Kika says,

 <<I´ve lately had three clients with low milk supply that does not respond to good breast draining and the rest of correct interventions. They all had in common that they had taken oral contraceptives (OCs) at a very young age (13, 13 and 14) for treating severe acne. Their breasts had normal appearance, but I´m wondering if the OCs somehow interfered in crucial pubertal breast development and this may be the cause of low milk supply. I´ve been browsing around but can´t find information...  Have you noticed this, or are you aware of any studies?>>



I first heard about a possible disruption of pubertal mammary gland development from Dr. Randall Craig, an infertility specialist who is way ahead of everyone else when it comes to these things. He told me that if a young girl was referred to him for menstrual issues, having already been put on OCs, he would yank her off ASAP. He said that when introduced early in the Tanner staging, it could cause a leapfrogging of stages that would result in altered development (he specified tubular breasts). He had no studies to share with me, just his observations. Now this is the first that I've heard that acne was the reason to start OCs, but whatever the reason, the risk is the same.  



Regarding acne... abnormal acne is frequently associated with excess androgen activity.  https://www.ncbi.nlm.nih.gov/pubmed/24278071  Androgens play a balancing role against estrogen during mammary development, and too many androgens during a critical window could detrimentally affect breast growth. Dr. Craig shared about how androgens can suppress or even cause regression of breast tissue in the pubertal years.  Thus OCs could be the red herring, and early hyperandrogenism (which can also trigger precocious puberty) could be the real underlying issue.



I am reaching out to mammary gland expert to see if she has any further thoughts.



Lisa Marasco





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