Best Birth Control for PCOS

Women of reproductive age sometimes suffer from an endocrine disorder called polycystic ovary syndrome (PCOS). Affected women might have ovaries that are enlarged and contain small fluid collections known as follicles in both ovaries. An ultrasound exam is used to view the follicles. Women with PCOS may experience excess hair growth, obesity, acne and prolonged or infrequent menstrual periods. If you are an adolescent, absent or infrequent periods might be symptoms of PCOS. Despite having PCOS, you should be aware of the birth control options best suited for you. This article will discuss the best birth control for women with PCOS.

The Best Birth Control for PCOS: Combination Pills

The best birth control for women PCOS is combination pills or oral contraceptives. This is because they contain 2 synthetic hormones – estrogen and progestin–that are naturally produced in the ovaries. Let's look at how this birth control pill helps:

Regulate Periods

Oral contraceptives help in getting lighter and regular periods. They regulate the cycle and make your period come every 28 days or less, mostly on extended pill cycles. Birth control pills contain progestin (synthetic progesterone), which provides the necessary progesterone for the lining to shed and prevent the risk of endometrial hyperplasia.

A normal cycle involves release of hormones like progesterone and estrogen that cause the uterine lining to thicken and proliferate. After ovulation, progesterone levels increase and decrease before menstrual periods. The shedding of the lining is caused by the decrease in progesterone levels.

Women with PCOS rarely ovulate, meaning the rise and fall of progesterone is prevented and thus there is no shedding. So, the lining is exposed to estrogen for a longer time, resulting in the uterine lining thickening more than usual. This, in turn, results in erratic and heavy bleeding which is not the same as a normal period since ovulation has not occurred. With time, if the endometrium is not exposed to progesterone, you might get endometrial hyperplasia, the overgrowth of uterine lining, which might lead to endometrial cancer. However, this is rare.

Other Benefits

  • Less unwanted hair growth: Oral contraceptives are the best birth control for PCOS since they can decrease the levels of androgen hormones and reduce hirsutism (excess hair growth). It might take 6 months before unwanted hair on the chest, back, stomach and face decreases.
  • Decrease acne: The hormones present in the pills will assist in preventing acne in skin. However, it might take a few months to see the benefits.
  • Reduce cramps: Birth control pills can help in reducing cramps and in some cases completely getting rid of them.
  • Decrease likelihood of getting anemia due to lighter periods. Birth control pills also decrease the risk of getting ovarian cysts, ovarian cancer and endometrial cancer.
  • Prevent pregnancy: Women with PCOS ovulate occasionally and irregularly, so there is still chance that you may get pregnancy accidentally. Take oral contraceptives offer protection from this kind of unexpected pregnancy.

Despite oral contraceptives facilitating bleeding once in 28 days, they do not cure PCOS. As soon as you are off the oral contraceptives, the irregular cycles are likely to recur.

Side Effects of Using Oral Contraceptive Pill for PCOS

As the best birth control for PCOS, women do not experience any side effects when taking the pill in most cases. However, side effects can happen and different women will react differently to different types of oral contraceptives.

1. Blood Clots

Though it is very rare, a clot might form in your lungs or leg. This is a very serious side effect. If you notice sudden pain or swelling in your leg or you experience shortness of breath, consult your health care provider. If you have had a history of blood clots, do not take the pill. Inform your health care provider of any family members who have had clots in the past. Being overweight, smoking, sitting in a plane for long hours and surgery can cause blood clots.

To reduce your risk, drink plenty of water, walk around when going for long trips and avoid smoking. If you are about to go for surgery, discontinue the pill 3-4 weeks before the operation and allow yourself to recover fully before you get back on the pill.

2. Spotting

This is very light bleeding that you will experience from day 1 to day 3 after starting the oral contraceptive, or when you miss a pill. If the bleeding lasts more than a few days or it becomes heavier, or the bleeding starts a few months after you have been on the pill, consult your health provider.

3. Headaches

Headaches are caused by stress at home or school, inadequate sleep, migraines or sinus infections. Oral contraceptives can make headaches better or worse. If your doctor suspects your headaches are linked to the pill, he might prescribe a contraceptive with less estrogen or take you off the pill for a while. If you have a history of migraines, ask your doctor if the pill is the best option for you.

4. Other Side Effects

  • Nausea: You might experience nausea when you start using the pill, but it will fade away after some days. Nausea is unlikely to occur if you take it with a bedtime snack or after dinner.
  • Mood changes: Feeling high or low can happen to almost anyone and it is not necessarily linked to the pill. Regular exercise and a healthy diet as well as seeing a counselor might help with the mood swings.
  • Weight Change: Some teenage girls lose weight while others gain, but most girls remain the same. Maintain a healthy diet, drink plenty of water and exercise a lot.
  • Enlarged or Sore Breasts: In some instances, your breasts might become larger and/or tender. However, this is very unlikely.

Other Birth Control Methods for Women with PCOS

Apart from the oral contraceptives, the best birth control for PCOS, women with PCOS can use the following methods to deal with the symptoms of PCOS:

  • Progestin: Irregular periods can also be treated by taking progestin (Provera) hormone for 10 to14 days every 1-3 months. For most women with PCOS, progestin will induce periods and decrease the risk of uterine cancer. However, it does not prevent pregnancy and does not help with cosmetic concerns (acne and hirsutism).
  • Antiandrogen: After 6 months of hormone treatment and there is no improvement in excess hair growth for women with PCOS, an antiandrogen called spironolactone is added. Other options for this include wigs and hair replacement.
  • Lifestyle change: Problems associated with weight gain can be solved by being active and maintaining a healthy diet. Weight loss is the most effective method of managing irregular periods, insulin abnormalities and other PCOS symptoms. Beside, hormones will not help with diabetes, cholesterol, blood pressure and heart risks, so this makes a healthy diet and exercise vital in your treatment.
  • Metformin (Glucophage): This is medication that improves production of insulin in the body. It was initially made for type 2 diabetics, but it is also recommended for PCOS patients. It helps with irregular periods and weight loss.

Watch the video to know the birth control story experience of girl with PCOS:

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