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Melasma is not the only form of hyperpigmentation caused by hormonal changes hyperpigmentation is associated with numerous endocrine disorders including Addisons disease (insufficiency of adrenal hormones), Cushings disease (excess cortisol and ACTH), acanthosis nigricans (associated with insulin resistance), and Graves disease (overproduction of thyroid hormones)

Lazzaroni E, Ben Nasr M, Loretelli C, Pastore I, Plebani L, Lunati ME, et al

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Here's why those numbers can feel so shocking, why this stage might actually be the easiest time to learn what your body needs, and where a high protein meal replacement shake can help you get there without needing to force in such large amounts of meat