What’s the Best Birth Control for People with PCOS?

Polycystic ovary syndrome (PCOS) is a common endocrine disorder occurring in 6 to 12 percent of people with ovaries in the United States, according to the Centers for Disease Control and Prevention (CDC).

Generally, people with PCOS experience at least two of these conditions:

• Hyperandrogenism: when the ovaries produce excess androgens (hormones that contribute to growth and reproduction in men and women)
• Ovulatory dysfunction: when the ovaries stop releasing eggs as often as they should
• Polycystic ovaries: when the ovaries become enlarged with multiple small cysts

Additionally, people with PCOS may also experience some of these symptoms:

• hormonal imbalance
• bloating
• cramps
• acne
• pelvic pain
• weight gain
• excess hair growth on the face and body
• irregular periods
• lack of ovulation

So far, there is no cure for PCOS. However, people who have this condition may be able to manage some of their symptoms with hormonal birth control.

Keep reading to learn which forms of hormonal birth control may be useful for you.

What is PCOS?

PCOS is a hormonal condition that occurs during childbearing years (usually ages 15 to 44) among people who have a vagina. It essentially means that cysts (partially formed follicles) grow on the ovaries, which contain eggs.

The follicles contain immature eggs, but they never mature enough to trigger ovulation. The lack of ovulation alters levels of female hormones:

• estrogen
• progesterone
• follicle-stimulating hormone (FSL)
• luteinizing hormone (LH)

Progesterone levels are lower than usual, while androgen levels are higher than usual.

People with PCOS commonly have high levels of insulin that may not work effectively, male hormones known as androgens, or both. Some women also experience insulin resistance as a result.

In some cases, the following factors may play a role:

• family history
• genetics
• hormones
• lifestyle

Additionally, some people may have polycystic ovaries, but not PCOS.

Common symptoms of PCOS include:

• irregular periods
• heavy bleeding
• hair growth on the face and body
• acne
• weight gain
• male pattern baldness on the scalp
• darkening of the skin
• headaches

How birth control can help PCOS

Hormonal birth control has been described as a “first-line medical treatment” for managing PCOS.

People with PCOS who do not have immediate plans to get pregnant may benefit from using forms of birth control, like:

• the pill
• the vaginal ring
• the patch
• hormonal intrauterine devices (IUDs)

These forms of birth control have been found to help with symptoms of PCOS.

Hormonal birth control, specifically those with estrogen and progestin (two synthetic female hormones), can:

• lower the production of male sex hormones, thus helping managing acne, excessive facial and body hair, baldness, and other symptoms associated with high androgen levels
• regulate the menstrual cycle
• reduce a person’s risk of ovarian cancer and endometrial cancer — a condition that is 2.7 times more likely to develop in people with PCOS — by close to 30% than people who don’t use it

Best birth control for PCOS

Oral contraceptives

Oral contraceptives are the most common and effective option for managing PCOS symptoms. They may be combination pills, having both progestin and estrogen or progestin-only pills.

The hormones in oral contraceptives may help:

• regulate menstrual flow
• manage hyperandrogenism symptoms like acne and extra hair growth
• reduce a person’s risk of developing ovarian cancer and endometrial cancer

People who use oral contraceptives may also experience other positive health outcomes like:

• a lighter menstrual flow
• decreased dysmenorrhea and anemia
• a lower risk of ectopic pregnancies
• a reduced risk of pelvic inflammatory symptoms
• infrequent menstrual migraines
• reduced premenstrual syndrome (PMS) symptoms
• a decreased risk of osteoporosis

Aside from these benefits, oral contraceptives have an above 99 percent efficacy rate of preventing unplanned pregnancies when taken correctly.

Some common side effects of using oral contraceptives include:

• nausea
• mood changes
• breast tenderness
• headache
• spotting
• bloating
• abnormal uterine bleeding
• possible weight gain or loss
• a mild rise in blood pressure in some oral contraceptive combinations

It’s important to note that research suggests that oral contraceptives may contribute to severe PCOS symptoms and increase the risk of obesity, type 2 diabetes, heart diseases, and blood clotting.

Therefore, it’s suggested that oral contraceptives should only be recommended as an alternative treatment option for PCOS to high risk groups like those at risk for chronic diseases, older adults, or people who have diabetes or hypertension.

Still, experts also note, based on available research, the benefits of using oral contraceptives outweigh its risks.

Skin patch

The patch contains estrogen and progestin and is an effective and convenient birth control method for managing PCOS symptoms.

This long-acting reversible contraceptive is a thin plastic patch that releases about 150 micrograms (mcg) of progestin and 35 mcg of estrogen into the body through the skin.

You may apply the patch on the:

• buttocks
• upper body
• stomach

Try not to wear the patch on:

• your breast
• irritated skin areas
• where your clothing might disturb it

You need to wear the patch on the same area for 21 days, remove it for seven days (this should be when you get your period), and then replace it with a new patch.

Like the pill, the patch can help with:

• ovulation
• period regulation
• reducing bloating and cramps
• reducing acne
• reducing excess hair growth
• lowering your cancer risk

The patch produces the same side effects as oral contraceptives. However, there may be a bit more breast tenderness and potential reaction on the part of the body you wear it on.

Vaginal ring

The vaginal ring is a soft, flexible, transparent plastic ring that you insert into your vagina. This method is another long-acting reversible contraceptive that helps treat PCOS symptoms.

Like the patch, it also contains estrogen and progestin and is worn for 3 weeks, removed for a week for menstrual flow, and reinserted after.

The vaginal ring shares the same benefits and side effects as the skin patch. The ring releases 15 mcg of estrogen and 120 mcg of progestin into the body through the vagina.

According to the NuvaRing website, people who smoke and are over 35 years old should not use the vaginal ring. Smoking and using hormonal contraceptives may increase their risk of heart and blood vessel conditions.

The manufacturers also recommend that people with a history of blood clotting and high blood pressure should consider avoiding this form of hormonal birth control.

Severe side effects include:

• blood clots
• allergic reaction
• high blood pressure
• toxic shock syndrome
• liver problems
• gallbladder problems

Progestin-containing intrauterine device (IUD)

Up to 14 percent of people with ovaries use intrauterine devices (IUD) that may contain progestin or nonhormonal copper.

IUDs containing progestin are a highly effective form of birth control that can help ease PCOS symptoms in the same way combination or progestin-only pills do.

IUDs are small T-shaped plastic devices that release progestin into the body each day. This device is inserted into the uterus and can remain there for 3 to 6 years, according to the CDC.

Potential side effects of using progestin-containing intrauterine devices include:

• headaches
• nausea
• hair loss
• mood changes
• low sex drive
• irregular periods
• missing periods

How to choose

If you have PCOS, talk with a doctor about the best treatment option for you.

Research suggests that some of the side effects of oral contraceptives like mood changes, weight gain, and increased risk of cardiometabolic diseases may contribute to the severity of PCOS symptoms.

For this reason, consider speaking with a doctor first who may evaluate your medical history for risk factors like:

• older age
• smoking habits
• obesity
• high blood pressure
• stroke
• diabetes
• blood clotting

After this evaluation, your doctor may recommend hormonal birth control or other treatment options for PCOS as appropriate.

When you work through your options, remember to consider:

• Ease of use. If you’re looking for something that requires minimal thinking about your contraception, you may consider the ring, patch, or IUD. However, an oral contraceptive might be your best bet if you want something easy.
• Side effects. Most hormonal birth control options share similar side effects. Still, your doctor may be able to recommend one over another to cater to any concerns. It may take a few different options before you find the right one for your body and lifestyle.
• Cost. If you have insurance, try to check in with your insurance company to determine whether any birth control methods are covered and what your out-of-pocket costs may be. You may also speak with a doctor about patient assistance programs if you’re uninsured.

Where to get birth control for PCOS

SimpleHealth

SimpleHealth is a telehealth provider of birth control.

Here’s how SimpleHealth works:

1. Book an online consultation to talk through your medical history.
2. Wait for a doctor licensed in your state to review your application and give you a prescription.
3. Receive your delivery at no additional cost.
4. Receive automatic refills after your first purchase.

They prescribe oral contraceptives pills, skin patches, and vaginal rings, all of which may help treat PCOS symptoms.

Their consultation fee is $20. You can become a part of their automatic refill program for $15 a month.

This consultation fee also covers continuous access to a doctor, a valuable service for people with PCOS who may benefit from regular check-ins.

Most health insurance companies may cover the entire cost of their service.

Pandia Health

Pandia Health is an online birth control provider that offers simple and convenient access to birth control.

To use their services:

• You fill out an online health form on their website.
• A doctor reviews your order and prescribes the right birth control for you.
• You get a free delivery afterward.
• You also get automatic refills for a year.

Online registration costs $20 and gives you unlimited access to a specialist doctor who is available to answer any questions or concerns you may have.

A pack of contraceptive pills costs $15 out of pocket. Insurance companies may fully cover the cost.

They prescribe all brands of birth control, so people with PCOS can enjoy a broader selection of options when choosing birth control for managing their symptoms.

Nurx

Nurx is a birth control service provider that offers various contraceptive methods including oral contraceptive pills, vaginal rings, skin patches, the morning after pill, and the birth control shot.

To get birth control medication you can:

• Choose the medication you want or a medical expert can help you make a choice.
• Wait for a doctor within their network to review your order and write you a prescription.
• Receive your prescription via delivery directly to your home in discreet packaging at no extra cost.

They require you to pay an initial $15 fee which covers an online consultation with a doctor licensed in your state and unlimited access to a doctor for a year.

The contraceptive pill costs $15, the vaginal ring costs $150, and the skin patch costs $180. With health insurance, you can get these medications at no cost.

If you have PCOS, you may be able to get the right hormonal birth control for your needs and speak with a doctor from their team about any concerns you may have at any time.

Lemonaid

Lemonaid is another telehealth platform that prescribes and delivers birth control to your doorstep.

These are the steps you take to get birth control:

• You will need to answer some questions that may inquire about your medical history.
• A doctor or nurse will review them. You’ll receive your prescription within 24 hours.
• They’ll then deliver three packs of your birth control pill within 2 to 3 business days.
• You’ll automatically receive your birth control medication every 3 months.

Their consultation fee is $25, and it gives you year-long access to a healthcare professional. The birth control pill costs $15 a pack for any brand. Most health insurance plans will fully cover the cost of the service.

Lemonaid’s birth control service provides simple, stress-free, and cost-effective birth control options for people with PCOS to help treat their symptoms.

In-person doctor visit

You may also visit a doctor in person.

They may:

• request and review your health history
• recommend PCOS treatment options for you
• answer any concerns you may have about managing PCOS symptoms

Frequently asked questions

Can birth control help PCOS weight loss?

The general consensus is that birth control cannot directly help with PCOS weight loss. However, the right birth control pill can be part of a good treatment plan for managing PCOS.

There are other FDA-approved drugs that may help handle weight loss in combination with a healthy diet.

If PCOS is affecting your weight, talk with a doctor or other medical professional.

What is PCOS caused by?

To date, experts are yet to identify what causes PCOS. However, certain conditions may play a role, including insulin resistance and increased androgen levels.

Is there a cure for PCOS?

So far, there’s no cure for PCOS. A person with PCOS may use certain medications and adopt specific lifestyle recommendations for long-term management of their symptoms.

The Office on Women’s Health (OWH) provides these options for treating PCOS symptoms:

• Using hormonal birth control, which can regulate periods and reduce androgen production.
• Talking with your doctor about starting metformin, a medication that can reduce androgen and blood sugar levels. Taking metformin for PCOS is considered off-label drug use as the Food and Drug Administration (FDA) has not approved metformin for treating PCOS symptoms.
• Using anti-androgen medications that prevent androgens from affecting the body and in turn, managing PCOS symptoms associated with elevated androgen levels like baldness and acne.

Which brand of birth control is best for PCOS?

Experts recognize combination pills as a first-line and highly effective treatment for PCOS symptoms.

Some popular combination pill brand names include:

• Mircette
• Yaz
• ​​Estrostep
• Velivet
• Natazia
• Ortho-Novum
• Lybrel
• Estrostep Fe
• Yasmin
• TriNessa

Can birth control make PCOS worse?

In some cases, birth control may make PCOS symptoms worse. But this situation is more likely to occur if birth control is taken without first consulting with a doctor or the prescription is not followed exactly.

A 2019 study suggested that birth control may make PCOS worse and contribute to the development of chronic conditions such as obesity, type 2 diabetes, and heart diseases.

This situation makes it necessary for people with PCOS to speak with a doctor, who can and may review their health history, check for the presence of conditions that may put them at higher risk, and recommend the best treatment for them.

Takeaway

Although there currently isn’t a cure for PCOS, if you have this condition, you can use hormonal birth control to help manage your symptoms and enjoy other health benefits related to using it.

Consider speaking with a doctor either online or in-person before choosing a treatment option for managing your PCOS symptoms.