Case Study: Teenage Acne, Irregular Cycles
Names have been changed for patient privacy.
Nicole’s Background
Nicole is a smart, active high school senior. At 14, Nicole got her first period, generally considered late for the onset of menstruation. Nicole was never regular, but three months could pass before she had her next period. Problem Nicole had always experienced some acne issues, but it was getting progressively worse. She started seeing a dermatologist who prescribed a daily antibiotic. After a year, she had noticeably gained weight and was feeling hungry all of the time. Treatment Plan We ran a variety of tests to uncover the root of Nicole’s problem. Thyroid and adrenal functions were normal, but she was producing high levels of luteinizing hormones (LH) and follicle stimulating hormone (FSH) levels, not normal for a 17-year-old woman. This points to a low ovarian reserve, which can reduce pregnancy chances. Nicole was producing too much testosterone, which contributed to acne outbreaks and hair growth on her face, nipples, abdomen and chest. This is characteristic of Polycystic Ovarian Syndrome (PCOS). Additionally, Nicole's blood sugar was mildly elevated, and she was deficient in certain vitamins. The chronic use of antibiotics had killed off healthy bacteria in the bowel. Given Nicole’s age, the best way to control excessive LH production was to take an oral contraceptive. We asked Nicole’s dermatologist if her oral antibiotic could be switched to a topical rinse. A short course of antifungal medication was also prescribed to kill the yeast that was prevalent in her intestine due to taking endless antibiotic medication. To restore bowel health, Nicole also added a daily probiotic and took additional vitamin supplements. Results Within the year, Nicole left for college with renewed energy. The acne was gone, she was trimmer (sugar cravings had lessened, making it easier for weight control), testosterone levels were back to normal, and bowel health had greatly improved. |