Bump....if anyone can help. The bio-identical hormone specialist in my area charges $500 for the first visit and $300 for the next one, plus lab tests. So I need some advice please, my insurance won't cover any other tests and doctor's visits.

I haven't used it since January, but I did use bioidentical progesterone cream (pro-gest by emerita to be precise), for about 3 months back in Nov. - Jan. I was never tested for low progesterone, but am pretty sure I have low progesterone (my estrogen and androgen levels tested normal, and estrogenic things like flax seed oil and spearmint tea make my skin worse).

I'm curious, how did you manage to get tested for low progesterone? My doc wasn't interested in testing for it. Did you have it done through a regular MD, or an alternative medicine practitioner, or..?

Progesterone cream didn't cause any weight gain that I noticed. It seemed to improve my skin pretty dramatically at first - large, painful pimples would sort of disappear overnight! And then it seemed to make my skin worse a couple of months into using it. I'm not sure if this was because I didn't use it at the right time of the month, or if I was actually allergic to another ingredient in the cream. Toward the end my breakouts were almost like an allergic reaction: I would be fine, I would apply progesterone cream (usually to my arms or legs), and 20 minutes later would feel hot and itchy all over, especially on my face, and large cysts would form in a matter of seconds (the good news is they also went away fairly quickly when I stopped using progesterone).

My cycles were pretty irregular when I started using it (and got even more irregular after I started using it), so it was difficult to figure out how to use the cream 14 days on and 14 days off as instructed - I would start it on day 14 as instructed and end up using it for 26 days or more... so maybe I ended up overdoing the cream & this caused me to break out more. My guess is it might work fine for someone who has a regular, 28-day cycle and isn't sensitive to other ingredients in the cream.

I would be interested in hearing what your endocrinologist recommends - I still suspect I have low progesterone and am wondering if there is a more foolproof way to correct the problem!

Also wondering if you've had any good results with MSM cream? (as an acne treatment and/or scar treatment?)

I haven't used it since January, but I did use bioidentical progesterone cream (pro-gest by emerita to be precise), for about 3 months back in Nov. - Jan. I was never tested for low progesterone, but am pretty sure I have low progesterone (my estrogen and androgen levels tested normal, and estrogenic things like flax seed oil and spearmint tea make my skin worse).

I'm curious, how did you manage to get tested for low progesterone? My doc wasn't interested in testing for it. Did you have it done through a regular MD, or an alternative medicine practitioner, or..?

Progesterone cream didn't cause any weight gain that I noticed. It seemed to improve my skin pretty dramatically at first - large, painful pimples would sort of disappear overnight! And then it seemed to make my skin worse a couple of months into using it. I'm not sure if this was because I didn't use it at the right time of the month, or if I was actually allergic to another ingredient in the cream. Toward the end my breakouts were almost like an allergic reaction: I would be fine, I would apply progesterone cream (usually to my arms or legs), and 20 minutes later would feel hot and itchy all over, especially on my face, and large cysts would form in a matter of seconds (the good news is they also went away fairly quickly when I stopped using progesterone).

My cycles were pretty irregular when I started using it (and got even more irregular after I started using it), so it was difficult to figure out how to use the cream 14 days on and 14 days off as instructed - I would start it on day 14 as instructed and end up using it for 26 days or more... so maybe I ended up overdoing the cream & this caused me to break out more. My guess is it might work fine for someone who has a regular, 28-day cycle and isn't sensitive to other ingredients in the cream.

I would be interested in hearing what your endocrinologist recommends - I still suspect I have low progesterone and am wondering if there is a more foolproof way to correct the problem!

Also wondering if you've had any good results with MSM cream? (as an acne treatment and/or scar treatment?)

I heard of an adverse reaction to progesterone cream, it's not uncommon - maybe your body didn't need it anymore after the first month? Or maybe you just applied it for too many days in a row. If your periods are not regular, you are supposed to use it for 2 weeks, then go off it for 2 weeks. It's hard to tell why you started getting a bad reaction, though. Did you also break out in the parts where you directly applied the cream? Were you rotating your areas of application? I apply it to different areas (where the skin is thin, for better absorption) to avoid dermal fatigue. I'm using kokoro balance creme, and the ingredients seem fine but I'm not sure how effective yam-derived progesterone is. At this point, though, I didn't want to go for the compounded pharmacy cream because that one is stronger and can sometimes contain progestin. I'm gonna keep trying this one for 3 months and then re-check my hormones. I must say, even if it's a placebo response, using this progesterone cream has helped with mood swings and depression.

The progesterone hormone they tested for is 17-hydroxyprogesterone - a regular MD requested it. The doctor wouldn't have even tested for that if it wasn't included in the basic hormone test of that particular hospital. When my results came back, all other hormones typically associated with acne seemed normal (depending on how reliable the blood testing is - it's debatable). So the doctor was puzzled because she couldn't prescribe spironolactone or birth control in case it screws up the other hormones. She even said she didn't think low progesterone can cause the kind of cystic acne as I have, but I researched the symptoms of low progesterone and acne is one of them along with hirsutism which I also have mildly. The only herbal treatment my skin had responded to in the past was vitex/chaste berry, which regulates excess estrogen and can boost progesterone , so I suspected I needed to go down that route instead of trying to lower testosterone (which I tried before with saw palmetto, but didn't see long term results). Why do you suspect you have low progesterone? Some of the symptoms of low progesterone are similar to high testosterone/ androgens or high estrogen, that's why it can sometimes be tricky to tell what your particular imbalance is. Even blood tests are not 100% reliable. Next time I will get the saliva testing because that seems to be more trustworthy. You may want to do a comprehensive hormone testing, including thyroid and insulin, because it could be one of those that is causing your imbalance since the usual suspects are normal.

I actually saw 2 endocrinologists, and my conclusion is that most doctors don't know how to correct acne that doesn't seem to be the result of estrogen or androgens. Unfortunately, there is no fool proof way to boost progesterone, it's one of the hardest imbalances to fix and therefore the acne caused by it is probably one of the most persistent cases of acne.

The first doctor I saw recommended looking into progesterone creams or progesterone pills, and referred me to an endocrinologist specializing in bio-identical hormone therapy. The second endocrinologist basically told me to go on a heavy course of antibiotics for months, and I immediately refused because I don't want to mess with my liver. Unfortunately, my insurance couldn't cover the visits to the bio-identical hormone specialist, so now I am using the cream on my own until I can afford to re-check my hormones in a few months. Stress plays a part in hormonal imbalances, and I am trying to find ways to reduce it including acupuncture, exercise, relaxing, etc. I also started taking a stress formula b-complex with vitamin c, but I don't think I do too well with supplements that contain B6 or B12. I started using it because it's supposed to help regulate hormonal imbalances caused by stress etc.

As for the MSM cream, I only use it topically on scars and it helps. When I apply it to large areas, though, it sometimes clogs my pores so I avoid using it on active acne and as a moisturizer. So I recommend it as a scar treatment (takes a few weeks to kick in), and I recommend calamine lotion as an acne treatment for stubborn acne.

Sorry for the long post - I had to edit it to ask if you have gluten intolerance. If so, then you may have other food intolerances as well, and that could be messing up your hormones too.

Thank you for all the info - this is very helpful!

You may be right about my not needing it after the first month. I never broke out in the places I applied the cream, thank goodness! (I did rotate, btw, but maybe not as much as I should have). Now that I'm re-checking the ingredients, I'm thinking maybe I was reacting to the vitamin E in the cream rather than the progesterone. But it's hard to say. I'm glad to know about Kokoro balance cream - I just checked it out, it looks safer than the stuff I used. If it's helping with mood swings, that sounds promising!

I actually have celiac disease, but you're right - it does the same thing as gluten intolerance in terms of causing absorption issues and food intolerances (in addition to gluten, I avoid dairy, corn, soy, peanuts, oats, millet, potatoes, rice and sugar).

I think I have low progesterone because my skin got much worse when I took spironolactone (this was before my progesterone cream experiment). That and the fact that my estrogen and testosterone tested normal. But my progesterone could be normal or even high for all I know - I'm hoping to get it tested soon. Thanks for all your ideas on hormone testing and for sharing your experience. As you said, the trouble is figuring out how to pay for these things when insurance doesn't cover it! I've had trouble with supplements too - not sure if it's the B vitamins or the outrageous doses of vitamin D that celiacs are supposed to take.

Thanks for the info about MSM cream - I started using it a couple of days ago for scars & thought it might be exacerbating my active acne...so that's good to know! I'm also glad to know about calamine - never heard of using it as an acne treatment. I've been using inner eco coconut water probiotic kefir on my face (dairy&sugar free), it's great for smaller pimples & reducing inflammation, but doesn't do much for the really stubborn cysts. I'll have to give calamine a try!

No problem, I'm happy to help. I have literally tried almost everything short of accutane for the past 15 years. How long were you on spironolactone btw? They tried to put me on that before I got my last hormonal test (and I'm glad I never agreed to take it), and the doctor told me that it usually makes acne worse before it gets better so maybe you were experiencing an initial breakout? Unless your acne got progressively worse for months on it. I think the saliva tests will point you in the right direction. I'm saving up to do those too, because blood tests are not as accurate for hormones, but that's usually what most hospitals offer first unless you request a different method.

The other thing that might help you would be to check for liver and gut problems (such as digestion issues and leaky gut). If your liver and gut are not functioning properly, then they are unable to regulate hormones properly and filter out excess toxins and hormones. I wish I was more disciplined to do a full liver flush, but I haven't been able to do that yet. I had some success with the candida diet, but I wasn't too strict about it so the results didn't last long. The thing that helped me was supplementing with l-glutathione to help with liver detoxification. Most research says it's not easily absorbed in supplement form, but it worked for me better than milk thistle and other common supplements. My acne is very temperimental, and usually responds to obscure things that other people's acne doesn't respond to. Go figure!

I hope the MSM works out for you! Like I said, it doesn't help me with active acne (in fact, I think it can cause pimples if I apply too much), but it helps fill scars if used daily. I've never heard of coconut water probiotic kefir for acne...how do you put it on your face? As a mask?

My room-mate had progesterone cream (for body building? not yams, but the prescription stuff) he was finished with it and let me use it. I would rub a little onto my neck each night. It DID help me sleep and relax. I don't think it had much effect on my skin though but my skin wasn't that bad back then. If that's the cause of your problems you could try it.

I noticed that the creme makes me sleepy and relaxed too. I'm using the yam-derived one to see if it works, and then I might get the compounded one but I'm not ready to use something as strong for now.

15 years...yep, I can relate to that! I wish there was a real cure out there. The trouble is it seems like the causes of acne are so individual.

I was on spiro for about 3 months. My skin stayed more or less the same for the first month or so, and then I started getting cysts in places where I never broke out before... It could have been an initial breakout, I suppose. I would have stuck it out a while longer to see, but my doctor took me off it when I started experiencing fatigue & muscle weakness.

I'm curious - do you plan on going through a regular MD or endocrinologist to get your saliva test, or some other route?

Hmm, I've never given much thought to the liver...will have to check that out. My doc recently told me I have "slightly elevated" liver enzymes (result of celiac), but that it's nothing to worry about & not connected to acne at all....I wonder.

That's interesting about the L-glutathione. Any negative effects or initial breakout with that? I also made an attempt at the candida diet recently & had very good results for the first couple of weeks that didn't last...I probably wasn't strict enough, either. It's tough to keep it up.

The water kefir is tricky to apply because it has the consistency of...well, water. I tried dabbing it on with a cotton ball, but that didn't do much so I just pour it into my hand and splash it on my face, let it dry, and leave it overnight...so I guess it's kinda like a mask.

It can get a bit too drying if I overdo it, though.

Although females who take Progesterone only birth control seem to get breakouts? Also Progesterone is like the 'pregnancy hormone' or the ovulation hormone, if you think about it, it means Pro Gestation. It prepares the body. A lot of pregnant women get breakouts.

Celiac24 I also think I get elevated liver enzymes because of the medication I take. I hear naturopaths talk of the liver connection. BUT when I had a liver infection due to glandular fever I didn't have a pimple on my face! (I was also on Yasmin at the time). So I don't know if it was the BCP keeping me clear or if liver and skin aren't really linked :S. It does make sense how they are linked though.

The liver helps regulate hormones and flush out excess hormones, so it can definitely affect acne. If you had good results with the anti- candida diet, it might be an indication that you need to improve your liver and your diet. I had good results at first too, but then I loosened up on the diet because I was hungry all the time and didn't have too much time to cook. I still follow it loosely, but have now added a bit of fruit and gluten-free cereal. L-glutathione was recommended to me by a naturopath, in addition to NAC and milk thistle. However, I only took l-glutathione because NAC can have some potentially serious side effects and milk thistle gave me a nasty breakout and nausea. The only documented side effects from l-glutathione are insomnia and headaches, so I took my chances with that one instead. I saw results the second day of taking it, and it gradually helped reduce inflammation but it is not recommended for long term usage so I stopped 2 months into it (I was also getting some stomach cramps, so I figured it did its job detoxifying the liver, and I didn't want to push it). Selenium was another supplement that was recommended, but haven't tried it yet. I weighed all the side effects, and glutathione was the safest to take. I tend to get the side effects, that's why I was worried.

For saliva testing, I am still asking various MDs for prices to see if somehow my insurance will cover part of it. I already did an allergy test at a naturopath's office a few years ago, but he used a questionable method (with metals and a weird contraption) so I'm not sure how reliable that was.

Hey, I read that vitamin A is supposed to lower estrogen and increase progesterone levels, so eating foods high in vitamin A (liver!) could help. Apparently Ray Peat said this, but I read it somewhere on the forum, so I've got no proper source unfortunately. Ray Peat is a biologist/physiologist popular in the paleo blogosphere and seems fairly reliable after a cursory glance. I've enjoyed some of his articles in the past, but don't know much about him overall though.

He seems to have a good page on the effects of progesterone supplementation (creams or oral).

http://raypeat.com/articles/articles/progesterone-summaries.shtml

It includes this bit:

 

Excess stress (which can block progesterone synthesis and elevate estrogen) may bring on symptoms in someone who never had them. Spending a summer in Alaska, with an unusually long day, may relieve the symptoms of a chronic sufferer. Dark cloudy winters in England or the Pacific Northwest are powerful stressors, and cause lower production of progesterone in women, and testosterone in men. Toxins can produce similar symptoms, as can nutritional deficiencies. A very common cause of an estrogen excess is a dietary protein deficiency--the liver simply cannot detoxify estrogen when it is under-nourished.

With a diet high in protein (e.g., at least 70-100 grams per day, including eggs) and vitamin A (not carotene), I have found that the dose of progesterone can be reduced each month. Using thyroid will usually reduce the amount of progesterone needed. Occasionally, a woman won't feel any effect even from 100 mg. of progesterone; I think this indicates that they need to use thyroid and diet, to normalize their estrogen, prolactin, and cortisol.

Hey, I read that vitamin A is supposed to lower estrogen and increase progesterone levels, so eating foods high in vitamin A (liver!) could help. Apparently Ray Peat said this, but I read it somewhere on the forum, so I've got no proper source unfortunately. Ray Peat is a biologist/physiologist popular in the paleo blogosphere and seems fairly reliable after a cursory glance. I've enjoyed some of his articles in the past, but don't know much about him overall though.

He seems to have a good page on the effects of progesterone supplementation (creams or oral).

http://raypeat.com/articles/articles/progesterone-summaries.shtml

It includes this bit:

Excess stress (which can block progesterone synthesis and elevate estrogen) may bring on symptoms in someone who never had them. Spending a summer in Alaska, with an unusually long day, may relieve the symptoms of a chronic sufferer. Dark cloudy winters in England or the Pacific Northwest are powerful stressors, and cause lower production of progesterone in women, and testosterone in men. Toxins can produce similar symptoms, as can nutritional deficiencies. A very common cause of an estrogen excess is a dietary protein deficiency--the liver simply cannot detoxify estrogen when it is under-nourished.

With a diet high in protein (e.g., at least 70-100 grams per day, including eggs) and vitamin A (not carotene), I have found that the dose of progesterone can be reduced each month. Using thyroid will usually reduce the amount of progesterone needed. Occasionally, a woman won't feel any effect even from 100 mg. of progesterone; I think this indicates that they need to use thyroid and diet, to normalize their estrogen, prolactin, and cortisol.

I.e. stress and insufficient vitamin A could contribute to low progesterone.

I've decided to start eating beef liver at least once a week for the vitamin A. Mainly I'm trying this in case it could lower my oil levels, but if it helps with estrogen dominance, all the better. I haven't got any hormone tests done, but I've noticed that I tend to break out around ovulation and at the start of my period, both of which happen to be times when estrogen levels are high compared to progesterone. So I think estrogen dominance is an issue in my case. I might also try progesterone creams, since I've got a couple old tubes I never used in my cupboard.

Hope things are going well for you, wishclean.

Hey, thanks for the info. I'm vegetarian (with some fish occasionally), but I still get enough amount of vitamin A through my diet. I haven't tried eating liver, but other people on the forum have tried eating it consistently to help with breakouts. Have you noticed any results?

I break out around those same times of the month as well, no matter what I do. I did a course of supplementation with l-glutathione for liver detoxification and anti-oxidant support, and for the time I was taking it my ovulation breakouts were less severe and it greatly reduced inflammation. However, it's not meant for long term supplementation, and I had to quit for a while because I was getting some stomach cramps.

It's too soon to tell if the progesterone cream is helping. What I noticed is that my breakouts are less frequent while I'm using it, but I'm only supposed to use it 2 weeks per month, so the other 2 weeks I'm at the mercy of my hormones.

I hear ya about the stress factor! My allergist suggested I attend biofeedback sessions to figure out how to handle chronic stress and other bodily functions. I'm starting next week and will update if I find it useful.