Could it be that your Cystic Acne is being caused by, or associated with PCOS?
PCOS (Polycystic Ovarian Syndrome) affects between 5 – 15% of all women, making it one of the most common endocrine disorders in women of reproductive age.
Whilst half of all PCOS patients present with insulin resistance and obesity, all patients share a primary defect in androgen (male sex hormone) production and some experience severe acne.
The majority of PCOS patients tend to remain undiagnosed until later in life, with treatment only sought when reduced fertility is experienced, such as trying to fall pregnant.
The consequences of PCOS include high androgen levels, hirsutism, acne and infertility. The acne can range from mild to cystic and nodular acne.
PCOS has also been linked with conditions such as metabolic syndrome and a myriad of cardiovascular risk factors including obesity, elevated blood pressure and high cholesterol.
Diagnosing PCOS
The well-recognised criteria for diagnosing PCOS is the Rotterdam Criteria. You must be positive for two out of three following signs:
- Clinical evidence of hyper androgenism;
- No ovulation (evidence)
- Ultrasonographic evidence of a polycystic ovary.
PCOS Risk Factors
- insulin resistance
- obesity
- family history of PCOS
- stress
- nutritional deficiencies
- high glycaemic load diet
- sedentary lifestyle
- liver dysfunction
Signs and Symptoms of PCOS
Common signs and symptoms of PCOS include:
- Enlarged ovaries, generally 2-3 times larger than normal, resulting from multiple cysts
- Irregular menstrual cycles
- Hirsuitism (espcially facial hair)
- Central obesity – “apple-shaped” obesity centred around the lower half of the torso
- Infertility, generally resulting from chronic anovulation (lack of ovulation)
- Elevated serum androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulphate (DHEAS), causing hirsutism and occasionally masculinisation.
- Androgenic alopecia (male-pattern baldness)
- Jaw-line acne, oily skin, seborrhoea
- Insulin resistance
- Prolonged periods of PMS-like symptoms
- Sleep apnoea
- Chronic pelvic pain
- Blood sugar imbalance
- Hypothyroidism
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Pathology Testing for PCOS
| TEST | INTERPRETATION GUIDELINES |
| Follicle Stimulating Hormone (FSH) | FSH stimulates follicle development in the ovaries and is often used as a gauge of ovarian function. Elevated FSH levels indicate poor follicle development and consequently, anovulatory cycles. |
| Luteinising Hormone (LH) | LH triggers the release of the ovum from the ovary – the LH surge at around day 12 leads to ovulation within 48 hours. Elevated LH levels can indicate ovarian dysfunction. Reduced levels of LH may indicate hyperprolactinaemia. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS. |
| Prolactin (PRL) | Prolactin promotes breast development and milk production. Its release is stimulated by TSH and inhibited by dopamine. Elevated prolactin levels may interfere with ovulation and cause infertility. |
| Oestradiol (E2) | Oestradiol is the main oestrogen produced by the ovaries in response to LH and FSH. Reduced levels may indicate ovarian abnormalities. |
| Progesterone (P4) | Progesterone is produced by the corpus luteum after ovulation and is required to stimulate endometrial growth. Reduced progesterone levels can indicate luteal phase defects and/or anovulatory cycles. |
| Dehydroepi-androsterone Sulphate (DHEAS) | DHEAS is a mild androgen produced by the adrenal glands. Elevated levels may indicate PCOS and acne. |
| Testosterone | Testosterone is the major androgen. Elevated levels in women can lead to acne and infertility. |
| Glucose Tolerance Test | Blood glucose is monitored. Can be used to detect impaired glucose tolerance. |
| Botanical/Vitamin Supplement | Benefits |
| Cocoa, Cinnamon and Chromium for Metabolic Syndrome | Insulin resistance is a core driver of PCOS. Cocoa (45% polyphenols) enhances glucose uptake, insulin responses and mood balance, whilst antioxidant cinnamon reduces post-prandial blood sugar levels. B vitamins, zinc and chromium support glucose transport and overall energy metabolism. Gymnema is included to manage sweet cravings and taste. |
| Inositol, Peony & Liquorice to Clear Testosterone | A blend designed to manage excessive testosterone activity and insulin resistance which commonly occurs post menopause. Inositol greatly enhances insulin sensitivity, combined with peony & liquorice to inhibit ovarian testosterone synthesis and increase aromatase activity to support oestrogen levels. |
| Magnesium and Broccoli for Women’s Health | Magnesium plays important roles in oestrogen detoxification in the liver and bowel, and deficiency can contribute to hormonal imbalance. Blended with phytonutrients this combination is tailored to support healthy female hormonal metabolism and support feminine wellbeing. |
| Lycium Hypothyroid support | Lycium, Withania, ginger are all herbs that improve thyroid function and assist energy production and metabolism particularly with stress or inflammation as contributing factors. Selenium, iodine, zinc and vitamin A all play important roles in thyroid hormone synthesis, metabolism or activity and optimal thyroid hormone production and receptor function. |
| Resveratrol Age Well | Research shows resveratrol and curcumin effective in PCOS – anti-inflammatory, T regulating and improves insulin signalling. |
| Shatavari Ovarian Support | Key reproductive herbs Shatavari and Dong Quai are combined with other herbs and nutrients to enhance ovarian function. |
| Vitex, Ginger & Withania to Increase Progesterone | An herbal and nutritional blend is designed to manage the symptoms and causes of progesterone deficiency, working in both the brain and the body to provide effective relief for PMS, painful periods, irregular cycles and infertility. |
Supportive Hormone Clearance &
Skin Detox Program
Female hormonal health is highly dependent on effective liver and bowel clearance of oestrogens (and other steroid hormones), as well as effective detoxification of environmental toxins.
A Skin/Gut Detoxification Program is designed to support gut health and address the primary source of toxicity in patients. This includes the appropriate herbal medicine tinctures required for hormonal regulation and antibacterials/antiparasitics for infection elimination and inflammation reduction.
Obesity and insulin resistance increase oestrogen and testosterone production and may impair fertility, increase systemic inflammation and drive PCOS and Acne.
Naturopathic medicine and natural treatments are the most effective ways of addressing the true causes of PCOS and Acne in a gentle, safe and manageable way.