Using Birth Control to Treat PCOS

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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

birth control for PCOS
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 healthcare provider 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 healthcare provider 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 healthcare provider 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


Taking birth control to treat PCOS can be risky when combined with certain other conditions or lifestyle factors. Your healthcare provider 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 healthcare provider, you will be more likely to find the therapy that is right for you.

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4 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.
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  2. NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development. What are the different types of contraception.

  3. 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

  4. PCOS Society (India). Consensus statement on the use of oral contraceptive pills in polycystic ovarian syndrome women in IndiaJ Hum Reprod Sci. 2018;11(2):96‐118. doi:10.4103/jhrs.JHRS_72_18