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A touch of acne about once a month is a common occurrence for millions of women of child-bearing age who do not have PCOS (polycystic ovarian disease).

A touch of acne about once a month is a common occurrence for millions of women of child-bearing age who do not have PCOS (polycystic ovarian disease). A real problem with acne that just won't go away no matter the time of month is a frequent complication of polycystic ovarian syndrome.

 The cause of PCOS acne is elevated levels of testosterone. This masculinizing hormone is produced in the bodies of both males and females, especially during the teenage years. In addition to causing hair growth, muscle growth, and aggressive mood, it also thickens and toughens the skin. Testosterone makes the skin grow over pores, trapping oil and bacteria inside.

The immediate result is a whitehead. (A blackhead is an open pore in which the oil has darkened after exposure to the air.) The bacteria inside the pore can cause inflammation and infection resulting in a pimple. Testosterone is a bigger factor in acne in adults than in teens. This hormone can cause the thicken and toughen at any time of life, but teenage skin is still growing fast. Adult skin is slower to respond to skincare adult acne treatment and any underlying hormonal imbalance has a really persistent effect. Metformin helps control PCOS acne. It's inexpensive. It's safe for almost all women who need to take it. It does not add any female hormones to the system. It only helps bring the production of testosterone in a woman's body back down to normal levels.

Metformin does this in two different ways. It stops the ovaries from making testosterone from a chemical called androstenedione. This helps reduce acne and hair growth. It also makes cells all over the body-except in the ovaries-more sensitive to insulin.

As you probably know, insulin is the hormone that cells use to take the glucose sugar they burn for fuel out of the bloodstream. It also helps cells store fat. When blood sugar levels get too high, insulin resistance works the same way as an emergency shutoff at gasoline station. Cells stop responding to insulin so they won't be overrun by sugar. The sugar stays in the bloodstream and can only be absorbed by tissues that don't need insulin to get their glucose fuel, such as the ovaries.

When the rest of the body won't accept sugar, the ovaries have to. Their metabolic machinery kicks into high gear and they have no choice but to produce massive amounts of hormones, including testosterone. The combination of testosterone and insulin goes to the brain and is detected by the hypothalamus, which sends out a signal that results in the production of a third hormone, luteinizing hormone. This is the hormone that keeps eggs inside the ovaries and stops ovulation. Just getting blood sugar levels back down, one way or another, helps bring the whole endocrine system back in balance. Ideally, a combination of metformin and low-calorie, high-protein diet is ideal for lowering the testosterone levels that cause breakouts of acne. Some women see visible improvement in as little as 14 days.

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