Intro/ramble: 

hi guys so its been a while, im back with another research topic because i'm just curious and want to brainstorm.

ok so. 

the times i break out are two days before ovulation and including ovulation day, and about a day before my period. i always break out in the same spots, too. (spots, ha, get it, nvm). 

so im currently ovulating and i have a pimple right in between my brows, and my skin feels super sensitive and just really soft, but not in a good way, like my skin is not as tight, my pores look larger and are opened, and i dont know, my skin just looks more textured around this time. 

and the pimple i usually get a day before my period is not even a pimple its more like a freaking bomb under my skin, its large, cystic, painful, and weirdly shaped, as its more oval like and long, it just looks like an ugly lump. 

ok so we always hear about pms acne, and how people breakout before their periods. but what about breaking out before and during ovulation?

that is the case, for me, and a lot of other women too, apparently. 

i also started researching the fertility awareness method for birth control, so ive become obsessed with tracking my cycles, and i've gained so much knowledge about the female body and her cycle. 

so before i get into the digging and all the science stuff i want to explain some terms so any girl reading this could understand in the case that she doesn't know, or wants to learn more about her body. 

so let's begin.

i like to think about the menstrual cycle being split up into 4 phases. 

The four phases of your menstrual cycle:

Phase 1: Your period (menses)- This is the phase where you bleed for however many days you usually bleed for. your first day of your period marks the first day of your cycle. 

Phase 2: Follicular phase- This is the day your period ends, to the day you ovulate.

Phase 3: Ovulation- The day that you ovulate (if you have a period app normally it will give you the predicted day of ovulation, but since its not 100% accurate, i usually say ovulation happens on the day the app says, plus or minus one day. so if it says u ovulate on the 26th, u could ovulate the 25th, 26th, or 27th. just keep in mind your ovulation day is not exact with each cycle, normally it could be a day or two later than your last cycle, maybe even earlier. 

Phase 4: Luteal Phase- This is the day after you ovulate to the first day of your period. the number of days between the first day of your last period and the first day of your current period is how long your cycle is. generally, research says that a "normal" cycle is 21-35 days, but i would say that a regular 40-day cycle is still healthy, but i am not an expert, so whatever. 

so these are the four phases of your menstrual cycle. 

and throughout these four phases, your hormones fluctuate dramatically, and i mean teenage drama queen dramatic.

so i am now going to discuss the changes in your hormones throughout your cycle, as well as things you may notice as these changes occur. 

Hormones throughout the cycle (science stuff) In the menstrual cycle, estrogen is responsible for the thickening of the uterine lining in the follicular phase, leading up to ovulation, and after ovulation estrogen levels drop and stay low during the luteal phase. 

Testosterone is crucial for the sexual development in women, i.e, sex drive, clitoral sensitivity, and ability to reach orgasms. too little testosterone in women leads to low sex drive and energy, while high testosterone causes irregular periods, acne, hair loss and in more severe cases, infertility. 

since this is a cycle i'm talking about, its kind of hard to pinpoint a place to start, so ill just start at the beginning of your period, even though you'll need to read through the next phase in order to understand the one prior to it, if that makes sense.. 

so the first day of your period- at this point, all of your female hormones (estrogen, progesterone) are low because they just went through a month's worth of fluctuation. but, the other hormone present in our bodies is testosterone, and this is higher in ratio to estrogen and progesterone during the few days before your period, and all the days of your period, so it being the dominant hormone during this phase gives way to acne flare ups. 

to better understand this phenomenon, ill explain the role of testosterone in the female body. so first, i'll just say it now to get it out of the way; testosterone is the sex hormone. it increases sex drive in women, and thats why men are given the "horny" trait, because their main hormone is testosterone, while our main hormone is estrogen/progesterone. 

this is why some women who take certain brands of combination birth control pills, notice a decrease in sex drive. the estrogen/ low androgenic progestin combo pill causes testosterone to decrease in the body, which can really help someone with high testosterone and acne, (and not cause low sex drive) but if your testosterone levels are normal prior to taking the pill, it will lower them further and can hinder your sexual experiences, AND cause androgen rebound once you get off it, so if your didn't have acne before taking the pill, you can have it after stopping it. so be careful. i already made a blog post titled "intro/hormonal research" where i discuss the dangers of birth control, so you can check that out if you'd like, its kinda roughly written, and its all my opinion based off my own experience with birth control, so i'm definitely biased. anyways, 

in relation to acne, this is the reason why you break out a few days before your period begins, and you can also break out during your period, as testosterone stays high in ratio to estrogen and progesterone up until a few days before your begin ovulation. (see graph A below).

with the first day after you period ends, we're now in the follicular phase. the hormone that begins to slowly rise after your period ends is estrogen.

as you approach your next phase, ovulation, testosterone begins to increase and becomes high with estrogen at the time of ovulation, but estrogen is the dominant hormone here.  The other dominant hormone that spikes at ovulation is called Luteinizing hormone.  (see graph B). This is the hormone that signals the egg in ovulation to be released, starting ovulation. 

I included two graphs below: 

A)

b)

Graph A analysis:

this graph shows the relationship between the three main hormones in the female body, Estrogen, Progesterone and the big yucky mister T. (testosterone). testosterone is important to the female body, just as much as the other hormones, so calling it yucky isn't very nice, but testosterone imbalance is the main culprit behind acne in women. so yeah, he's yucky.

I like this graph because it clearly shows how the increase in estrogen is correlated with the increase in testosterone during the follicular phase. so they say that estrogen is the dominant hormone in the follicular phase of your cycle, and they're right, but what most people or articles online fail to mention is that testosterone is in close relation with estrogen, and when estrogen fluctuates, so does testosterone. 

so in chart A u can see that estrogen and testosterone increase gradually after your period stops, and spike in time for ovulation.

progesterone is low during the follicular and ovulatory phases, but it begins to increase rapidly right after you ovulate and stays high throughout your luteal phase, but then drops down along with estrogen and testosterone as soon as your period begins. 

Graph B analysis:

Here is a graph showing the fluctuation of Luteinizing hormone (LH), as well as Follicle Stimulating hormone (FSH) throughout your cycle. both of these hormones are responsible for ovulation, estrogen production, and necessary for the release of the monthly egg. 

let's discuss what each of these hormones actually do. 

Luteinizing hormone (LH): spikes dramatically at the end of the follicular phase, in response to the dominant follicle (egg) in the ovary releasing estrogen, which then signals the egg to be released,  during the process of ovulation. 

Follicle Stimulating hormone (FSH): increases estrogen, causes monthly follicle to grow in the ovary. 

As shown in chart B, FSH is higher in relation to estrogen during the menses and follicular phase, while LH is low and steady. then, there is a small spike in FSH right before ovulation, and this means the dominant follicle is grown and ready to be released. LH then spikes to signal the release of this follicle, which is called ovulation. 

During ovulation, the egg that has been released travels down the fallopian tube and waits there for a sperm to come and fertilize it. 

if sperm does come, it fertilizes and attaches to the uterine wall and the progesterone surge during your luteal phase stays high as the pregnancy progresses. 

if sperm does not come, the egg and uterine wall begin to break down during your luteal phase, all of your hormone levels plummet, and your period begins. 

then the cycle repeats! oh, what fun it is to be a woman, we come with a free rollercoaster ride all month long, all year long, for the rest of our lives. oh, what fun indeed. 

Conclusion

The key here to figuring out why you break out the same time each month, (or having certain symptoms the same time each month) is identifying the phase that your'e in when your acne (or other symptoms) flares up. you can then see which is the dominant hormone responsible for the flare up, and your can better understand your body. 

I can talk about other symptoms in relation to your cycle, but since this is acne related, i'll just try to focus on that.

So from personal experience, as i stated in the beginning, i always break out during ovulation, which i always found odd because estrogen is the dominant hormone during this time, and estrogen is supposed to clear your skin and give it glow, but that wasn't really the case with me. 

then as i did more research, i saw that luteinizing hormone spikes at ovulation, and i guess this spike somehow causes my acne to flare. like i said, im not an expert and ive tried researching the effects of luteinizing hormone on things such as acne, like maybe it has a direct pathway to the skin? but i could not find anything on it! so im just making assumptions at this point about it.

but i've also had a hunch that my prior use of the copper iud has some responsibility for my acne flaring during ovulation. 

I think this is because the copper iud increases estrogen levels, and disrupts the environment in your uterus so when LH, FSH, and estrogen are doing their job to thicken the uterine wall during the follicular phase, something is disrupting that process, and that something was the copper. 

i may be neurotic at this point, because i took out my copper iud like 7 months ago, but i just feel like theres residual copper left in my uterus and with each passing menstrual cycle, its getting "reactivated" in the uterus, but hopefully its also slowly getting excreted with every one of my periods. 

i hope that made some sense, i don't know, i'm just brainstorming because theres no one who can corroborate what im saying, and theres no forums on this specific symptom, like, anywhere.  

so anyways, i guess i'm done. i hope someone finds this helpful in any way, and i hope that i somewhat did a good job at explaining the relationship between your hormones during your menstrual cycle, and maybe you can now start brainstorming why you break out during certain times of the month. 

i also included a poll so if you guys would like to check that out and vote, i am really interested to see all the different answers. 

thanks for reading.

good luck. 

xo, 

eliza