by Ashley G
(Rockford, IL)

I am 33 and had my hormones tested in July. I have low progesterone 32pg/mL everything else was in range. My Estradiol was 1.5pg/mL which was in range but the ratio of the two is off. I just don't understand WHY I have melisma if my estrogen isn't high!

I was on progestin only birth control for about 6 months 2 years ago and once I came off of it (horrible sadness and hair loss) I developed melisma almost over night. I have read that progesterone cream could help but also could make it worse.

Anyone have any luck clearing melisma with progesterone cream? I am nervous to try as it might make it worse. I am at a loss. My self esteem is all but gone at this point. I've avoided the sun this summer and now my Vit. D has suffered.

Comments for Melasma

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Nov 21, 2018
by: Joy

Hi Ashley

Melasma is very often caused by excess estrogen. Birth control would have added to your excess estrogen. You say that your estrogen isn't high but the ratio between progesterone and estrogen indicates that it is high. Your ratio is 47:1 it should be around 600:1. The Hormone Testing page explains how the ratio is worked out. Please read this page, Wray explains all about Melasma.

Between 100-200mg progesterone has helped many but you many need to use more. You will have to experiment to see what suits you. The How to use Progesterone Cream page explains in more detail. Please take note of Estrogen Dominance symptoms. Often things do get worse before they get better.

Vitamin D3 is very important as explained in Wray's post. Nothing less than 5,000iu's per day is needed. Magnesium and vitamin K2 with no soy are important co-factors needed when taking vitamin D3.

Nov 29, 2018
by: ashley

Thanks Joy,

It was progestin only BC so I am wondering why that would ever make me estrogen dom. I also did try progesterone cream 1/4 tsp twice a day but just last few days of my cycle and I feel that it just made it worse so its either the estrogen was fighting back or it is the progesterone itself causing the melisma? I will look at the links you provided. Thank you

Nov 30, 2018
by: Joy

Hi Ashley

Progestin is synthetic and would have an affect on estrogen levels. Between 100-200mg progesterone is needed, you are not using enough, please refer to the How to use Progesterone Cream page. The amount you are using is aggravating your estrogen receptors. As explained, excess estrogen is one of the reasons for your melasma, not progesterone. I suggest that you increase your progesterone and make sure that your vitamin D3 level is within range. It does take time.

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