PCOS Treatment Using Birth Control to Treat PCOS By Nicole Galan, RN facebook twitter linkedin Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." Learn about our editorial process Nicole Galan, RN Medically reviewed by Medically reviewed by Brian Levine, MD on January 19, 2020 linkedin Brian Levine, MD, MS, FACOG, is board-certified in obstetrics and gynecology, as well as in reproductive endocrinology and infertility. Learn about our Medical Review Board Brian Levine, MD on January 19, 2020 Print Table of Contents View All Table of Contents How It Helps Combined Contraceptives Progestin-Only Options Contraindications Hormonal contraceptives (birth control) are commonly used for the treatment of polycystic ovary syndrome (PCOS) symptoms, such as acne and unwanted hair. However, finding the one that is right for you (combined, which contains estrogen and progestin, or progestin-only) can be challenging, and there may be reasons why you are able to take one, but not the other—or none at all. How It Helps Illustration by Brianna Gilmartin, Verywell Birth control is not a cure for PCOS, but it can help treat and relieve some of the symptoms of PCOS. Birth control performs three main functions to treat PCOS: It protects the uterus by ensuring regular ovulation. Failure to regularly ovulate can increase the buildup of uterine tissue (called endometrial hyperplasia) which may increase the risk of uterine cancer. With a combined contraceptive, progestin works against estrogen to prevent hyperplasia. It helps reduce excessive male hormone (androgen) levels in the blood, particularly testosterone. By doing so, symptoms of acne, androgenic alopecia (male pattern baldness), and hirsutism (unwanted facial and body hair) can be alleviated. It protects against unwanted pregnancy in people whose ovulation cycles are often difficult to track. Combined Hormonal Contraceptives Combined hormonal contraceptives contain both estrogen and progestin, and are considered the first-line treatment for people suffering irregular periods and androgens as a result of PCOS. There are several options to choose from, including oral contraceptives ("the pill"), a transdermal patch, and an intravaginal ring. Because there have been few quality studies comparing the use of one type of combined oral contraceptive versus another in treating PCOS, it is largely up to you and your doctor to decide which may be the most appropriate. There are several different forms of hormonal oral contraceptive, each with different actions and a different breakdown of ingredients. They can be classified as: Monophasic: Hormone levels remain consistent. Biphasic: Progestin increases halfway through the cycle. Triphasic: Three different doses of progestin and estrogen change approximately every seven days. Estrogen Levels in Birth Control Pills Oral contraceptives can be further classified by the amount of estrogen contained in each pill. Low-dose formulations contain 20 micrograms (mcg) of estrogen alongside progestin. Regular-dose contraceptives contain 30 mcg to 35 mcg of estrogen, while high-dose formulations contain 50 mcg. It's important to note that even the lowest dose of estrogen is effective in preventing pregnancy and may be less likely to cause side effects such as bloating, weight gain, and mood swings. By contrast, high dosages may increase the risk of irregular periods rather than reduce it. On the flip side, low or ultra-low estrogen is associated with a risk of breakthrough bleeding, which can cause some women to stop taking them. Progestin Levels in Birth Control Pills It is equally important to determine which type of progestin is being used in a combination pill. Some have a high androgenic activity that can aggravate acne or facial hair growth, undermining their usefulness in PCOS treatment. Low-androgen combination pills include: Desogen (desogestrel/ethinyl estradiol) Nor-QD (norethindrone) Ortho Micronor (norethindrone) Ortho-Cept (desogestrel/ethinyl estradiol) Ortho-Cyclen (ethinyl estradiol/norgestimate) Ortho-Novum 7/7/7 (ethinyl estradiol/norethindrone) Ortho Tri-Cyclen (ethinyl estradiol/norgestimate) Ovcon-35 (ethinyl estradiol/norethindrone) Tri-Norinyl (ethinyl estradiol/norethindrone) Because these pills may have other side effects, it is important to speak with your doctor about the risks and benefits before making a choice. Progestin-Only Options In cases where a person is experiencing abnormal menstruation, but none of the androgenic symptoms of PCOS, the doctor may offer a progestin-only contraceptive as an alternative. There are two main types that can prevent pregnancy and uterine hyperplasia without affecting testosterone levels: Continuous options such as the "minipill" or the Mirena or Paragard hormonal intrauterine device (IUD) Intermittent therapy by means of the oral drug Provera (medroxyprogesterone), which is taken for 12 to 14 consecutive days per month Contraindications Taking birth control to treat PCOS can be risky when combined with certain other conditions or lifestyle factors. Your doctor may not want to prescribe you birth control if any of these circumstances apply: You have diabetes You are a smoker over the age of 35 You have hypertension (high blood pressure) You have had major surgery followed by a period of prolonged immobilization You have a history of heart disease You have had a stroke A Word From Verywell Managing PCOS can be a tricky business, especially since it is linked to a number of other symptoms, including obesity and high glucose levels. It may take time to find a hormonal solution but, if you remain committed to your treatment and candid in your interactions with your doctor, you will be more likely to find the therapy that is right for you. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Yildiz BO. Approach to the patient: contraception in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2015;100(3):794-802. doi:10.1210/jc.2014-3196 NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development. What are the different types of contraception. Updated January 31, 2017. Zimmerman Y, Eijkemans MJ, Coelingh bennink HJ, Blankenstein MA, Fauser BC. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(1):76-105. doi:10.1093/humupd/dmt038 PCOS Society (India). Consensus statement on the use of oral contraceptive pills in polycystic ovarian syndrome women in India. J Hum Reprod Sci. 2018;11(2):96‐118. doi:10.4103/jhrs.JHRS_72_18