Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder that impacts women in their reproductive years. Onset typically occurs in adolescence, with symptoms that may vary over time.
PCOS can lead to hormonal irregularities, irregular menstrual cycles, elevated androgen levels and ovarian cysts. Menstrual irregularities, often accompanied by anovulation, can hinder fertility.
PCOS is a primary contributor to infertility. While PCOS is a lifelong condition with no cure, certain symptoms can be managed through lifestyle modifications, medications, and fertility interventions.
The exact cause of PCOS remains unknown but individuals with a family history or type 2 diabetes are at a heightened risk.
PCOS is a major concern in public health and is a prevalent hormonal disorder that impacts women in their reproductive years. It is estimated that around 8-13 percent of women in this age group are affected by this condition, with a significant number of cases going undiagnosed, reaching up to 70 percent.
Certain ethnicities have a higher prevalence of PCOS, and these groups often face additional complications, especially related to metabolic issues. The effects of PCOS, both biological and psychological, particularly in terms of obesity, body image and infertility, can give rise to mental health difficulties and societal discrimination.
Hormonal contraceptives are frequently utilised in the management of polycystic ovary syndrome (PCOS). While their contraceptive properties are beneficial for those who do not desire pregnancy, these medications can also address imbalanced hormone levels that contribute to PCOS symptoms like acne and excessive hair growth.
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However, determining the most suitable contraceptive can be a daunting task. There may also be specific reasons why one medication is suitable for you while another is not — or why none are suitable at all.
Lets find out how birth control can alleviate PCOS symptoms and why combined hormonal contraceptives containing estrogen and progestin are often the preferred choice.
Birth control serves three main purposes in the treatment of PCOS
- Excessive levels of male hormone (androgen), especially testosterone, in the blood can be effectively reduced with the aid of this treatment. This, in turn, can help alleviate or prevent symptoms associated with acne, male pattern baldness (androgenic alopecia), and unwanted facial and body hair growth (hirsutism).
- It safeguards the uterus through the maintenance of consistent ovulation. Irregular ovulation can lead to the accumulation of uterine tissue, known as endometrial hyperplasia, thereby raising the likelihood of uterine cancer. In a combined contraceptive, progestin counteracts estrogen to inhibit hyperplasia, which involves the excessive growth of cells.
- It provides protection against unplanned pregnancy for individuals with irregular ovulation patterns.
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Combined hormonal contraceptives, which consist of both estrogen and progestin, are widely regarded as the primary treatment for individuals experiencing irregular periods or elevated androgen levels due to PCOS.
Various options are available, such as oral contraceptives (commonly known as “the pill”), a transdermal patch, or an intravaginal ring. Given the limited number of high quality studies comparing different types of combined oral contraceptives for PCOS, the decision on the most suitable option largely rests with you and your healthcare provider.
There exist various types of hormonal oral contraceptives, each exhibiting distinct mechanisms and composition. These contraceptives can be categorised as follows:
- Monophasic: These contraceptives maintain a consistent level of hormones throughout the cycle.
- Biphasic: In this type, the level of progestin increases halfway through the cycle while the level of estrogen remains constant.
- Triphasic: Contraceptives of this nature involve three different doses of progestin and estrogen, which change approximately every seven days.
Side effects of taking birth control pills
Some women may experience changes in their menstrual cycle when taking birth control pills, such as a decrease in monthly bleeding or irregular spotting.
Typically, these irregularities will resolve after a few menstrual cycles. Weight gain is a common concern for many women considering the pill but with the low-dose options available today, this is generally not an issue.
While some women may experience side effects like nausea, breast tenderness, or bloating when starting the contraceptive pill, these symptoms usually subside within a few months. Overall, birth control pills are considered safe and effective. Although there is a slight increase in the risk of blood clots in the legs or lungs, this is rare in young, healthy non-smoking women. However, the risk is higher for obese individuals and older women.
Who should you avoid using birth control for PCOS
Using birth control as a treatment for PCOS can pose risks if you have specific medical conditions or lifestyle factors. Your healthcare provider may refrain from prescribing birth control if any of the following circumstances apply to you:
- If you have diabetes.
- If you are a smoker over the age of 35.
- If you have hypertension (high blood pressure).
- If you have undergone major surgery followed by an extended period of immobilization.
- If you have a history of heart disease.
- If you have experienced a stroke.
A healthcare professional might suggest weight loss by following a low-calorie diet along with engaging in moderate exercise routines. Shedding even a small amount of weight, such as 5 percent of your body weight, could potentially enhance your overall health.
Weight loss has the potential to boost the efficacy of medications prescribed for PCOS by your provider and it may also aid in addressing infertility concerns. Collaborate with your healthcare provider and a registered dietitian to devise an optimal weight-loss strategy.
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