Hormonal birth control that contains both estrogen and progestin can help rebalance a person’s hormones, alleviating many symptoms of polycystic ovary syndrome (PCOS).
People with PCOS have a hormonal imbalance that causes unusually high levels of testosterone. This imbalance changes how the ovaries function and can cause them to develop many small cysts.
People with PCOS may also ovulate infrequently or not at all. PCOS is a leading cause of infertility.
This article looks at which birth control options are best for PCOS.
Fast facts on PCOS and birth control:
- Doctors do not yet have a cure for PCOS.
- The symptoms of PCOS vary from person to person.
- Combination birth control is a common treatment for PCOS.
- Birth control pills help regulate the menstrual period, making it more predictable.
COCs are birth control pills that contain two hormones. These hormones are usually estrogen and a synthetic form of progesterone called progestin. COCs also stop the ovaries from releasing an egg, which prevents pregnancy.
COCs can regulate the hormonal imbalances in PCOS by increasing a person’s estrogen levels and decreasing the amount of testosterone their body produces.
The 2021 article states that COCs can regulate the menstrual cycle and alleviate some other symptoms of higher testosterone levels, such as excess hair growth and acne. They may also reduce the risk of endometrial cancer.
Other possible benefits of COCs and other hormonal birth control pills include:
- a lighter menstrual flow
- less painful periods
- a lower risk of ectopic pregnancies
- a reduced risk of pelvic inflammatory symptoms
- reduced premenstrual syndrome (PMS) symptoms
- a decreased risk of osteoporosis
Some examples of combined oral contraceptives include:
The 2021 article notes that not all people can safely take COCs. Though they are generally safe, they present some risks.
People with PCOS can talk with a doctor about the best birth control options based on their symptoms and other risk factors.
A progestin-only pill (POP), also called a minipill, contains progestin but no estrogen. Like COCs, a POP can help manage hormonal imbalances in people with PCOS and has many of the same benefits.
A person may need to take the POP continuously without a break. This may lead them to stop having periods. Generally, a person’s period will resume when they stop taking the pill.
While the POP is not the first treatment option for PCOS, doctors may recommend it for those who cannot take a combination contraceptive.
Potential benefits and risks
Minipills are less likely to cause side effects than combination pills. However, they can cause the same effects.
Those who smoke or have cardiovascular problems, obesity, or diabetes may have fewer side effects with a POP.
Anyone who develops unpleasant side effects from taking a combination pill may also wish to switch to a POP.
Combination and progestin-only pills are also highly effective at preventing pregnancy. At typical usage rates, which factor in correct and incorrect use, they are about 91% effective.
“Perfect” vs. typical birth control use
This article talks about perfect and typical use of birth control. Perfect use describes how effective a form of birth control is if people use it exactly as the instructions recommend every they have sex. Typical use describes how effective a form of birth control is if a person sometimes uses it per the instructions but may also use it irregularly or imperfectly.
Even with perfect use, contraception is not 100% effective. People should discuss birth control options with a healthcare professional to find the right option for them.
Pills for painful periods
People who get some relief from combination pills but continue to experience painful or heavy periods may wish to switch to a pill that reduces the frequency of their period.
The following pills can make people have less frequent periods:
Birth control pills are not right for everyone, as some people find it inconvenient to take a pill every day.
Non-pill combination options that blend progestin with estrogen tend to be the most effective. Progestin-only options may pose fewer risks and side effects.
All of these options are more than 99% effective with perfect use. With typical use, however, they may have reduced effectiveness.
- Birth control injections: A person can receive an injection of progestin into the body every 3 months. These are around 96% effective at preventing pregnancy with typical use.
- Birth control patches: These release estrogen and progestin into the bloodstream through a patch on the skin. With typical use, they are about 93% effective at preventing pregnancy. Doctors do not recommend these for people with a BMI of 30 or higher due to reduced effectiveness and a risk of blood clots.
- Birth control rings: A person wears a ring inside the vagina, where it releases progestin and estrogen. These are 93% effective with typical use.
- Birth control implants: These are small rods that a doctor inserts under the skin. A rod will release only progestin and can prevent pregnancy for 3 years or longer. With typical use, implants are more than 99% effective.
- Intrauterine devices (IUD): A doctor will insert an IUD into the uterus, where it typically releases the hormone progestin. These are more than 99% effective with typical use. Another type of IUD contains copper only and does not release hormones or help with symptoms of PCOS.
Nonhormonal birth control options will not help with symptoms of PCOS. These options include the following:
Learn more about different types of birth control.
When choosing birth control, people may consider:
- Side effects: All medications can come with side effects. Common side effects of birth control can include changes in period duration and heaviness, breast tenderness, and weight gain.
- Lifestyle: It is important for a person to find a form of birth control that they find convenient and tolerate well. Some people may prefer using a method that does not require taking a pill every day.
- Combination or singular hormone: Different hormones can have different effects on PCOS symptoms. People can discuss their options with a healthcare professional and ask for a different form of birth control if they do not tolerate one that a doctor suggests.
This section answers some common questions about birth control and PCOS.
Can birth control help with PCOS weight loss?
There is no clear link between hormonal contraception and weight gain. People
Can birth control worsen PCOS symptoms?
Research does not suggest that hormonal birth control worsens PCOS symptoms. In fact, birth control methods such as COCs
It is best for people who believe birth control may be worsening their PCOS symptoms to contact a healthcare professional as soon as possible to discuss other treatments.
Does birth control actually help PCOS?
According to a
Combination birth control is one of the
However, it is best for people to discuss their options with a healthcare professional to determine which treatment method may best suit their circumstances.
Women’s health resources
Visit our dedicated hub for more research-backed information and in-depth resources on women’s health.
Hormonal birth control can help with PCOS symptoms. Lifestyle changes, such as maintaining a moderate weight and doing regular exercise, may also help. Some people may wish to try supplements or certain diets.
People with PCOS can talk with a healthcare professional about their symptoms and their treatment goals to create a comprehensive treatment strategy. A doctor may refer them to a specialist for further advice.
Birth control can be a part of a treatment approach for PCOS, but it does not have to be the only option.