Choosing Collagen

I was able to meet with Dr. Lanna Cheuck, a trained urologist and now powerhouse in the world of aesthetic medicine.

She was in her late 30s, noticing changes and took the approach of healing “from the inside out and outside in, from head to toe.”

She discussed the landscape of aesthetics where the low-hanging fruit is Botox and fillers.  I asked if this is mostly where the demand is within the industry and her practice.  The industry is undoubtedly saturated and these treatments are a low barrier of entry.  This has become so popular that non-physician medical professionals are opening successful practices: nurse practitioners, physician assistants, nurses.  This varies by state regulations.

When she first branched out of practicing urology, she focused on aesthetics first.  She then built the weight loss program, now is expanding into sexual health.  The reason for this is because aging “goes hand in hand with weight gain, mental health, sexual health and aesthetics”.  Being a trained urologist, she’s now finding her specialty again with building a sexual health program for her patients.

I asked what one piece of advice she would give to midlife women

“Being educated and having community where people talk about their midlife issues”

Changes in our bodies are happening constantly, as we speak, though we may start to actually notice these changes long before our periods stop.  This is termed perimenopause, a term used with increasing frequency as attention is drawn to this time in a woman’s life.

For me as an obgyn, the education has been just as much for me as it has for my patients.  I am a fully trained obgyn and was not trained in any such thing as perimenopause.  I had very little training in menopause care.  We had exam questions on osteoporosis diagnosis and treatments, but otherwise very little.  I prescribed no hormone replacement therapy (HRT) during residency.  I rarely if at all ordered a test for osteoporosis or treated osteoporosis.  I remember during my first year after residency texting one of my attendings from residency for advice on treating osteoporosis.  The patient population in the resident clinic was largely early reproductive age and obstetric, we just did not have the experience with a midlife population. 

 This is not to say this is unique to where I trained or a fault of the program, this is a national trend.  In a survey of obgyns, only 20% felt they had menopause training.  80% of program directors (overseeing the residents) felt that more menopause training was needed during residency.

I had a lot of learning to do and I’ve put a lot of time and effort into this area now that I’m outside of my training years.  If physicians are good at one thing, it’s learning. Now I feel that I can educate and treat my patients better than I could before.

What can we do now as perimenopausal and early menopausal age women?

Dr. Lanna and I discussed that our patients should understand we can and should take care of ourselves differently, perhaps better than ever before.  “Now’s the time to build as much as we can, prevent as much as we can,” she said.   “Now’s the time to build up our muscle mass,

now’s the time to build up our collagen.”

As far as collagen goes, if we wait too long, we can’t get that back.  “We lose 40% of our collagen after age 40” Dr. Lanna explained to me.  We can protect our collagen with non-procedural and procedural methods.

Non-procedural methods include:

• collagen supplements

• skin moisture

• vitamin C

Procedural methods are meant to stimulate our body’s ability to make collagen, and include:

• Collagen injection (this is similar, but not the same as “fillers”)

• micro needling (tiny needles create a micro injury in the skin)

• radio frequency

• Platelet-rich plasma

• Polynucleotides (extracted DNA from salmon or trout sperm)

If you’re not ready for the procedural category yet, I’m not either.  I stick to collagen supplements, overall healthy diet including antioxidants like green tea and blueberries.  I’m using coconut oil as my moisturizer before bed and will be starting a vitamin C serum very soon.

As far as muscle mass, I would argue it’s never too late to build muscle mass, but why wait?  If you are frail from lack of muscle, it will be harder to start.  If you have a bone fracture from osteoporosis, it will be much harder to start.

As Dr. Lanna said, and I completely agree, now’s the time.

This is why I’m making these changes now, likely 10-15 years before my last menstrual period.  I’m not just here to tell you to make changes, I’m doing it with you.  I’m sharing my journey.

Resources:

https://www.glamourmagazine.co.uk/article/salmon-sperm-facial-polynucleotides

https://doctorlanna.com/how-are-collagen-injections-different-from-dermal-fillers/

A huge thank you to Dr. Lanna for taking the time to have this conversation with me!