Posted 05 August 2004 - 09:05 AM
GuardedlyOptimistic,
Androgens cause acne in the majority of Hormonal Acne cases (oppesed to allergic acne cases). There are other women that have commented that they have broken out from taking Ortho, despite it being advertised more so for clearing one's skin.
Now, get this, Progesterone has androgenic properties and therefore, if you don't know what causies your acne, and take extra progesterone, your body may chose to convert it into Testesterone instead. Or it may not.
Estrogen Dominance and one form of Polycystic Ovarian Syndrome (PCOS) are associated with a lack of Progesterone. When these women (or men) take Vitex (boots progesterone production), use Natural Progesterone Cream (NPC) or take Micronized Progesterone, their problems improve. Sometimes that is all they have to do.
Now, our bodies can produce extra androgens that are thanks to one or more of several hormonal disorders. Both forms of PCOS are also associated with androgen production, either via adrenal glands or ovaries. In regards to the 1st form of PCOS the problem is that somehow something got screwed, and the body converts those androgens (that the stimulated follicle produces) into some estrogen (but not in the follicle). That estrogen in turns tells the pituitary to stop producing Follicle Stimulating Hormone (FSH). FSH is responsible for creating a mature oocyte in the follicle. So what happens is you are left with higher amounts of LH (luteinizing hormone), which encourages androgen production, and lower amounts of FSH (Follicle Stimulating Hormone). This results in an immature follicle and this cycle continues (the multiple follicles), hence why some women around here rarely or never menstruate (with PCOS). Progestrone helps because it inhbits LH (which starts ovulation). That way your body will end that vicous cycle and become regulated again.
Under normal circumstances, during this period our estrogen levels and progesterone levels drop to a lower level in order for ovulation to begin. Now, my guess is that women with cystic ovaries don't produce a lot of estrogen, but its that normal or little amount that they do, or from the phytoestrogens, produce at this time that helps trigger the end of ovulation (by inhibiting FSH) before the egg (oocyte) was even released. Again, these follicles/cysts are still producing testosterone. The addition of Progesterone for these women, allows this full process of ovulation.
There's another form of PCOS, that has more to do with being Insulin Resistant (but both can). That's the form that I have and I actually produce high amount of the adrenal androgen DHEA (but have tested negative for a adrenal defect) and Free Testosterone. Free Testosterone can be produced from ovary androgens or adrenal androgens. The problem here though is that an increase in Insulin reduces your ability to properly regulate your testosterone levels. So they give women Estrogen in the form of Birth Control, to aid in regulating this. Estrogen or Lowered Insulin levels, boosts our Sex Hormone Binding Globulin (SHBG) which binds to Free Testosterone, in order to prevent it's activity and converion into the super bad testosterone, DHT.
Another disorder that is sometimes confused with PCOS is that of Non-classical Congenital Adrenal Hyperplasia (NCCAH / LOCAH). The primary difference here is that the body has a liver enzyme defect (out of possibly 5 enzymes) that is required for the production of Cortisol. The body tries to produce more cortisol as a result of lacking it, but only ends up only producing more androgens. Of course you can also produce too much cortisol along with too much androgens. The treatment for NCCAH is to use glucocorticoids like Dexamethosone, where upon the body regulates itself and stops overproducing those androgens.
You can also be Hypothyroid and have acne. Again, the connection here is that you have a low SHBG which we need to prevent an over production of DHT. I don't know too much more about this disorder, but I'm sure someone else around here does. Unfortunately some women with PCOS, seem to also have NCCAH and be Hypothyroid!
So if you are breaking from Ortho it may be because it has too much progestin in it. There are other birth control pills you can try. I used Tri-Levlen and it never caused me to breakout. I am not deficient in progesterone, LH, or FSH, but if you are going to take BC you do need the progesterone in order for it to work. Of course, you don't have to take BC to get clear skin.
Methods such as BC, or Insulin Sensitizers, or Spironolactone, or Low Carb Diets, work by having an Anti-androgenic effect. The either boost our SHBG or they block DHT from binding at the androgen receptors. So if you aren't happy with what you are currently using, then you may want to get more lab results from and Endocrinologist and see what your hormone levels are really like and get the appropriate treatments.
HTH =)
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HI GUYS,
