PCOS and birth control pill: Your questions answered

Worried about hormonal birth control pills causing polycystic ovarian syndrome (PCOS)? Here is an article that answers your questions about PCOS and birth control pills.

Picture of a Black woman with long hair on a white robe taking a pill

Key takeaways:

  • Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects women of reproductive age.
  • The cause of PCOS is not fully understood. Health experts believe a combination of genetic and environmental factors can cause it.
  • Birth control pills cannot cause polycystic ovarian syndrome (PCOS). Instead, birth control pills are used to treat symptoms associated with PCOS.

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects people with ovaries who are in their reproductive years. PCOS isn't life-threatening but can cause hormonal imbalance, enlarged ovaries containing multiple small cysts, and other symptoms that can affect a woman's reproductive health.

Do birth control pills cause PCOS?

Birth control pills do not cause polycystic ovary syndrome (PCOS). Contrary to this misconception, birth control pills are prescribed as a treatment for PCOS and its symptoms.

The exact cause of PCOS is not known, but health professionals believe it is caused by genes and environmental factors. Also, research shows that adult females with a family history of PCOS,  type 2 diabetes, obesity, and those who are inactive are at higher risk of developing the condition.

Hormonal birth control pills can help with PCOS-related issues, such as regulating periods, reducing acne, and managing excess hair growth (hirsutism) by lowering androgen levels.

These pills contain hormones (usually a combination of estrogen and progestin or progestin only) that help regulate the menstrual cycle and suppress ovulation; this helps reduce some of the symptoms of PCOS.

What is post-pill PCOS? Is it a medical condition?

No, post-pill PCOS is not a medical condition. Post-pill PCOS is also known as pill-induced PCOS. This is a term used when a person develops the symptoms associated with polycystic ovary syndrome (PCOS) after they have stopped using hormonal birth control pills. 

Taking birth control pills helps regulate your menstrual cycles and hormone levels. And when you suddenly stop taking the pills, you may experience fluctuations in your hormonal levels, which can also cause PCOS-typical symptoms.

Notably, experiencing such symptoms after stopping your birth control pills doesn’t mean you have PCOS. Some people who have PCOS and are on pills may not discover they have PCOS until they stop taking pills; this doesn't mean the pills caused the PCOS.

It is also important to note that post-pill PCOS is not a recognized medical diagnosis.

Can birth control help treat PCOS?

Hormonal birth control can be an effective treatment option for managing the symptoms of PCOS, but it does not cure the condition itself.3

Birth control pills can help address some of these symptoms and provide specific relief for women with PCOS by:

  1. Regulating menstrual cycles: Birth control pills can help regulate menstrual cycles in those with PCOS, making periods more predictable and reducing the risk of endometrial hyperplasia (a condition that can lead to uterine cancer).
  2. Reducing in androgen levels: Some birth control pills contain anti-androgenic effects (they work by blocking the effect of androgen, which is known as the male hormone). This can help reduce the symptoms associated with high androgen levels in those with PCOS, such as acne and excess facial or body hair.
  3. Decreasing the risk of ovarian cysts: Hormonal birth control pills can help suppress the development of ovarian cysts in some cases, although the pills may not eliminate them entirely.
  4. Improving hormonal balance: Hormonal birth control pills can also help balance hormone levels in women with PCOS, although they may not address the underlying hormonal imbalance.

Some people with PCOS may also benefit from other treatments and lifestyle changes, such as dietary changes, exercise, and weight management.5

It's important to note that while hormonal birth control pills can be a helpful treatment option for managing PCOS symptoms, it doesn't address the root causes of PCOS. Therefore, it is not a cure for the condition. 

Which birth control is best for PCOS?

The choice of birth control for people with PCOS depends on their specific symptoms, lifestyle, and reproductive goals.6 It's essential to consult with a doctor who can tailor the treatment to your needs. 

Here are two common birth control options that your doctor may suggest for managing your PCOS:

  1. Combination Birth Control Pill: This contains both estrogen and progestin and is often prescribed to regulate the menstrual cycle, reduce androgen levels (male hormones), and manage symptoms such as acne, and hirsutism (excess hair growth) associated with PCOS.
  2. Progestin-Only Pill: This is also known as a mini-pill. It contains only progestin and can be an option for females who cannot tolerate estrogen. While they may not control your menstrual cycle, as well as combination pills, they can help with birth control and PCOS symptom management.

Other medications for managing PCOS

Here are other medications that doctors may be prescribe to help manage PCOS:

  • Anti-Androgen Medications: Medications such as spironolactone and flutamide can help reduce symptoms related to excess androgen production, including acne and hirsutism (excessive hair growth).
  • Metformin: This medication is commonly used to treat insulin resistance and can help regulate blood sugar levels in people with PCOS. It may also help with weight management and ovulation.
  • Clomiphene: Doctors often prescribe Clomiphene citrate to induce ovulation in people with PCOS who are trying to get pregnant. It makes the ovaries release eggs.
  • Letrozole: Another medication used to induce ovulation in people with PCOS is letrozole. It may be an alternative to clomiphene in some cases.
  • Gonadotropins: In cases where clomiphene or letrozole are not effective, doctors may use gonadotropin injections to stimulate ovulation.
  • Progesterone: Progesterone therapy, often in the form of oral medication or a hormonal intrauterine device (IUD), can be used to induce regular periods and manage abnormal uterine bleeding in people with PCOS.
  • Weight Loss Medications: In cases where weight management is a primary concern, healthcare professionals may consider medications like orlistat or a bariatric surgery.

Additionally, some people with PCOS may require a combination of these medications to address their specific symptoms and fertility goals.

Does birth control pill cause weight gain in people with PCOS?

Weight gain is a concern for many people, including those with polycystic ovarian syndrome (PCOS). 

A study shows that some healthcare professionals and people who use birth control pills have observed an increase in body weight while managing certain PCOS symptoms.

It's important to note that the effect of birth control pills on weight can vary from person to person, and while some people may experience weight gain when on the pill, others may not. 

Also, for people who gain weight, the increase in weight is often minimal and can often be managed with a healthy diet and regular exercise.

Can birth control pills delay period?

Yes, birth control pills can delay a period. Here's how it works:

  • Combination birth control pills, which contain both estrogen and progestin hormones, can be used to delay a period. To delay your period while on the pill, skip taking the inactive pill at the end of a 21-day pack, and start a new pack immediately.
  • You can also use the progestin-only birth control pills to delay your period. Like combination pills, you can skip the inactive pills and start a new sachet immediately.

Some birth control pills are designed for extended cycle use, which means they are designed to reduce the frequency of periods to as little as four times a year. Examples include Lybrel and Seasonale.

Research shows there is little or no risk associated with delaying your period. However, you may notice breakthrough bleeding (i.e., bleeding or spotting between periods). This is common in people using hormonal birth control pills and may not be applicable to everyone.

It's important to note that not all birth control pills are suitable for period delay, and users should discuss the ideal birth control option with their healthcare team. The healthcare professionals will provide guidance on how to safely and effectively use birth control pills to delay your period.

When to seek medical attention

It's important to see a doctor if you experience any of the symptoms commonly associated with PCOS, such as: 

  • Acne
  • Fatigue
  • Weight gain
  • Thinning of hair
  • Infrequent or absent ovulation
  • Prolonged menstrual cycles
  • Increase hair growth on the face, chest, and back.

Seeing a doctor is particularly important if these symptoms occur simultaneously, persist, or interrupt your daily life.

Also, if you are using hormonal birth control pills, you should speak with a doctor if you notice something abnormal while taking the pills or when you stop taking them.

Early diagnosis and management of polycystic ovarian syndrome (PCOS) can help prevent long-term complications like infertility, diabetes, and heart disease.

Wrap up

PCOS is a hormonal disorder that occurs in women of reproductive age. Clinicians are not sure of the exact cause, but there is no scientific evidence that shows that birth control pills cause this condition.

Instead, hormonal birth control pills are used to manage the symptoms of PCOS by controlling hormonal levels, regulating periods, and treating acne and excessive hair growth.

If you suspect you have PCOS or are concerned about its development, consult with a doctor for a proper diagnosis and treatment.