Many women have acne, and it is not uncommon for acne to flare around the time a woman has her menstrual period. But when should you be concerned that a more serious hormonal problem is causing your acne?
If you are a woman who has acne that does not improve with standard therapies, especially if it is moderate to severe, then it is worth considering if you have an excess of male hormones, which is also known as hyperandrogenism. All women and men have both male and female hormones. When there is a significant excess of male hormones in a woman, it is called hyperandrogenism and may be a sign of underlying disease.
Acne that is difficult to treat, flares before your period, starts in adulthood, and/or involves your lower face and neck may be a sign of hyperandrogenism. Other signs of hyperandrogenism include irregular menstrual periods, hair loss on the scalp, or excessive hair growth on the face, breasts, or stomach.
Causes of Hyperandrogenism
The most common cause of hyperandrogenism in women is polycystic ovarian syndrome (PCOS). PCOS is not always easy to diagnose. In addition to the signs of hyperandrogenism noted above, women with PCOS often have abnormal menstrual cycles and multiple cysts on their ovaries.
If your doctor is concerned that you might have PCOS, then they will order laboratory tests to look for increased levels of male hormones in your blood, and they may order an ultrasound to look for cysts in your ovaries. Your doctor might need to order other tests to rule out less common causes of hyperandrogenism, including tumors and other problems of the pituitary gland, adrenal glands, and ovaries.
Importance of Treating PCOS
It is important to know if you have PCOS, since it can be associated with high blood sugar and resistance to the effects of insulin, which can lead to increased blood sugar levels. Obesity, infertility, high blood pressure, and high blood fats are also often seen in women with PCOS.
Weight loss is an important treatment for PCOS. Some oral contraceptives can also be helpful. Your doctor may prescribe medicines to decrease or interfere with the effects of androgens. They may also recommend medications like metformin to make you more sensitive to the effects of your own insulin.
If you are a woman with acne that is hard to treat, then be sure to see your dermatologist to treat your acne and to consider an evaluation for hyperandrogenism and PCOS.