What are the best birth control options for Pcos?

PCOS is becoming increasingly common today. It is said that about 9-13% of women in reproductive age are affected by PCOS. But being common does not make it normal. Polycystic ovary syndrome (PCOS) is a hormonal imbalance. It disrupts ovulation, leading to irregular periods, excess androgen (male hormone) production, and can cause symptoms like acne, unwanted hair growth, and weight gain. 

This blog explores different birth control options suitable for PCOS, their benefits and drawbacks, and how to choose the best fit for you.

Impact of Birth Control on PCOS Management:

Birth control for PCOS acts by regulating hormones. Combination oral contraceptives (COCs) containing estrogen and progestin are the first-line treatment option. These medications work to manage PCOS:

• Ovulation Suppression: COCs suppress ovulation to prevent pregnancy and establish a more predictable menstrual cycle.
• Androgen Reduction: By regulating hormone levels, COCs help in decreasing androgen production, reducing symptoms like acne and unwanted hair growth.
• Cervical Mucus Thickening: COCs thicken cervical mucus, creating a barrier that further makes it difficult for the sperm to reach the egg.

Birth Control Options for PCOS:

There are several birth control methods available. Each method has certain advantages and considerations. Here’s are some popular options for PCOS management:

• Combined Oral Contraceptives (COCs): This is the most commonly adopted method in cases of birth control for PCOS. They contain estrogen and progestin, effectively regulating periods and reducing androgen levels. There are many COC brands available. 
  • Advantages: Highly effective in preventing pregnancy (over 99% with perfect use), regulates menstrual cycles, reduces PCOS symptoms like acne and unwanted hair growth, convenient daily dosage.
  • Considerations: Can cause side effects like nausea, breast tenderness, mood swings, and blood clots (rare). You should avoid this option if you are a smoker or someone with a high risk of blood clots.
• Progestin-Only Pills (POPs):  These pills only contain progestin, and can be a suitable alternative for those who cannot take estrogen. It is best suited for breastfeeding women or those with a high risk of blood clots.
  • Advantages: These pills have fewer side effects as compared to COCs. They’re a safe option for breastfeeding women.
  • Considerations: Comparatively less effective in preventing pregnancy as compared to COCs (around 98% with perfect use). It’s use may cause irregular bleeding and are less effective in reducing PCOS symptoms.
• Progestin-Releasing Intrauterine Device (IUD):  This is a T-shaped device  that is inserted into the uterus. It releases progestin continuously for several years (depending on the type). It prevents pregnancy by thickening cervical mucus and suppressing ovulation.
  • Advantages: Highly effective in preventing pregnancy (over 99% with perfect use). It has a long-term impact (3-10 years). It reduces periods or stops them completely. It may also improve PCOS symptoms.
• Considerations: IUDs require insertion and removal by a healthcare provider. It may cause irregular bleeding initially. It is not suitable for everyone (e.g., those who want regular periods).

Which Birth Control Should You Choose?

Every woman has unique needs and preferences. You should consider the following options and then choose the method that suits you the best.

• Medical History: You should discuss any pre-existing health conditions with your doctor. You should tell them if you have any allergies, or risk factors like smoking.
• PCOS Symptom Severity: You should find out  the symptoms that cause you the most concern. Whichever method you choose should be based on targeting those concerns.
• Desired Level of Effectiveness: You should consider the long-term and short-term impact of the method that you will choose. If taking a pill on daily basis is a concern, the you should consider longer-acting methods like IUDs.
• Lifestyle and Preferences: You should take your daily routine into consideration when choosing a birth control method. See if you’re comfortable with insertion procedures. Also make sure to check if the method may impact the desired frequency of periods.

Conclusion:

Birth control methods can be effective in managing PCOS symptoms and achieving menstrual regularity. But you should know that it is not the only option.  You should adopt a comprehensive PCOS treatment plan that also incorporate lifestyle modifications like maintaining a healthy weight and exercising regularly. Some people can also find relief through dietary adjustments or specific supplements. You should explore all your options and then choose one that fits you the best.