What To Know About Birth Control If You Have PCOS

Polycystic ovarian syndrome, also known as PCOS, is one of the most frustrating health imbalances to deal with as a woman. As if dealing with a monthly menstrual wasn't tiring enough, PCOS can lead to a host of other problems that are associated with your female reproductive system. According to the Centers for Disease Control and Prevention, more than five million women in the U.S. struggle with PCOS and deal with hormone-raging symptoms that include irregular periods, an increase of facial hair, acne, and multiple small cysts on the ovaries. The condition has also been found to have a negative impact on mental health with medical researchers at Clue, a period-tracking app, reporting that women with PCOS are three times more likely to experience anxiety and depression. 

Because of its hormone-rocking nature, it's an incredibly difficult disorder to navigate and makes decisions like choosing the right birth control even more pertinent. Hormonal birth control and PCOS has become highly debated, but we've narrowed in on all the research to find the answers.

Diagnosing PCOS can be tricky because of certain signs that may fly under the radar such as unexplained weight gain, increased acne, or thinning scalp hair, per the Centers for Disease Control and Prevention. There is also no single test for the disorder; however, through pelvic exams, blood tests, and ultrasounds, a physician can diagnose the condition upon finding an increase in androgens or male hormones, glucose intolerance, or cystic masses (via the Mayo Clinic). Though PCOS affects one's ability to become pregnant, it's still important to consider the effects of birth control as it can both positively and negatively affect PCOS symptoms and underlying factors contributing to the disorder. 

Although there is no cure for PCOS, per the American College of Obstetricians and Gynecologists, the hormones in birth control can help regulate menstrual cycles while also treating the cosmetically unpleasant symptoms including facial hair and acne. Because women with PCOS produce too much insulin and androgens or male hormones, doctors at West Med Family HealthCare suggest taking birth control that includes estrogen and progesterone. These hormones help to lower testosterone and help the body return to homeostasis by reducing out-of-wack androgen levels. There are, however, some risks involved when taking birth control for PCOS.

If left untreated, uncontrolled PCOS can lead to serious risks and health problems. According to Johns Hopkins Medicine, PCOS can develop into greater diseases including type 2 diabetes, high blood pressure, and uterine cancer. Because of the hormones present in birth control, it can quickly help to gain control of PCOS symptoms. Those struggling with irregular periods and who are also overweight run a greater risk of developing endometrial hyperplasia, which can lead to cancer (via Tzu Chi University). Birth control, therefore, can help prevent these dangerous developments by helping to regulate irregular cycles or heavy periods. 

It's also important to note that 70% of women with PCOS struggle with insulin resistance as the main cause of hormone imbalance, according to women's health specialist Dr. Sadaty. There are also other contributing factors that should be addressed including an imbalanced gut hosting dangerous bacteria, high cortisol levels, and toxic exposures. According to Dr. Sadaty, taking birth control can conceal these underlying factors while removing unattractive symptoms like facial hair and acne, however, it's important to consider the source of these symptoms rather than hiding them. She advises using a progestin-coated IUD like Mirena or Skyla if you struggle with insulin resistance while also battling heavy bleeding. If your main concern is high androgen, opt for a birth control pill with progestins drospirenone or norgestimate. Regardless, it's important to speak to your healthcare provider first to see which options are best for you.