I am a 24 y/o female with dry/combination skin. I have had great skin my whole life, never an issue with breakouts. Enter Mirena IUD. I got the Mirena in March of 2016, and that December (about 9 months later), I started getting cystic acne around my jaw, mouth and cheeks. Never on my nose, forehead or temples, so purely hormonal cystic acne. I thought it was weird and had to be something to do with my diet, after I made a quick call to my OBGYN about my IUD (the first thing I thought of that might be causing it) and she confirmed that the progesterone-only hormones were only being released locally in my uterus, so therefore there's no way that I could have been breaking out from my Mirena (BS if you ask me).

From there, I did a bunch of research, thought I was allergic to tons of foods (I still think I'm ultra-sensitive to soy, even though it never gave me an issue before the Mirena), tried essential oils, Vaseline, drinking tons of water, AHA/BHA, retinoid creams, etc. Nothing helped. I cannot go on antibiotics due to other health reasons, so that was out of the question for me. Many-a-visit to Western medicine practitioners was unsuccessful. My dermatologist prescribed a low dose of Differin and a sulfur face wash which did not make any notable difference. After many phone calls to my OBGYN, I was made to feel crazy for believing it was my Mirena (I get it, I'm not a medical professional, but I know my body and myself). My GP told me to just "wait out the storm, it will get better." No one helped. That's when I set out to figure it out myself with the help of Google (not advised, but hey, it's 2017).

I started doing more research into the hormonal IUD and seeing that many people had the same issues with cystic acne. Some people said acne on Mirena was due to the absence of a balancing estrogen, which many women had while they were on the pill prior to going with the hormonal IUD. I was on a low-estrogen birth control for many years leading up to my decision to get the Mirena, so that didn't really make sense for my personal situation. Plus, the first 9-10 months I had the Mirena, my skin was completely unaffected. So, I am stumped.

Does anyone know if the Mirena causes low progesterone levels in the rest of the body (even if indirectly)? Or does it cause estrogen dominance? I have read articles that say you can have:

• Too much estorgen
• Too much progesterone
• Normal amount of estrogen, with low progesterone (often masquerades itself as estrogen dominance, when it really is not)

Any help or advice on this topic would really help me out as I search for natural supplements that are safe to take long term to combat this . I love my Mirena for everything else, so I hate to have it removed. Plus, I hear your hormones go out of whack for months after removal anyway, so I feel a bit stuck.

I have tried the DIM supplement for about 60 days, has not made a huge impact. I also recently got Evening Primrose Oil (EPO), but I just started taking it so it's too early to tell if that helps. I have read about Vitex but I'm not sure of its affect on the Mirena's effectiveness, and many have said it breaks them out worse (it is stimulating a hormone they have too much of already, obviously).

Thank you so much in advance!