Women with PCOS: Is your acne caused by androgens?

Ladies, let’s continue talking about PCOS, in particular – androgens. 

Androgens are often referred to as ‘male hormones’. But don’t get us wrong – they’re just as important in women as they are men.

What are androgens and what do they do?

Basically, androgens are a type of sex hormone such as DHEA, testosterone, Androestenedione and DHT. These guys regulate our energy, libido, hair growth, ovulation, muscle growth, mood regulation, bone density, and more. They’re also required as a precursor to make estrogen, so they play a super important role in supporting the maturation of ovarian follicles AKA eggs. 

When functioning properly, androgens do amazing work. But when they’re out of balance, if you have too many androgens, it can directly increase the production of sebum in your skin. Hello acne. Because us ladies don’t have as much testosterone as men any slight change or increase in androgens can wreak havoc for the skin. If you’re seeing acne flare ups the week before your period, this might be why! It’s also why women with Polycystic Ovarian Syndrome can experience excessive hair growth, impaired ovulation, acne along the jawline and chin, plus irregular cycles.

What are androgens made of?

Androgens are made from all different parts of the body, and it’s different again for each person. Normally it can be said that 25% of testosterone is made within the ovaries, 25% within the adrenal glands and the other 50% is made in adipose tissue (also known as fat!). 

So when we are assessing your skin and diagnosing a treatment protocol we have to look at you as an individual and where your excess testosterone is coming from. Perhaps it might be the ovaries, but it also might be a stress response or a result of body composition.

How do we treat androgen imbalance?

Like we said, every case is going to be different based on the root cause of androgen excess. But in general, we assess pathology test results, implement sustainable dietary and lifestyle changes along with customised supplementation. We’re all about the customised treatments! 

If you have adrenal PCOS: We’ll need to make some long-term sustainable lifestyle changes. Especially focussed around supporting and nourishing your adrenal glands. Our adrenal glands are what regulate our ‘fight or flight’ response and if you’re constantly on the go, always running off adrenaline, constantly drinking coffee and not balancing any of this out with slow, restorative practices then you’re setting yourself up for overstimulation. And – you guessed it, excess androgen production which leads to sebum production which equals acne! 

This is where mindfulness practices, stress coping mechanisms, slow lifestyle changes and modulating light exposures will work wonders. We may also upp your supplement game with B complex vitamins, vitamin c, medicinal mushrooms and adaptogenic herbs. 

If you’ve got insulin resistant PCOS: More lifestyle changes, plus a whole lot of diet talk! Insulin directly affects acne because it stimulates the cells within the ovaries to produce testosterone, resulting in increased oil production in the skin. This would also affect maturation of a dominant follicle and delay ovulation – causing those pesky PCOS irregular cycles.

Diet-wise we ensure our clients enough consuming complex carbs (oats, brown rice, sweet potato, quinoa) to avoid spikes or declines in your blood sugar levels. Complex carbs slowly release glucose into the bloodstream, helping your blood sugar levels remain stable throughout the day. If required, we might also supplement with inositol, magnesium, chromium and B Complex vitamins to improve cellular response to insulin. 

Insulin can also reduce the amount of SHBG being produced (SHBG carries testosterone and essentially makes it ‘inactive’ so it can’t bind to receptors). By working on modulating your insulin response, we can work on increasing your SHBG to support the transport and elimination of testosterone. 

Inflammatory PCOS: We have to look at this from so many angles. Is the inflammation coming from your diet? Adrenal stimulation? Potential dietary sensitivity? Exposure to toxins? First we eliminate the main dietary inflammatory culprits (gluten, sugar, dairy, alcohol, caffeine) to set a solid foundation to work with. Then we help our clients reduce the amount of toxins they’re exposed to (hello Dermaviduals products!) because these toxins may be putting stress on the liver. 

Re. supplements, we find Omega 3 and turmeric are our go-to’s for reducing inflammation as they directly reduce the pro-inflammatory mediators in the body – essential for supporting the health of our epidermis and dermis skin layers. 

Post-pill PCOS: Oh how we love working with clients who have come off/coming off the pill! Post-pill we see a surge in androgen production and major acne flare ups as a result. This is because the pill has suppressed androgen production for so long. But don’t worry – your body is working hard to balance this out, it might just need a little help. 

We can support you with nutrients and herbs for regulating the pathway involved with testosterone metabolism and clearance. This normally means looking after your gut health and liver function. Some super potent androgen inhibitors include peony, licorice, reishi and – always – zinc! 


Bonus lifestyle and nutrition tips! 

Follow The CSE diet!

We often recommend three months without gluten, dairy, alcohol, caffeine and sugar to make sure these aren’t triggering your acne. Eliminating these foods also help restore the gut, ease liver strain and reduce inflammation. 

Optimising mineral status!

Trace minerals are required for hundreds of different mechanisms in the body. We love zinc and magnesium for their essential role in regulating androgen metabolism and supporting the nervous system during periods of stress. 

Restorative sleep!

We could give you all the anti-inflammatories in the world but if you aren’t getting enough sleep, then it’s going to wreak havoc on your skin. Our sleep hormone, melatonin, is actually one of our body’s major antioxidants – so get your sleep for glowing skin! 

Need some skin love? Book your consult today.

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