Understanding Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder affecting 5% to 10% of females, 18 to 44 years of age. It is characterized by irregular menstrual cycles, excess androgen production, and the development of small cysts on the ovaries. Women with PCOS may experience symptoms such as infertility, acne, excessive hair growth (hirsutism), weight gain, and mood swings.
While PCOS cannot be cured, there are several treatment options available to manage its symptoms and improve hormonal balance. One such treatment option is oral contraceptive pills, which have shown promise in helping women with PCOS regulate their menstrual cycles and alleviate associated symptoms.
In this article, we will explore the relationship between oral contraceptive pills and PCOS, discussing different types of birth control, their impact on hormonal balance, and how they can help manage the symptoms of PCOS.
Oral Contraceptive Pills (OCPs) and PCOS
Impact of Contraceptives on Hormonal Balance
Oral contraceptive pills work by regulating hormonal levels in the body. There are two main hormones responsible for maintaining the menstrual cycle, follicle-stimulating hormone, or FSH, and luteinizing hormone, or LH. FSH stimulates the growth of ovarian follicles, which contain eggs. LH triggers ovulation, the release of a mature egg from the ovary. Their levels are disrupted heavily due to the change in androgen levels due to PCOS, which can inhibit the release of FSH, leading to a relative increase in LH levels. This imbalance can interfere with the normal process of follicular development, ovulation, and the regular menstrual cycle and even cause the formation of ovarian cysts in people with PCOS.
Combination Pills vs. Progestin-Only Pills
Combination pills (COCs) are oral contraceptive pills that contain both estrogen and progestin hormones. They regulate the menstrual cycle, reduce symptoms like acne and hirsutism, and prevent ovarian cysts by suppressing the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), as well as reducing androgen production. However, they may not be suitable for everyone, so consulting with a doctor is important to determine if they are the right choice.
Progestin-only pills (POPs) are oral contraceptive pills that only contain progestin. They primarily work by thickening cervical mucus to prevent sperm from reaching the egg. POPs can help by inhibiting FSH and reducing the overstimulation of the ovaries. For women with PCOS who are not trying to conceive, progestin-only pills may be prescribed to regulate the menstrual cycle and reduce symptoms such as irregular periods and excessive hair growth.
Combination pills are often preferred due to their additional benefits, such as more regular menstrual cycles and reduced androgen levels. However, for women who cannot or prefer not to take estrogen, progestin-only pills can be a suitable alternative.
Benefits of Oral Contraceptive Pills for PCOS
Regulation of Menstrual Cycles: One of the key benefits of oral contraceptives for women with PCOS is the regulation of menstrual cycles. By taking birth control pills consistently, women can experience more regular and predictable periods, reducing the discomfort and uncertainty associated with irregular bleeding.
Reduction in Androgen Levels: High levels of androgens, such as testosterone, are often observed in women with PCOS, contributing to symptoms like acne and hirsutism. Oral contraceptives, particularly those containing anti-androgenic progestins, can help lower androgen levels, leading to an improvement in these symptoms.
Prevention of Ovarian Cysts: Oral contraceptives work by preventing the formation of ovarian cysts, which are a common feature of PCOS. By regulating the hormonal fluctuations that lead to cyst development, birth control pills can help reduce the risk of cyst enlargement and the associated pain and discomfort.
Choosing the Right Oral Contraceptive
Consultation with a Doctor: When considering oral contraception as a treatment option for PCOS, it is essential to consult with a doctor who can assess your individual needs and guide you in choosing the most suitable type and dosage of birth control.
Potential Side Effects and Considerations: While oral contraceptive pills can be beneficial for women with PCOS, it is important to be aware of potential side effects and considerations. Common side effects may include nausea, breast tenderness, and breakthrough bleeding. For more information, refer to our post on the potential side effects of oral contraceptive pills.
Additionally, oral contraceptive pills do not address the underlying hormonal imbalances associated with PCOS, and discontinuation may result in a return of symptoms. It is thus important to include lifestyle changes like a balanced diet and regular exercise to manage the symptoms side by side.
Conclusion
Oral contraception offers a valuable treatment option for women with PCOS, helping to manage symptoms, regulate menstrual cycles, and improve hormonal balance. Combined oral contraceptives and progestin-only pills have demonstrated effectiveness in reducing androgen levels, preventing ovarian cysts, and providing symptom relief. However, it is crucial to consult with a healthcare provider to determine the most suitable oral contraceptive based on individual needs and considerations.
Remember, while birth control can help manage PCOS symptoms, it is not a cure and a holistic approach that includes lifestyle modifications and regular monitoring is essential for long-term management of the condition.
References
Ndefo, U. A., Eaton, A., & Green, M. R. (2013). Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. P & T : a peer-reviewed journal for formulary management, 38(6), 336–355.
Legro, R. S., & Arslanian, S. A. (2021). Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 106(3), 745-794.
Cooney, L. G., Lee, I., Sammel, M. D., Dokras, A., & Higham, J. P. (2017). Fertility awareness‐based contraceptive use among women with polycystic ovary syndrome: a pilot study. Journal of the American Association of Nurse Practitioners, 29(3), 147-154.
Moran, L. J., Hutchison, S. K., Norman, R. J., & Teede, H. J. (2011). Lifestyle changes in women with polycystic ovary syndrome. The Cochrane Database of Systematic Reviews, (7), CD007506.