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The Ovarian Retirement Plan: 

Managing Perimenopause & Menopause 

By Rebecca Booth, M.D. OB/GYN & Co-Founder VENeffect Skin Care


What defines perimenopause and menopause? 

What is Perimenopause?

Late 30s & early 40s, hormonal transition as the biological clock is winding down. 

What is Menopause? 

When ovulation ceases, on average around age 52. 

When women hit their late thirties or early forties, many notice that their hormonal cycles begin to shorten; periods often change and PMS may become more dramatic. The term perimenopause is more of a description rather than a true developmental state. It is a time of hormonal transition as the biological clock is winding down, part of what I call the “Ovarian Retirement Plan.”

Menopause marks the cessation of ovulation; usually identified in retrospect as a woman experiences the last of her periods (literally defined as the first day of the first year of no periods). As women, we are born with all of the eggs we will ever have, and the tiny eggs are “spilling” like the sands in two half-century hourglasses (the ovaries). This process goes on throughout a woman’s life until the eggs are depleted around age 51-52.

There are events and conditions that can lead to early menopause, but just as the age of puberty can vary widely, so can the age of menopause. As a woman’s ovarian reserve is determined before birth, the age of puberty does not affect the age of her ovarian retirement. Family history is only a mild factor but does play a small role.

What are the primary effects of perimenopause and menopause?

Top 10 Symptoms of Perimenopause and Menopause:

  • Vaginal dryness/pain with sex

  • Dry, thinning facial skin/wrinkles

  • Thinning, brittle, dry hair

  • Hot flashes (known as "flushes" to researchers)

  • Insomnia 

  • Fatigue

  • Abdominal weight gain

  • Anxiety

  • Word-finding difficulties/short-term memory loss

  • Loss of libido

Estrogen decline is the primary cause of perimenopause & menopause effects 

Estrogen has a positive effect on virtually all elements of feminine beauty  – from our hair to our skin and our overall feeling of well-being. Estrogen decline and retirement around menopause has a noticeable effect on the female aesthetic, but can be managed by lifestyle,  nutrition and self care.  


Estrogen decline in perimenopause and menopause has as significant effect on the skin of the face. The face has the second highest concentration of estrogen receptors in the skin of a woman’s body, second only to the reproductive skin. Thus, the rapid loss of estrogen in our forties and fifties, and the corresponding effect on collagen, shows up quickly and dramatically on the skin of the face. A study on the decrease of skin collagen in postmenopausal women found a decrease of 2.1 percent per year in the first fifteen years postmenopause. Thus, on average, from age fifty to sixty-five more than 30 percent of skin collagen will be lost due to the cessation of estrogen.

HAIR: Estrogen decline  reduces lubricity in the skin and scalp – leaving skin more dry and hair more brittle with less natural shine. 

SLEEP:  Estrogen decline also contributes to disruption in sleep patterns and the complicating factor of hot flashes can exacerbate sleep deprivation in addition to the discomfort at all times of day.

WEIGHT: Estrogen helps us metabolize carbohydrates more efficiently and loss of estrogen has an effect on energy levels as well, as spikes in insulin can leave a woman with more highs and lows. Abdominal weight gain is 

VAGINAL DRYNESS/PAIN: Estrogen reduction during perimenopause and menopause  also has a dramatic impact on the skin on and around the vagina, accelerating loss of elasticity as the skin in this area has more estrogen receptors than any other area. The decline in estrogen with the biological clock may cause discomfort and pain during sex due to the decline in skin elastin as well as skin collagen. It is one of the most common issues I hear from my menopausal patients. Talk with your gynecologist about topical estrogen cream to help with vaginal skin. 

Our collagen peaks with peak estrogen around 27 and declines in our thirties with accelerated loss of elasticity in our forties, fifties and beyond. VENeffect preserves and restores collagen, dramatically increasing elasticity.  

Read more about the Estrogen - Collagen connection and the efficacy of topical phytoestrogens. 

A word about Hormone Therapy

I support hormone therapy for the woman who needs it and is a candidate for it assuming she understands the risks as well as the benefits. Many women, however, perceive menopause as a transition and not something they would opt to treat as an altered state. Most women are not willing to accept  the risks of hormone therapy and some women have no symptoms with menopause. My recommendation is to make an appointment with your gynecologist with the specific intent of discussing the topic of hormone therapy, taking into account your personal medical history and weigh the benefits and risks with your doctor to make an educated decision.  For many women potential treatment and lifestyle changes can make a true difference in our quality of life.  

What non-prescription solutions are available for the effects of peri & menopause?

There are many recommendations that I make to my patients, friends, and our VENeffect clients that do not require a prescription that can help significantly with the symptoms of estrogen decline:


My number one recommendation is exercise – 22 minutes a day (2.5 hours a week) of movement combined with a yoga or Pilates practice to improve metabolism, flexibility, support the vertical spine and inspire skin and mood.  Read more exercise tips.


Eating a diet rich in phytoestrogens is a must, including nuts, seeds and legumes that will pass along the plant protein, from the reproductive part of the plant, to lower insulin (sugar) sensitivity, and inspire skin to better elasticity. Learn more about adding phytoestrogens to your diet.


Topically, skin care rich in phytoestrogens are also effective as they mimic the benefits of estrogen without the risks. My sister and I created VENeffect in our forties as a way to help inspire skin to peak hormonal vitality. Now that we are both menopausal, we can speak from personal, as well as professional experience to help women navigate the hormonal processes and provide solutions that truly make a difference.  VENeffect Skin Care products are loaded with potent  phytoestrogens.

Notable Features of Topical Phytoestrogens:

  • Increase collagen content

  • Increase hyaluronic acid production (the dewy substance that gives us the glow)

  • Improve skin elasticity

  • Anti-inflammatory

  • Anti-oxidant

  • Photo protective

  • Improve wound healing

Your Ovarian Retirement Plan - Time to 

Negotiate With Nature!  

The VENeffect line offers breakthrough anti-aging skin care products that source their potency from a proprietary blend of phytoestrogens to safely and effectively preserve and restore the youthful glow of healthy, vibrant skin.

Deluxe Sample (3ml) as gift with purchase of any VENeffect Product

$ 195.00$ 146.00
$ 60.00$ 45.00

About Rebecca Booth M.D.:

Rebecca Booth, M.D. is a board-certified obstetrician and gynecologist who has been practicing medicine for over 30 years as Co-Managing Partner in one of the largest OB/GYN practices in the southeast of the United States: Women First of Louisville. She is a nationally recognized expert in hormonal wellness and author of The Venus Week: Discover the Powerful Secret of Your Cycle…At Any Age  (Da Capo Lifelong Books, 2008). She, together with her sister Cecil Booth, founded an anti-aging skin care line, VENeffect, with a breakthrough phytoestrogen technology to replenish lost elasticity and luminosity. She has appeared on The Today Show and been extensively featured in leading women’s magazines including O: The Oprah Magazine, Good Housekeeping, Redbook, Glamour Shape, Prevention, and Self. She has been published in leading medical journals. Dr. Booth earned her medical degree from the University of Louisville School of Medicine. She resides in Louisville, Kentucky.

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