Birth control, specifically hormonal birth control, can help support those with PCOS by managing some symptoms like hormonal imbalance or irregular periods.
The most common birth control suggested for PCOS is hormonal birth control pills.
The best birth control for PCOS is the birth control that you and your doctor decide best suits your needs, symptoms, and lifestyle.
Most of us know all too well that menstruating is no walk in the park—there are periods, cramps, discharge, contraceptives, and fluctuations of hormones. But people with PCOS (polycystic ovary syndrome) experience additional uncomfortable symptoms due to hormonal imbalance. However, thanks to science and birth control, some birth control can help manage these symptoms.
Discover more about what PCOS is, how to manage it, and what the best birth control for PCOS is below.
What is PCOS?
PCOS is a common hormonal imbalance that affects as many as 5 million people in the US. While all people with female anatomy produce androgens (referred to typically as “male” sex hormones), those who experience PCOS produce slightly more, which can cause an assortment of health issues.
To be diagnosed with PCOS, doctors typically look for signs such as—
Lots of hair on the body and face (also known as hirsutism)
While these are common symptoms, every person's experience varies, thus healthcare providers work 1:1 with patients to diagnose PCOS.
Can birth control help PCOS?
Birth control pills are often the first thing healthcare providers try when managing PCOS. Birth control pills, specifically combined oral contraceptives (combination of estrogen and progestin), can help manage some symptoms of PCOS.
For example, birth control can help:
Regulate your period: Birth control pills can help regulate periods because of the way they are made. Most birth control pills have 3 weeks of active pills (pills containing hormones) and one week of inactive pills (pills without hormones). During the inactive pill week, you get your period. This regulation from the pills helps prevent excessive growth of uterine lining (which can cause abnormal patterns, heavy bleeding, etc.) and regulate periods.
Improve hormone balance: People with PCOS experience what is called hyperandrogegism, simply meaning an excessive amount of androgens are produced, which can cause things like acne, weight gain, hair growth, and more. Birth control pills can help improve hormone balance and hyperandrogenism.
Are there downsides to taking birth control for PCOS?
While birth control is often recommended for PCOS, each case of PCOS is evaluated individually. Healthcare providers often evaluate other health factors like age, smoking, obesity, and diabetes. They may also weigh risk factors like insulin resistance or blood clots.
Best birth control for PCOS
Like any use case of birth control, the “best” birth control comes down to the individual. Many with PCOS may choose to pick the birth control that addresses their symptoms. For example, some birth control may be better for regulating periods, while others may help with acne or other symptoms. Here are some popular birth control choices for people with PCOS.
The Pill
As we mentioned before, the pill, aka oral contraceptives, is common for people with PCOS as one way to help with symptoms. There are two types of pills: the combined oral contraceptive (also known as COC) and the mini-pill (great for those who COC doesn’t work for).
Combined oral contraceptives
Combined oral contraceptives are birth control that contains a combination of estrogen and progestin. People with PCOS who experience irregular periods or symptoms of androgen excess such as acne, facial hair, or excessive body hair may find some relief because of the combination of these two hormones.
Mini Pill
Mini pill refers to the progestin-only birth control pill, meaning it just has progestin. Progestin-only pill is sometimes recommended to those with contraindications to combined oral contraceptives, such as breastfeeding, migraines, or sensitivity to estrogen.
Common mini pill brands include—
The patch is another form of hormonal birth control. Unlike pills that are taken every day, the patch is put on for 21 days and then removed for 7 days and the process repeats. This might work well if someone doesn’t want to remember to take something every day but instead would prefer to change twice a month (once to put on and then take off). However, the patch isn’t recommended for anyone who weighs more than 198 pounds.
Similarly, a vaginal ring is a hormonal birth control option that is inserted in the vagina for 3 weeks and then taken out for a week period. This option is just as effective as birth control pills in treating some symptoms of PCOS.
The year long ring option offered by The Pill Club is Annovera.
IUD (Intrauterine device)
An IUD (or intrauterine device) is a device inserted into the uterus. It is another option for PCOS. However, you’ll want to specifically consider a hormonal IUD vs. a copper IUD, because the hormones in the IUD can help relieve PCOS symptoms. In addition to that, hormonal IUDs can help prevent pre-cancerous thickening of uterus lining, and prevent heavy bleeding.
Who should take birth control while diagnosed with PCOS?
For those not interested in having a child, birth control may be a good option for PCOS symptom management. For most people, hormonal birth control can help regulate periods and support hormone balance. However, for people with cardiovascular risk, blood clotting risk, or insulin resistance, you may want to consider something else.
Regardless, your healthcare provider can help evaluate the best options for you based on your health information and lifestyle.
What are common side effects for people with PCOS taking birth control?
While everyone responds slightly differently, side effects for people with PCOS tend to be similar to general side effects of birth control, such as—
A common concern for anyone, including those with PCOS, is whether birth control will cause weight gain. It should be noted, however, there have been no direct studies showing a relationship between weight gain, birth control, and PCOS.
If you have questions about side effects, ask your healthcare provider.
Choosing the best birth control for PCOS
At the end of the day, the best birth control for PCOS is really based on each individual, their symptoms, health concerns, and lifestyle. Hormonal birth control options like the pill or the ring have been shown to help manage some PCOS symptoms like hormonal imbalance and period regulation.
National Library of Medicine. Oral Contraceptive Pills. https://www.ncbi.nlm.nih.gov/books/NBK430882/
National Library of Medicine. An Update on Contraception in Polycystic Ovary Syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774551/
National Library of Medicine. Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774551/
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