What's the Best Form of Birth Control for Women With PCOS?

Polycystic ovary syndrome, or PCOS, is a hormonal disorder that’s one of the most common causes of infertility in women.

Approximately one in every 10 women of childbearing age is affected by PCOS, making it an extremely common condition. If you have PCOS, you may experience a variety of symptoms that can affect everything from your mood to your skin, weight and menstrual cycle.

While there currently isn’t a cure for PCOS, most symptoms can be treated using medication, including several hormonal methods of birth control.

Below, we’ve explained what PCOS is, how it can develop and the effects it can have on your health and fertility. We’ve also explained how you can treat PCOS using hormonal methods of birth control such as the pill, patch and other contraceptives. 

PCOS and Birth Control: The Basics

• Currently, there’s no cure for polycystic ovary syndrome. However, some forms of birth control can help to control androgen levels and provide relief from symptoms.
  
  

• If your PCOS affects your period, using hormonal birth control may help to make it more regular and predictable.
  
  

• As well as the pill, several other forms of hormonal birth control can help to treat PCOS symptoms, including the injection, implant and IUD.
  
  

• Non-hormonal forms of birth control, such as condoms, don’t affect your hormones and will have no effects on PCOS symptoms.
  
  

• In addition to hormonal birth control, other treatments are available for PCOS. You may need to take a different type of medication or make changes to your habits, diet and/or lifestyle.

What Is Polycystic Ovary Syndrome (PCOS)?

Polycystic ovary syndrome, or PCOS, is a hormonal disorder that affects women. It develops when a woman’s ovaries or adrenal glands produce overly high levels of male sex hormones, which are commonly referred to as androgens.

This excessive production of androgens can cause a range of symptoms and health problems, including infertility.

If you have PCOS, you may experience difficulties ovulating. Your period may come sooner or later than expected, or you may only have a few periods every year. In some cases, you may completely stop getting your period for several months at a time. 

Most symptoms of PCOS are caused by high androgen levels. In addition to an irregular period and other issues related to the menstrual cycle, other common symptoms of PCOS include the following:

• Acne. Women with PCOS often develop acne on the face and body. This is caused by increased sebum production -- a common byproduct of high androgen levels.

• Excessive body hair growth. Some women with PCOs experience hirsutism -- a type of excessive hair growth that affects the face, chest and back.

• Thinning hair and/or hair loss. The increase in androgen production caused by PCOS may cause hair thinning or, in some women, pattern hair loss.

• Darkening of the skin. Some women may experience darkening of certain patches of skin, including in creases around the armpits, breasts, neck and groin.

• Weight gain. Many women with PCOS experience  weight gain, while others may find it difficult to lose weight.

• Skin tags. Skin tags, a type of small, skin-colored growth, may form in certain areas of the skin, including the armpits and around the neck.

Because of its effects on your menstrual cycle, PCOS may lead to the development of cysts on your ovaries. If you no longer get your period, you may be unable to become pregnant. 

PCOS typically affects women of childbearing age, with most cases occurring between the ages of 15 and 44. Many women with PCOS begin to notice symptoms in their 20s or 30s, often after experiencing difficulties becoming pregnant.

Currently, experts aren’t completely aware of why PCOS develops. However, research indicates that several factors may play a role, including excessive insulin production, androgens, genetics and certain types of low-grade inflammation.

Treating PCOS Using Birth Control

Although birth control doesn’t cure polycystic ovary syndrome, certain forms of hormonal birth control can help to manage and provide relief from PCOS symptoms.

Several different forms of birth control are used to treat PCOS. The most common is the birth control pill. If you have PCOS, using a birth control pill can help to relieve your symptoms and make living with PCOS significantly easier.

Most women with PCOS use a combination birth control pill that contains synthetic versions of the hormones progestin and estrogen. Some combination pills offer additional benefits, such as preventing acne breakouts.

In certain cases, using a combination pill may not be appropriate for you. For example, if you’re older than 35, a smoker or are just sensitive to the effects of estrogen, your healthcare provider may instead recommend using a progestin-only birth control pill, or “mini-pill.”

Other hormonal forms of birth control can also be used to treat PCOS. For example, options like the patch, ring (NuvaRing®), injection (Depo-Provera®) and hormonal IUD (Mirena®) can all be used to treat the symptoms of PCOS.

Although many most women opt to use the combination birth control pill, there’s no “best” form of birth control for treating PCOS in everyone.

Each form of birth control offers specific advantages and disadvantages, from convenience and ease of use to effectiveness. You can learn more about the strengths and weaknesses of each form of hormonal birth control in our detailed guide to birth control options. 

Non-hormonal forms of birth control, such as the copper IUD, sponge, diaphragm and condoms, do not target the androgen hormones that contribute to PCOS and have no noticeable effect on PCOS symptoms. 

Other Medications for Treating PCOS

In addition to hormonal forms of birth control, several other medications are commonly used to treat PCOS. These include:

• Anti-androgens. Medications that block the effects of androgen hormones, or help to reduce androgen production, are often prescribed off-label to treat some symptoms of PCOS.
  
  Anti-androgens can help to control facial and body hair growth, androgen-related hair loss and acne caused by PCOS. Since anti-androgens can contribute to birth defects, you’ll need to use a form of birth control if you’re prescribed this type of medication.

• Metformin. Metformin, a medication that’s primarily used for diabetes, can control blood sugar levels and lower your body’s production of insulin and certain androgen hormones that contribute to PCOS symptoms.
  
  Although metformin hasn’t been approved by the FDA for treating PCOS, it’s sometimes prescribed as an off-label treatment for managing symptoms and restarting ovulation. It may also have other positive effects, such as reducing weight and cholesterol levels.

Other Steps You Can Take to Treat PCOS

If you have PCOS, it’s important to talk to your healthcare provider about using birth control or a different type of medication to manage your symptoms. Used as prescribed, medications can be highly effective at controlling your PCOS symptoms and improving your quality of life.

In addition to using medication, you may also want to try the following techniques to make your PCOS symptoms easier to manage: 

• Maintain a healthy body weight. If you’re currently overweight, make an effort to reach a healthy body weight. Losing weight may help you to maintain a more regular menstrual cycle and provide relief from some PCOS symptoms.

• Try to exercise regularly. Staying active with regular exercise can help to relieve some symptoms of PCOS. Try to exercise often, even if it’s just a light walk, as this can help to lower blood sugar levels, keep you at a healthy weight and reduce depression that is sometimes associated with PCOS.

• Avoid simple sugars and carbohydrates. Diets rich in simple sugars may raise insulin levels and make the effects of PCOS worse. Consider talking to your healthcare provider about a diet that’s lower in simple carbohydrates.

• Use hair removal products. If you experience facial or body hair growth as a result of PCOS, consider using hair removal creams or medications such as eflornithine HCl to get rid of unwanted hair and slow down future growth.

In Conclusion

If you have PCOS, it’s important to talk to your healthcare provider. Several forms of hormonal birth control can be used to treat PCOS, including the birth control pill, patch, ring, injection and even the hormonal IUD. 

Used as prescribed, hormonal birth control may help to bring your symptoms under control and bring regularity to your menstrual cycle. 

If birth control isn’t effective, other options are available. Based on your specific symptoms and general health, your healthcare provider may recommend taking another form of medication or implementing lifestyle changes to make your PCOS symptoms less severe.