hormones yet? You're not? Okay. This is what you need

to do. I've got so far, I was just saying in the last month, I

have 3 friends that are on hormones because I've

been pestering them. I was chatting with one the other day because I check in

on them like I'm their physician, which I'm clearly not. And I

checked in on one the other day and she said it was so strange. It

was about 2 days after you know, starting with the estradiol

or the estrogen patch and the progesterone. She said, I was sitting on the couch

and I had a moment of like, oh, there you

are. And I just, I get goosebumps

because I think how awful for people just to be

suffering. Right. Yeah. And it happens so

insidiously for some that they don't even realize

how Yeah. How far they've come from themselves until they

finally get to that point where they can't take it. They're at their breaking point

and they've been just putting up with it for months, if not years,

and it's harmed their relationships. It's taken enjoyment

and stolen time from them. So yeah, it's a real thing. And

it's very much like you said, that's one of the parts I find so

gratifying is when I start to see people back who go and

engage on this journey is that moment of, oh my goodness,

like here I am again. I feel like myself. I've

got my life back. I've got my relationship back. I don't wanna

murder my husband and my coworker and my children. I actually

love them. You know, it's like, it's kind of like we kind of laugh about

it, but it's like, yeah, I was feeling a little murdery. Did you not see

the crazy that was there? 'Cause it was right below the surface. And I'm like,

yeah girl, but you look good now. Like, I feel good. But it, it can

really be a game changer. And again, it's like quality of life, like,

right? Yeah. That's been lost. Our moms missed out on this.

We have a whole generation of women who did not have this offered because

of the Women's Health Initiative. Yeah. So true.

So true. It's been the most exciting moments too, when I've been in the

rooms assisting the docs and, you know, I'm thinking of one patient in particular that,

you know, her pre— did a few years. Remember when she sat up on the

side of the bed and she looked at herself in the mirror right after we

did some dermal fillers for her? I use collective we,

the collective we. Anyway, she, she sat up, she looks across from us

in into the mirror and she says, oh, there I

am. Yeah. It's the best. Maybe I will go on that dating app.

And she was what, 65? And we're cheering her on.

Yeah. And I think that's the coolest part of, of what we get to do.

Absolutely. Yeah. And that's the other thing. A lot of people think, oh, it's too

late. Right. It's never too late. And most of our

patients who are coming in for the aesthetic aspect of the changes they're

seeing, they're not looking to look like they're 20 or

30 or some sort of desperate clinging to

youth. That is not the motivation at all. As you said, it's image

alignment. And more than that, it's also that we have these

micro changes that occur on our facial anatomy that are

part of how we age that will translate to

emotional signals that we send. So, you know,

people end up looking sadder when they're older. They end up

looking grumpier as they're older. And it has nothing to do with their

internal emotional state or how they actually feel, but it's the structure. Right.

So that's the other thing that improves when we use aesthetics

in a structural, functional, and anatomic way. We're

actually returning people to their baseline so

that their emotions and their, the way they look

align as well. And they want to look refreshed. They want to

look happier. They want to look more approachable again, because it impacts

relationships, you know, and their perceived openness.

So, It's one of the most fun things that we do in

aesthetics for sure. So true. It's, it's again, it's

that whole conversation around how

communication is 80% nonverbal, right? Yes. So

the body language, again, those lines that say

angry convey something that may not align with that person's

personality at all. It's interesting, you know, when we have discussions around

wrinkle treatments and neuromodulators A lot of times the

11s, the angry lines, the squint lines, which again can just be

because you need corrective, you know, corrective lenses. Right. Or

again, you concentrate at a computer all day. It doesn't mean that you're angry or

unapproachable. So I have some individuals who have lines here and have

lines at the eyes, at the crow's feet. Most people are bothered by

these. And like the crow's feet are kind of like 50/50. Why?

Because crow's feet say happy. These ones say

angry. There was a psychology study, I'm trying I'm trying to remember what

year it was. And they were looking at the role of Botox in depression. I

don't know if you guys have seen that one. There's about 4 of them actually.

And so again, I question whether the

medication itself actually was an antidepressant or

was it more of the self-talk, even in this

nonverbal communication. It's like the phenomena of having a

good hair day. You know, when you have a good hair day, right? You're not

all that different. You still look like you, but you just, you hold your

shoulders back. You're queen of the world. and out you go.

Mm-hmm. When you have the opposite and you have these deep lines and

you look stressed, when you catch a glimpse of yourself in your

rearview mirror, on the windowpane of a storefront you're going

by, in the bathroom when you're washing your hands, you are

messaging yourself nonverbally that I am not

doing well, I'm stressed, I'm not coping well.

So again, I think just addressing some of those things is why this

whole nonverbal piece with image alignment inside,

outside, Or even in these scenarios where they've trialed it with depression,

I think part of it is the nonverbal communication piece of it. And I think

it's important. It makes people feel better. Yeah, absolutely.

Yeah. And I'd love to hear more about your journey with

your book and your YouTube

channel and all of that. Your passion for

education certainly comes through, and I'd just love to hear a little

bit more about that. Thanks. The book was

really fun to write, actually. I had a lot of fun with the

title. I won't tell you the ones we didn't pick unless we're all

sitting together around a— I was thinking hot sauce or wine. With a glass

of wine. There were some really funny ones that did not make the cut,

but the whole point of the book was to try to make

patient-friendly education. For those of us who kind of

grew up in the medical world during the 2002 Women's Health

Initiative, a lot of the new information has not yet permeated,

Oh, you're right. So it is hard and frustrating as a

patient because social media is loud to try to navigate,

well, what is real and what is not? And then you compound that with

the systematic problems we have in healthcare. First

of all, we don't have enough providers. Second, the providers we

have have not been offered updated education

around the changes in how we view and administer these.

And so again, it's very difficult as a patient to

find care and to know that you're getting and find care who has actually been

provided an opportunity to become current. So the book

is meant to try to empower those people. I have a workbook that goes

with it, and the workbook basically is sort of preparation

questions for going into your doctor's appointment, how to have

conversations around testing, how to

understand the hierarchy of these hormones, because there's

kind of an order that things need to be addressed, how to look

at some of the psychosocial pieces, because one of the things that

gets quickly glossed over in a busy

appointment is sort of the interplay between environment and

stress and how that can actually impact on

hormones. So stress does not just live in your head.

Stress can create all kinds of downstream

problems that can affect your sleep, contribute to

some of the anxiety and other things that we see going along with the

hormones. So it's, it's dealing and saying it's just stress is

to downplay the hormone part, but to downplay downplay

stress and not address stress also does not do credit to it.

So, it's about trying to understand that that does have a role, and especially

for somebody who is very driven,

high-performing, who lives in a high-stress world, to

acknowledge that the stress may actually impact on them when

they are a master of managing difficult things

sometimes is an important driver. Have you met my friends? Yeah, I know. Or

mine, or looked in the You know, so this comes

again. Some of the writing in the book really is about every

conversation I've had with every patient who sits in my chair.

I swear to you again, because I primarily see women who are of my vintage

who are having a lot of these changes. So we do this sort of thing,

and having all these life circumstances—quasi-adult

kids, aging parents, hormone changes, no sleep,

relationship—you know—all this stuff. And so we're trying to

navigate that, and I'm just doing Botox. But really, what I'm doing the most

beneficial. thing I'm doing is just listening. And so the book is about

that. And validating their experience. Exactly. And it's a shared experience.

So many people go around in a vacuum, like not even realizing

everybody looks so put together and like they have it going on. And you feel

like a pariah because you feel like you're the only one who is just faking

it. Everybody's faking it, or well, the majority are. And

you know, like everybody's just trying to cope. So the book is really meant to

try to bring empathy to self first,

empathy to those around, share experience and

hopefully some doorways to help people get off that little treadmill of

believing that and getting things better. So that was sort of the

whole premise behind the book and sort of the rationale. So hopefully it will help

reach people in a way that is digestible, understandable,

and that they can take, and most importantly, action on so that they feel better.

So that's where it came from. But yeah, I'm happy to bring it in. So

now I have something else to recommend to all my friends on my personal crusade

to keep us all Feeling our best.

That sounds fantastic. In every aspect of life. Yeah.

So I have a question for you, which is a bit changing gears,

but you touched on social media being really

loud and how access to evidence-based

information is oftentimes limited and difficult

for, you know, everyday women to access.

There's a topic that comes up a lot and And that is, you know, using

estrogen cream on your face because we know we

prescribe it for atrophy and skin

changes that occur in the vagina and vulval area. And

a lot of questions that come up are, well, can I use something like this

on my face to address wrinkles? What are your thoughts on that? So

interesting question. This also surfaces in my office too.

Harpreet, do you get this question in yours as well from your aesthetic crew? Do

they ask you about that a little bit? Very rarely, but sometimes, yes.

Sometimes. I've done, I've used it on my neck. Yeah. So there

are estrogen receptors in your skin. So yes,

absolutely. We do talk about that. So for, um,

most women who are candidates for estrogen, again, you have to have

that as a personalized conversation with somebody who knows your health the best. But

assuming that they are, let's assume they are, then using it

to help stimulate the estrogen receptors in their skin can sometimes be a lovely add-on

to the other things that we're doing. That they're doing.

So again, that can be in a cream preparation.

Estriol is the estrogen that we associate the most

with pregnancy, but it also tends to not

be implicated in proliferative things.

Like again, some of the estrogens like estrone would be one we would not like.

Estradiol may have benefits, but estriol tends to be

the most safe, I guess, as you want to call

it. So as a cosmetic product, you can see that added in. We

actually can do that through compounding pharmacies. So you can prescribe

that and you can do that. We have a skincare line here in the

office, which is almost like a little paint

mixer where the base of the cream is just peptides. And

then we put individual ingredients in. So it could be a

retinol or a niacinamide or vitamin C. And then for

these patients, what we can do is actually compound through the pharmacy a little

little bit of estriol, and then we can add that to

their skincare cream along with the other agents, and then we can put the estriol

in with it. But even for women who are using something outside of that, it's

something you can just have compounded at a local compounding pharmacy. So it's not

that hard to obtain. And whether you mix it in with an

existing product or you use it as a standalone and you just layer them,

it can work very well. And again, just like you said,

Face, neck, back of hands, my old lady

legs, you know, so I get those.

Bath in it. Yeah, exactly. Better lives

through chemistry. Right. Absolutely. Yeah. So there's a role for it

for sure. So are you getting asked about that in your practice?

Uh, not too much. Uh, it's more, I'm seeing it a lot

through social media and It seems to me like it's

still very much debated in the medical community. And I think like many things in

aesthetics, it's always quite quick to the forefront

and the evidence is usually slow to catch up. So there's quite

a lot of experimenting that we do in our practice and

kind of real-life case studies. If— I don't know if you feel that. And

just like Harpreet was saying earlier, before we actually started this call, you

know, Do you need a study if it looks better and you

feel better? I don't know. I guess, I mean,

I think the individualized care really is very, very key. So

in any context, whether that be a blood pressure pill, a diabetic

pill, or cosmetic cream or cosmetic product, what

applies to somebody else may or may not apply

to you. So again, the studies may say one thing, but there are always

outliers. What I say to patients is that there are, there are very few

certainties, you know, outside of death and taxes. Like seriously, there's

no always and there's no never. So again,

individualization and personal experience trumps

everything else. So completely. Yeah. And that's what makes it

challenging and interesting. Well, I wish we were

closer because this has been, I think we're all fairly like-minded. This has

been a really fantastic opportunity to sit down and chat.

Maybe we'll do it again sometime. Let's do it again. It was fun. Very

much appreciate it. And until next time, and

if any of our listeners out there have any questions, please

email us at [email protected]. And we are

going to link in the show notes Dr. Bocknick's

Instagram, her YouTube channel, and her

book. So yeah, check that all out.

Until next time, we'll see you then. Take care, everyone. Bye. Bye.