Hi, I’ve just recently been diagnosed with PCOS. I haven’t had a period in 9 months; I’m not overweight; I have ovarian cysts and acne. My OBGYN says I’m not insulin resistant. I just want to know how PCOS can cause acne if it’s not an insulin related matter. And how can I treat PCOS acne naturally?
If you have been diagnosed with PCOS it is most likely on the basis that your hormones are disordered and perhaps your OB/GYN has found that this is due to a dysfunction in your pituitary gland rather than as a result of insulin resistance. It is the pituitary gland which is responsible for regulating female hormones through balancing the cycle of FSH and LH throughout the month.
It is important that the presence or absence of insulin resistance has been determined correctly. The correct test is a 2 hour (or longer) Glucose Tolerance Test WITH Insulin levels. Both insulin and blood glucose levels need to be taken from a fasting state (0 hours), then at 30 minute intervals for at least 2 hours, longer if abnormalities are detected. It is possible for someone with insulin resistance to have ‘normal’ results on a regular glucose tolerance test as it does not show enough measurements throughout the time scale for the typical patterns of insulin resistance to show up. Many women with PCOS respond quite well to insulin sensitising and hormone balancing supplements and a lower ratio of carbohydrates to protein and fat within the diet.
Acne is an androgenic disorder, meaning that it is brought about by the effects of androgens, a family of steroid based hormones which include testosterone and dehydroepiandrosterone or DHEA-S. Acne is frequently caused by high levels of testosterone which stimulate the sebaceous glands in the skin to produce sebum which can clog up the pores. If this happens, then bacteria can grow in the trapped oil in the pore resulting in infection and inflammation which we see as pimples.
In women with PCOS, oestrogen dominance brought about by low progesterone levels can also trigger acne. In these cases, topical progesterone cream can help to restore the hormonal balance and reduce the acne.
In women with PCOS, both of these patterns are almost universally caused by insulin resistance and excessively high insulin levels, which stimulate the theca cells of the ovaries to produce testosterone which disorders the other fertility hormones, suppressing progesterone production. Many people think of testosterone as being a male hormone, but women do require it as well, though they generally only have about 10% of the amount found in men.
Many women find that acne increases the week prior to their period, nearly half of all women in fact experience a surge in acne then. It is not certain exactly what causes this phenomenon, however, it is likely that it is related to either, or a combination of, a surge in testosterone levels around the middle of the menstrual cycle and that the sebaceous gland stimulation takes a week to develop into acne, or higher progesterone levels in the latter half of the menstrual cycle which cause a degree of swelling and fluid retention which, in the skin, compresses the pores, causing them to close up. The positive side to that dreaded bloating before a period is that your skin never looks as smooth and your pores so small as just before your period arrives!
Vitamin A deficiency can aggravate and delay the healing of acne. Supplements such as Vitamin A or it’s precursor betacarotene and Zinc often help to resolve bouts of acne or delay reocurrence.
Vitex Agnus Castus is a great little herb for women with PCOS. It helps to normalise your hormones by balancing the FSH:LH ratio, regulating ovulation.
D Chiro Inositol has been found in studies to increase progesterone levels (amongst balancing out a half dozen other biochemical markers) in women with PCOS. This may help with acne irrespective of insulin sensitivity.