Melasma / Estrogen dominance

by Phillipa


I am a 40 year old female who has been suffering from melasma for the past 4 years. Prior to this I had perfect milky white blemish free skin. Knowing that this is related to a hormonal imbalance, I had a saliva test done and low and behold I am estrogen dominant. I think the fact That I have been suffering from fibrocystic breast disease was also a dead give away.......... I recently purchased the progesterone cream from your website to get me started , however I am confused about what the correct dosage for my ailments should be. I consider both to be severe. I have also been supplementing with Vitamin D 5000iu/ day as results showed I was deficient.



Comments for Melasma / Estrogen dominance

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Jan 02, 2013
Melasma / Estrogen dominance
by: Wray

Hi Phillipa You are correct, melasma is caused in part by excess oestrogen, which stimulates the melanocytes. These make melanin, the pigmentation in all skin types, see here and here. Contraceptives can cause it, and it's often a sign of adrenal stress too. It does occur in both sexes, but far more frequently in women, which again points to oestrogen. Progesterone can help resolve the problem, as it suppresses the excess oestrogen and it takes the strain off the adrenals. These make progesterone before they can convert it into cortisol, one of our stress hormones. Stress drops progesterone levels, thereby allowing oestrogen to dominate. I have found melasma a particularly difficult problem, but as you normally have a milky white skin, the progesterone should help. It's in darker skinned women, i.e. Mediterranean and darker that I've found it's very stubborn, studies have found this so too, see here. I'm interested you have a deficiency of vitamin D, which probably means it's very low, if your doctor/lab told you it was. They tend to use 30ng/ml or 75nmol/L as 'adequate', whereas the specialists are saying it should be a minimum of 50ng/ml or 125nmol/L. But better if it's 70-100ng/ml (175-250nmol/L), please would you check on this for me. Levels seem to be low in the general population in Australia, see here, here and here. My interest stems from the fact that vitamin D stops cells proliferating, much as progesterone does. They both affect the way genes express themselves too. In the case of melasma the melanocytes are producing excess melanin. I haven't found any papers directly studying melasma and vitamin D, but some on melanoderma. Which is hyperpigmentation of the skin, not necessarily the face. And it appears that it does help, both topical application of the vitamin D hormone or it's analogues, and vitamin D3, see here. Ironically people are told to use sunscreens, without giving thought to the protective role of vitamin D which can only be made without sunscreens! Continued below

Jan 02, 2013
Melasma / Estrogen dominance Part 2
by: Wray

Hi Phillipa It's UVA which damages the skin, UVB can cause burning if too long in the sun. UVB does increase the melanin content of the skin, as protection against burning. So it's a question of limiting the time in the sun, before burning takes place. This is an excellent, albeit long paper on melasma here. I feel you will probably need at least 10,000iu per day vitamin D, possibly 20,000iu, as 5000iu is only a maintenance dose. To get your levels up quickly you will need to take more. I normally suggest 100-200mg/day progesterone, but in your case I would suggest nothing less than 200mg/day. If you react badly to this, then please increase to 400mg/day. It should be used a minimum of twice a day, hourly is fine too, there's no hard and fast rule. But I would suggest applying it to your face twice daily, I do, it is beneficial too, see here. With reference to the melasma, as I said oestrogen does stimulate melanocytes, which causes them to produce more melanin. UVR stimulates them too, as melanin is protective against URV damage. A lack of vitamin D causes all cells to malfunction, so it could be a deficiency leads to over productive melanocytes. Although the melanocytes produce melanin, this pigment is then transferred to the surface cells or kerotinocytes, where the melanin forms it's protective shield. Vitamin D prevents overactivity of kerotinocytes, progesterone does too. There are ample progesterone receptors in the kerotinocytes, see here. Anovulatory cycles begin round about age 35, during these no ovarian progesterone is made. This makes me suspect oestrogen excess in your case, the tests show this to be true too. Plus you have fibrocystic breast disease, another oestrogen problem, we do have a page on Breast Cysts. It could be you lack iodine too, as this also causes cysts. Please let me know how you get on. Take care Wray

Jan 28, 2013
Side effects
by: Phillipa

Hi Wray,

Thanks for your swift reply. I have received your progesterone cream, and have started on your recommended dosage of 200 mg/day. I have two questions. Firstly can you overdose on progesterone? I have read else where that if you take too much progesterone it eventually turns to estrogen. Is this true?
Secondly how long do you need to take progesterone cream for?

Thx Pip

Jan 28, 2013
Side effects
by: Wray

Hi Pip No it's not possible to overdose, certainly not via a cream. Dr Dalton would give her patients with post natal psychosis 2400mg/day, or 1 1/4 tubes of cream. Although she used injections and suppositories, you might like to read this page here. And this one here. Progesterone is ultimately converted to the oestrogens, but via testosterone. There are three main groups of steroids.... mineralocorticoids, glucocorticoids and androgens. The three oestrogens are all converted from testosterone by the enzyme aromatase. Women make more testosterone each month than oestrogen.

Cholesterol → Pregnenolone → Progesterone → Corticosterone → Aldosterone

Cholesterol → Pregnenolone → Progesterone → 17-OH-Progesterone → 11-Deoxycortisol → Cortisol → Cortisone

Cholesterol → Pregnenolone → Progesterone → 17-OH-Progesterone → Androstenedione → Adrenosterone → two further hormones
Cholesterol → Pregnenolone → Progesterone → 17-OH-Progesterone → Androstenedione → Testosterone → DHT
Cholesterol → Pregnenolone → 17-OH-Pregnenolone → DHEA → Androstenediol → Testosterone → DHT
Cholesterol → Pregnenolone → Progesterone → 17-OH-Progesterone → Androstenedione → Testosterone → Oestrone ⇄ Oestradiol → Oestriol (also Oestrone → Oestriol)

This is a good chart by Genova Diagnostics. Continued below

Jan 28, 2013
Side effects
by: Wray

Hi Pip So progesterone is converted into many hormones, apart from having a role to play of it's own. Too much progesterone won't be converted into more of the other hormones, in fact it's a good way of suppressing any of them! Wish I could answer your next question, but it depends on the women, her circumstances, environmental insults, food, temperament, stress levels and of course symptoms. I've used it for 16 years now and don't intend stopping. Besides it's good for ageing, see here, here, here, here and here. Take care Wray

Apr 19, 2013
follow up
by: Phillipa

HI Wray,

I have been using Natpro for about 3 1/2 months to try to reduce the melasma on my face. It has not helped with that yet, however it initally helped with my estrogen dominance symptoms e.g tender breasts, but now the breast tenderness is coming back with a vengeance. Do I need to up my dose of progesterone?? I have been on 200mg of natpro per day. Advice desperately sought.

Apr 22, 2013
follow up
by: Wray

Hi Phillipa I'm pleased the progesterone has helped a bit, but such a pity the breasts have become tender again. Oestrogen dominance can come out of the blue. Have you been through more stress recently, as that drops progesterone levels, which could account for the breast tenderness coming back. Please rub the cream over your breasts as often as you need. And try using more, I'd start by increasing to 300mg/day. Please be aware you could get brief oestrogen dominance again when you do. Are you taking iodine? This is so important for breast health. If not please start taking it as soon as you can. As I said I've found melasma particularly difficult to treat, and that progesterone can sometimes help. Although I suspect vitamin D is more important, although the two do work synergistically so it could be your level is still too low. You said your level was low by lab standards, but you are only taking 5000iu per day. This is a maintenance dose, and won't raise levels very quickly. Please have another test done to see how high it's gone, I suspect you should be taking 10,000iu per day if not more. Vitamin D is also a potent pain killer. Take care Wray

Aug 25, 2014
Suffering from melasma
by: Anonymous

Hi im in my 40

I have suffered from melasma for many years now. I got it from pregnancy have tried everything I can possible do to see if i can miniminze the apprerance on my face. I'm tramitized now dont know what else to try.

A doctor prescribed me the projesterone cream,
Im a little scared to try it out from the bad sideffects that have read some women seem to see it get worse and not help clear melasma.

I dont want my melamsma to get worse is there anyone else out there who can tell me if its a good idea to try the projestrone cream.

Thanks :O(

Nov 30, 2014
by: Anonymous

I am Native American, 40 year old female with horrible melasma for 3 years now. I've had every bloodwork I think they offer. Low calcium is all they report. I thought by the norm range that my progesterone was low but dr says no. Should I be taking vit D?

Jan 11, 2015
Vitamin D deficiency
by: Anonymous

II am vitamin D deficient and have low progesterone. I have had melasma for an year and a half. I am not sure if the above is the cause of my melsma. I am curious if anyone has had success in treating their melasma by correcting their vitamin D level and/or balancing their hormones. I am also peri menopause so balancing hormones is one I still do not understand how to do. Any suggestions would be greatly appreciated.

Jun 25, 2015
had hysterectomy on estrogen 2mg
by: carol

I'm 42, had a TAH 9 years ago due to complications . Am on estrofem 2mg and have recently got bad melasma on my face.getting worse. What can i do to lighten it?

Sep 20, 2015
melasma better with test/est cream
by: Julie

i am 35 and in menopause due to chemo in my 20's. I use prog, est, and test bio identical replacement. I couldn't get rid of stubborn melasma but I tried putting my est/test combined cream on it and it is working! The problem is I can't figure out why? If it is caused by estrogen dominance wouldn't this make it worse?

May 24, 2016
melasma UGH
by: Rachel

I have been on progesterone for a year. I take it during days 8-28 of my cycle (a dime sized amount.
Sadly 2 things have been increasing: my melasma which used to be a patch on one side of my face is now both sides of my face and covers each cheek entirely. I am beyond horrified and it's effecting my self esteem incredibly.
Also my water retention in my thigh/ saddlebag area is crazy. Please make recommendations.

Sep 18, 2016
by: tara

I wanted to see if anyone can help me figure out the cause of my melasma. I'm 32 and I've had it for 4 yrs now and it has gradually spread. I've done every blood test I could think of and tried creams. My vitamin d level was at 35 I'm still wanting to check my progesterone also. But I'm starting to give up hope on finding an answer and tired of wasting money to have no answer! I just want my face back! Please if anyone can get back to me I would greatly appreciate it!!

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