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Hormones and Skin

There is a very clear connection between acne and hormones but still a lot of misunderstanding regarding which hormones exactly play the biggest role when it comes to skin health. The research is ongoing and so far, we know that androgen hormones are directly involved in the formation of acne for some women but there is also a big link between acne and estrogen dominance that the scientific community is just starting to explore more in dept.

When talking about androgens (male hormones), the common believe is that in some women elevated levels lead to acne but more in dept research is showing that it isn’t about the overall levels but how the body metabolizes those androgens. This is a very complicated topic but basically there are 2 metabolic pathways (5 alpha and 5 beta) that androgens can go through and women who favor the 5 alpha pathway tend to develop acne, polycystic ovary syndrome (PCOS), as well as some other androgen related issues like facial hair, hair loss or thinning hair, etc. All this is happening because the 5 alpha metabolism is a lot more androgenic than the 5 beta metabolism, up to 3 times stronger in fact.

So, what is the relation to estrogen? Unopposed estrogen (too much estrogen in relation to progesterone and testosterone) keeps the adrenals chronically overactive and they start pumping out more DHEA (androgen hormone) which, as we saw earlier, can lead to more acne and other problems when metabolized down the 5-alpha pathway. In a way estrogen is one of the root causes of imbalanced androgens.

Further more, estrogen dominance affects the body’s detoxification and elimination pathways. Unfavorable metabolism of estrogen and higher levels of circulating free estrogens in our body can contribute to pro-inflammatory changes and potential problems with our body's natural elimination pathways, ultimately leading to acne flare-ups.,

Two other hormonal factors that may be contributing to acne are insulin and cortisol regulation. Both of these hormones can have an impact on estrogen, testosterone and progesterone levels.

Insulin is a hormone that helps our body regulate and utilize glucose for energy production.  When insulin is high or not being properly regulated, it will tell our ovaries to produce more testosterone, leading to an increased likelihood of hormonal-related acne flares.

Cortisol is produced by the adrenal glands and is our body’s primary stress hormone.  Cortisol is necessary but too much or too little of this hormone can also negatively impact insulin levels, testosterone levels and testosterone metabolism, ultimately leading to breakouts.

Hormonal balance is incredibly important not only for skin health but for all processes that occur in the women’s body. They can impact our physical and mental health and quality of life and in some cases hormonal imbalance can lead to serious diseases and even cancer.

There is a well documented and researched link between the health of our gut microbiome and hormones. When gut health isn’t optimal, hormones become imbalanced. For example, Estrogen metabolism is influenced by conversion pathways and enzymes in our gut lining, as well as by certain types of gut flora, called “estrobolome” which is responsible for optimal estrogen elimination from the body.  Poor gut health increases the risk of estrogen-related diseases such as PCOS, endometriosis, and even breast cancer.

An imbalanced gut microbiome is also one of the causes of a low-performing thyroid, also known as Hypothyroidism. Symptoms of this include chronic fatigue, weight gain, and hair loss.

Insulin is in part regulated by Lactobacillus reuteri which is stored in the gut. With inflammation being a key symptom of an imbalanced microbiome, a deficiency of this beneficial flora makes it even worse.

Vitamin D3, which is a very important precursor hormone, is not absorbed well by the body if gut health is not optimal. Vitamin D3 is crucial to our health on many levels, skin being on top of the list and chronic deficiencies lead to a host of other problems.

Gut health also influences healthy cholesterol levels which is a precursor to maintaining a balance of Progesterone and Estrogen.

Symptoms of hormone imbalance

There are hundreds of symptoms associated with hormonal imbalance some of them are specific for the hormone in question but many of them overlap. It is also important to note here that you can’t just have one hormone that is off, hormones live in delicate balance between each other and if one is off there will be at least one other that will be imbalanced as well. 

Here are some common symptoms

  • Breast and/or ovarian cysts
  • Excessive facial hair on women
  • Excessive body hair on women
  • Night sweats
  • PCOS (poly cystic ovarian syndrome)
  • Premenstrual breast tenderness
  • Hot flashes/flushes
  • Erratic menstrual cycle or Excessive menstrual flow
  • Lack of menstrual periods
  • Depression
  • Period pains and/or ovulation cramps
  • Panic attacks or panicky feelings
  • Sense of confusion
  • Exhaustion
  • Hair loss from head
  • Sleep disturbances
  • Water retention
  • Mood swings
  • Anxiety
  • Abdominal bloating
  • Chronic fatigue
  • Lethargy
  • Tired all the time
  • migraines
  • Loss of libido
  • Insomnia
  • Palpitations
  • Inability to concentrate
  • Weight gain
  • Cold hands and feet
  • Irritability
  • Constipation


If you suspect you might have a hormonal imbalance, please see your doctor and request testing, ask for estrogen, progesterone, testosterone and a full Thyroid panel.  Many doctors refuse to test hormones unless you have severe symptoms, in this case I strongly recommend finding a functional or naturopathic doctor who works with the DUTCH test. The DUTCH hormone test is one of the most comprehensive tests out there that can give you full picture of not only your hormone levels but you can also see how well your body metabolizes those hormones (especially great for estrogen and androgen hormones).  

Make sure to get enough vitamin A B C D E and Magnesium

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