Women experiencing Polycystic Ovary Syndrome (PCOS) often contend with a range of symptoms, like infertility, weight gain, and among the most distressing, acne. While conventional medicine has made strides in managing acne, it frequently overlooks the underlying hormonal imbalances inherent in PCOS. This oversight stems from the broad reference ranges used for androgens. In this blog, we delve into why the medical model sometimes misses the mark and explore innovative strategies for clinical management of hormonal acne, including the utilisation of Cimicifuga racemosa (black cohosh) and broccoli sprout extract.

Understanding Hormonal Imbalances and Acne due to PCOS

To grasp the complexity of acne related to PCOS, it's vital to comprehend the hormonal imbalances at play. PCOS typically leads to elevated androgen levels, such as testosterone and androstenedione. However, conventional reference ranges for androgens are too wide, posing challenges in diagnosing androgen excess.

Recognizing Hormonal Imbalance Signs

In my clinical experience, pathology results often fall within established reference ranges for androgens. However, these ranges are notably broad. For instance, while the reference range for female testosterone is 0.3 to 1.8 nmol/L, levels exceeding 1.5 nmol/L can be the underlying cause of acne.

Moreover, there are multiple androgens beyond testosterone that contribute to hormonal imbalances. Androstenedione, considered a weaker androgen hormone, may not always be detected by routine lab tests. This oversight is particularly relevant in females experiencing unexplained acne issues.

Acne Treatments and Solutions for Hormonal Imbalance in PCOS

Upon identifying the issue, I employ several common treatment strategies for patients dealing with hormonal acne and PCOS.

1. Reducing Androgens for Acne Treatment:

• Cimicifuga racemosa (Black Cohosh): Clinical trials have shown that black cohosh can help decrease androgen levels in women with PCOS. Research published in the "Journal of Reproductive Medicine" (2018) linked black cohosh supplementation to a significant decrease in androstenedione levels, potentially addressing hormonal acne due to PCOS.

• Broccoli Sprout Extract: This extract contains sulforaphane, aiding in detoxifying androgens and eliminating excess hormones, including testosterone. Though ongoing research focuses on its effects on PCOS-related acne, sulforaphane is a key intervention in hormonal imbalance treatment and acne solutions.

2. Promoting SHBG Production to Address Hormonal Imbalance:

Elevating SHBG levels plays a pivotal role in regulating androgens, thereby reducing active androgens associated with hormonal acne.

• Inositol for Hormonal Acne Treatment: Clinical studies have demonstrated the effectiveness of inositol in enhancing SHBG levels. Myo-inositol supplementation significantly increased SHBG levels in women with PCOS, aiding hormonal balance and potentially alleviating hormonal acne.

  • Dosage 2 to 6 grams per day: start on a low dosage to avoid gastrointestinal issues

• Soy Isoflavones in Hormone Imbalance Treatment: Research indicates their positive influence on SHBG levels. Studies have shown notable rises in SHBG concentrations with soy isoflavone supplementation, contributing to hormonal regulation and addressing hormonal acne concerns.

  • Dosage: 50 to 100 mg per day

• Flaxseeds as Acne Solutions: Clinical research supports flaxseeds' role in augmenting SHBG levels, showcasing their potential in modulating hormone profiles and potentially offering acne solutions in individuals with PCOS.

Personalised Treatment Approach

Each person with PCOS is unique. While understanding hormonal imbalances is crucial, individualised treatment plans are essential. A comprehensive blood test to assess hormone levels accurately is the first step toward effective management. It is important to remember that the information above is not medical advice.

If you are struggling with acne and other symptoms due to PCOS, schedule an appointment today. Let us take the first step towards understanding the drivers of your specific presentation and explore tailored treatment options for your PCOS symptoms.

–-- Raul Pastrana, the Hormonal Naturopath, specialises in managing hormonal and digestive issues such as PMS, PMDD, PCOS, endometriosis, IBS, hypothyroidism, chronic fatigue and fertility problems. He has helped hundreds of clients to find the root cause of their issues and developed personalised treatment plans to manage their conditions.