A Conversation on Menopause: What 4 Experts Want Aesthetic Providers to Know

Menopause is reshaping the aesthetic industry—not as a trend, but as a demographic and clinical reality that's changing how practices should think about patient acquisition, treatment planning, and technology selection.

At a recent Cartessa Aesthetics conference held on World Menopause Day, four experts sat down to discuss what providers need to understand right now: Marc Estes, MD, founder of PURE Regenerative Medicine; Leslie Apgar, MD, OB-GYN; Corinne Erickson, MD, FAAD; and Melissa Oliveira, founder of HotPause Health. Here are five key observations from their conversation.

Key Takeaways

1. Aesthetic providers are often the first to see the effects of declining estrogen. Asking about hormone status should become as routine as asking about sun exposure.
2. Fibroblast activity declines with estrogen loss, which means energy-based devices like EVERESSE produce better outcomes when patients’ hormones are more in balance.
3. "Anti-aging" is out; "vitality" and "skin longevity" are in, and updating your language changes who walks through the door.
4. A menopause-aware practice isn't a single-treatment play—it's a patient-for-life acquisition strategy with compounding retention value.
5. You don't need to prescribe hormones to lead this conversation. Start with your devices, build a referral network, and get educated.

1. Aesthetic Providers Are Often the First to See It

When estrogen levels begin to decline, the signs show up on the skin before they show up in lab work. Thinning, dryness, accelerated collagen loss, volume loss, hormonal acne, and hair changes. Aesthetic providers are seeing these in patients every day.

"Women are bringing us the signs and symptoms of menopause to look at on their faces and on their skin," said Dr. Erickson. "We see the bone loss. We see osteoporosis as providers一by sinking and volume loss. We see the tanking estrogen and the dry skin and the loss of collagen and the wrinkles. So we are great openers for this conversation for so many females."

Dr. Apgar put the clinical reality plainly: "They lose 30% of their collagen in the five years after menopause. It's significant."

The panel's consensus: Asking about hormone status should become as routine as asking about sun exposure. When a patient presents with dry, rapidly changing skin and is of a certain age, that's the cue.

"If anybody complains of dry skin and they're of a certain age-ish, that should be a reflex, like a knee-jerk," said Dr. Erickson. "Ask about hormone status, whether the patient has retained her ovaries, and whether she is still menstruating."

Providers don't need to prescribe anything. They just need to ask.

2. Patients Who Are More Hormonally Balanced Respond Better to Energy Devices

This observation has direct implications for how you sequence treatments and counsel patients on expectations.

Estrogen decline doesn't just affect skin quality on the surface, it affects how skin responds to the energy-based devices you're already using. Declining estrogen suppresses fibroblast activity, which means the collagen-stimulating response that devices like EVERESSE are designed to trigger is dampened in patients who are hormonally depleted.

"We all know you're losing collagen, losing elastin as you age, and your fibroblasts are less active," said Dr. Estes. "But once you go through menopause, that just accelerates. And what is the entire point of most of these devices? Whether it's EVERESSE or VirtueRF, we're trying to stimulate the fibroblast so it begins to make more collagen and elastin. And so they're going to respond better."

Dr. Apgar reinforced the point from a surgical perspective: "You need those [hormones] for your skin to react to the energy-based devices that we are suggesting to you. So you are only going to help yourselves and help the patients if you help balance their hormonal status before you do these progressive treatments."

The takeaway for device-focused practices: understanding where a patient is hormonally gives providers better context for setting realistic expectations, sequencing treatments effectively, and explaining results. For patients who aren't candidates for HRT or aren't yet interested, that conversation also opens a referral opportunity.

3. Language Matters: Retire "Anti-Aging," Lead with Vitality

How you talk about menopause, aging, and treatment goals shapes who responds to your marketing, how consultations unfold, and whether patients feel seen or dismissed.

The panelists were direct: "anti-aging" is out. "We're all aging,” said Dr. Apgar, who suggested a reframe: "Vitality. Do you want to live with more vitality? Do you want to feel better while you're here? This is a great device to get you there."

Melissa Oliveira made an equally important distinction about why these patients are walking through your door in the first place. "It's not about vanity—it's about vitality. She's coming to you not from a vain standpoint. She wants to live longer. She wants to live better. She wants more health span."

Language shifts the relationship. Patients in perimenopause and menopause have often been dismissed by providers. When an aesthetic practice leads with education and meets them with language that acknowledges what they're actually experiencing, the response is different. "They are absolutely delighted to be taken seriously for the first time," said Dr. Apgar.

Dr. Erickson's prescription for practices: "Start with the education piece. Build trust. Build yourself as an expert in that area. And then when you start to break it down with the different treatments, you have an audience that trusts you and is ready to sign up." "And they often refer others, " adds Dr. Apgar.

4. This Is a Patient-for-Life Acquisition Strategy

A menopause-aware practice isn't a single-treatment play. The panelists described a compounding retention dynamic that changes the economics of patient acquisition when you understand who you're treating and why.

"She's going to be in menopause for the rest of her life—up to one third of it," said Oliveira. "That creates the potential for a long-term patient relationship, with significant implications for retention and lifetime value."

Dr. Estes described how cross-pollination works in his own practice, which runs aesthetic and HRT services in parallel: "Our HRT folks get free skin assessments and dermaplaning, and our aesthetics folks can easily get access because we talk to them all the time about the science of facial aging. And so next thing you know, they roll into our HRT program."

The referral effect extends outward, too. Satisfied patients bring partners. "We're getting a lot more men coming in because, first of all, their wives were heard and acted upon and guided," said Dr. Apgar. "And now she's seeing meaningful results from energy-based treatments, and he’s interested in achieving similar outcomes.”

The business case, in short: practices that lead with education, acknowledge the full picture of what menopausal patients are experiencing, and offer treatments aligned with their goals don't just close a single appointment. They earn a patient who trusts, returns, and refers.

5. You Don't Need to Prescribe Hormones to Lead This Conversation

The panel was careful to address a concern many aesthetic providers have: this feels outside my lane.

It isn't.

"You do not need to be an OB-GYN," said Oliveira. "You can complete an assessment to better equip yourself to support patients more effectively." She referenced the Menopause Society's certification program, which has tripled in enrollment in the past year, as an accessible starting point for providers who want to deepen their knowledge.

Dr. Erickson drew a direct analogy for the room: "How many of you talk to your patients about the importance of sunscreen and sun protection? Learning to talk to your female patients about their hormones is the new sunscreen. It is our internal defense against an intrinsic cause of aging and physical deterioration that we can do something about."

The path forward for device-focused practices doesn't require a prescription pad. It requires asking better intake questions, updating consultation language, getting educated on what patients are experiencing, and building a referral network—a gynecologist, an endocrinologist, a pelvic floor specialist—that makes a practice part of a larger ecosystem of care.

The Bottom Line

Perimenopausal and menopausal women are already in your practice. They're asking about skin laxity, dryness, texture changes, and volume loss. The providers who understand what's driving those concerns—and who can meet patients with the right language, the right treatments, and the right referral relationships—will be positioned to build something more durable than a device ROI story.

They'll build a practice that patients don't want to leave.

Cartessa Aesthetics is committed to helping providers navigate this shift with advanced technology and the clinical and business support to deploy it effectively. To learn more about EVERESSE and Cartessa's full portfolio of aesthetic solutions, contact us today.

Panelists: Dr. Marc Estes, Pure Regenerative Medicine; Dr. Leslie Apgar, MD, Corinne Erickson, MD, FAAD; Melissa Oliveira, HotPause Health.

Moderators: Jill Later, Chief Marketing Officer, Head of commercialization, Cartessa Aesthetics; Andrea Morrison, Executive Vice President, Clinical Education, Cartessa Aesthetics.

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