BIG problem - Painful cystic acne on rear

[2Sox]

My wife is on HRT - a compounded daily cream with estrogen, progesterone and testosterone (T was 8mg). Started in February and in July she started to develop these cystic acne bumps on her behind. Some developed into inflamed boils. Had to go on antibiotics for awhile to calm things down.

The doctor reduced her compounded dose of T to 4mg/day. Still breaking out. Needless to say she is very upset about this and very discouraged. She has suspended applying the cream for now but new eruptions are still developing.

The obvious answer would be the T dose was too high. But could there be other factors involved?

How long will it take for her body to normalize and not get these eruptions?

She's not completely soured on HRT - but she's very close to throwing in the towel. These eruptions are very painful - especially given the location. And antibiotics are definitely NOT an option. She's already been on two rounds.

I'd be very grateful for any advice and input on this you can offer. Thanks.

**Posted this on the women's forum also.

[Giggle]

Man I'm sorry - that sounds terrible.
Has she seen an infectious disease doctor to get it under control?
It seems odd to me that she went from February to July without trouble; I'd question if it was anything else than the RX.
One other factor may just be the time of year and the heat? Sweat + bacteria makes it more likely.

Ideally it would be good if they did cultures and made sure of what they were treating before using a shot-gun approach to antibiotics (just an assumption on my part tho). I've seen it too often...

[2Sox]

Man I'm sorry - that sounds terrible.
Has she seen an infectious disease doctor to get it under control?
It seems odd to me that she went from February to July without trouble; I'd question if it was anything else than the RX.
One other factor may just be the time of year and the heat? Sweat + bacteria makes it more likely.

Ideally it would be good if they did cultures and made sure of what they were treating before using a shot-gun approach to antibiotics (just an assumption on my part tho). I've seen it too often...

Thanks for your comments.
She does take 3 dance classes a week and showers afterwards, To clarify: She began on 4mg Test. When she increased to 8mg is when the problems started. She went back down to 4mg and now has stopped for over a week because she was still getting bumps. I'm thinking the dose should be reduced even further if/when she resumes treatment. She also would like to know if anyone else is on estrogen and progesterone at the same time.

[MArz123]

Accutane is the only thing that CURED my cystic ance, and yes i was on TRT at the same time.

I did a 5 month accutane course and it has never returned! Best thing i ever did ...worst side was dry lips, which as long as i applied chapstick or vaseline to was managable.

[thisAngelBites]

She also would like to know if anyone else is on estrogen and progesterone at the same time.

Sorry I can't help with the skin issue, but estrogen and progesterone at the same time is a common way to do HRT for women. Estrogen without progesterone is linked to increased rates of uterine cancer. Estrogen has a proliferative effect on endometrial tissue, whereas progesterone counters that effect. In a nutshell, the two balance each other out. A lot of anti aging docs use them together nearly all the time.

[2Sox]

Sorry I can't help with the skin issue, but estrogen and progesterone at the same time is a common way to do HRT for women. Estrogen without progesterone is linked to increased rates of uterine cancer. Estrogen has a proliferative effect on endometrial tissue, whereas progesterone counters that effect. In a nutshell, the two balance each other out. A lot of anti aging docs use them together nearly all the time.

Yes, this was my understanding as well. But my wife just told me that the more recent wisdom is to cycle progesterone, as constant progesterone is not the natural state of affairs in a woman's body.

[Vettester]

Yes, this was my understanding as well. But my wife just told me that the more recent wisdom is to cycle progesterone, as constant progesterone is not the natural state of affairs in a woman's body.

Yes, a lot of BHRT physicians will promote a cyclical protocol on progesterone, with premenopausal and perimenopausal patients medicating approx. the last 14 days of their cycles, and post menopausal women medicating continuously, taking a 5 to 7 day break every month. My wife went to a physician that worked this way.

Tell your wife to look at getting some Evening Primrose Oil. You both might be quite surprised to see just how effective it is with hormonal related acne and skin related issues, along with PMS related issues.

[imnotnatty]

when i first began my treatment my back went insane with cystic acne. Clyndamicin was the trick, either in cream or in pill form.

[2Sox]

Yes, a lot of BHRT physicians will promote a cyclical protocol on progesterone, with premenopausal and perimenopausal patients medicating approx. the last 14 days of their cycles, and post menopausal women medicating continuously, taking a 5 to 7 day break every month. My wife went to a physician that worked this way.

Tell your wife to look at getting some Evening Primrose Oil. You both might be quite surprised to see just how effective it is with hormonal related acne and skin related issues, along with PMS related issues.

Vette,
Thanks for your reply. My wife is postmenopausal. . Was this break you're referring to, a break from all BHRT or just progesterone for the 5-7 days?

The compounded cream she has combines estrogen, progesterone and testosterone. Possibly if she had taken a break every month, she wouldn't have developed the acne.

She has read that some doctors put even postmenopausal women on cyclical therapy, adding progesterone at the end of a cycle causing a menstrual period. The use of progesterone and estrogen at the same time mimics pregnancy...she is not comfortable with that. At the same time, she doesn't want to have monthly periods either! She'd like to know the experience of other post menopausal women in this area. She just wants to lose some weight and get some muscle mass and energy back.

She will definitely try evening primrose oil.

[Vettester]

[QUOTE=2Sox;6712545]Vette,
Thanks for your reply. My wife is postmenopausal. . Was this break you're referring to, a break from all BHRT or just progesterone for the 5-7 days?

QUOTE]

Yes, taking a 7 day break from ALL hormones would be the program. A lot of physicians will customize the dosage amount of estrogen to fluctuate; basically mimicking the body's natural production. As Angel mentioned, progesterone is needed to counterbalance estrogen, where cancer risks increase substantially, as well as other complications like fibroids.

Sox, the best thing for us at this point would be labs. It's hard to really say what's going on with the bumps, but labs would take the speculation out of play. FYI, my wife never did well with the test creams, nor did I with Androgel in the beginning of my journey. The transdermal application was causing an excess increase in DHT, which is common with creams/gels. She switched to 6mg - 8mg/wk (varies) of cypionate, injected subQ with Methyl B12 (400mcg), and her program is much more stable.

Let me know how she does with the Evening Primrose Oil. I'm telling you it is unreal with how well it works!!

[GeriatricOne]

I have suffered cystic acne too as a side effect of trt. I suffered too long trying this and that. I took 2 months off trt, but it didn't stop the acne.

Go see a dermatologist!

As soon as I consulted a dermitologist I began to get relief. I was prescribed prednisone to arrest the angry inflamation. Dramatic improvement in one week. Currently on 20mg prednisone daily and I have a couple of prescription creams. I am still experiencing some breaking out, but not as extensive and most importantly, not cycstic!

In 6 weeks the dermatologist will reevaluate. Accutane is a possible next course of action for me too. The dermatologist tells me there is a low daily dose option that doesnt dry the skin as severly and is easier on tne liver.

Go see a dermitologist and get her some immediate relief.

[2Sox]

In 6 weeks the dermatologist will reevaluate. Accutane is a possible next course of action for me too. The dermatologist tells me there is a low daily dose option that doesnt dry the skin as severly and is easier on tne liver.

Go see a dermitologist and get her some immediate relief.

Good advice. Dermatologist, Retin A, Accutane - All on the "to do" list.

Thanks.

[2Sox]

[QUOTE=Vettester;6712629]

Vette,
Thanks for your reply. My wife is postmenopausal. . Was this break you're referring to, a break from all BHRT or just progesterone for the 5-7 days?

QUOTE]

Yes, taking a 7 day break from ALL hormones would be the program. A lot of physicians will customize the dosage amount of estrogen to fluctuate; basically mimicking the body's natural production. As Angel mentioned, progesterone is needed to counterbalance estrogen, where cancer risks increase substantially, as well as other complications like fibroids.

Sox, the best thing for us at this point would be labs. It's hard to really say what's going on with the bumps, but labs would take the speculation out of play. FYI, my wife never did well with the test creams, nor did I with Androgel in the beginning of my journey. The transdermal application was causing an excess increase in DHT, which is common with creams/gels. She switched to 6mg - 8mg/wk (varies) of cypionate, injected subQ with Methyl B12 (400mcg), and her program is much more stable.

Let me know how she does with the Evening Primrose Oil. I'm telling you it is unreal with how well it works!!

Vette,

Thank you so much for your feedback on this. My wife is more hopeful and is much more composed.

Evening primrose is on our shopping list. Tomorrow she speaks to the doc about these recommendations and coming in for bloodwork.

[2Sox]

[QUOTE=Vettester;6712629]

Vette,
Thanks for your reply. My wife is postmenopausal. . Was this break you're referring to, a break from all BHRT or just progesterone for the 5-7 days?

QUOTE]

Yes, taking a 7 day break from ALL hormones would be the program. A lot of physicians will customize the dosage amount of estrogen to fluctuate; basically mimicking the body's natural production. As Angel mentioned, progesterone is needed to counterbalance estrogen, where cancer risks increase substantially, as well as other complications like fibroids.

Sox, the best thing for us at this point would be labs. It's hard to really say what's going on with the bumps, but labs would take the speculation out of play. FYI, my wife never did well with the test creams, nor did I with Androgel in the beginning of my journey. The transdermal application was causing an excess increase in DHT, which is common with creams/gels. She switched to 6mg - 8mg/wk (varies) of cypionate, injected subQ with Methyl B12 (400mcg), and her program is much more stable.

Let me know how she does with the Evening Primrose Oil. I'm telling you it is unreal with how well it works!!

Vette,

Thank's for your advice. My wife and I have been discussing your comments. As I stated before, she is post-menopausal. She is off the BHRT (combination estrogen, progesterone and testosterone cream) for over 3 weeks now and the cystic acne has finally subsided. She started taking the evening primrose and is considering going back on the topical hormone combination but taking a week off every 3 weeks seems like a great idea.

Also she is considering just taking low dose T cypionate shots and stopping the estrogen/progesterone cream all together.

What do you think would be the advantages of each protocol? Anyone else having some experience with women's protocols - your comments would be much appreciated!