The pill for PCOS - Is it helpful?

The reason the pill (combination oral contraceptive) is prescribed is because it essentially shuts off the communication from the brain to the ovaries preventing ovulation, which stops the ovaries from producing hormones like Estrogen and Progesterone. The pill contains synthetic versions of these hormones.

You may have been told that the pill regulates your menstrual cycle, this is inaccurate, let me explain why. Well, if the pill shuts off your hormones and ovulation, there is no menstrual cycle, there is only a bleed that follows a drop in synthetic hormones.

So now that we know how the pill works, let's see the pros and cons of taking the pill for PCOS:

Pros

It can regulate a bleed (not a period).

It can lower androgens (not regulate hormones).

It can lighten bleeds.

Cons

It can further worsen insulin resistance, which is a key driver of PCOS.

Some pills can be 'androgenic', take a look here for more information on this.

It does not prevent risk factors such as diabetes.

It does not regulate your menstrual cycle.

It has been linked to depression.

A study found "Side effects of combination oral contraceptive pills (COCP) such as weight gain, mood changes, and adverse effects on cardiometabolic risk factors may at times exacerbate the problems in PCOS women. Thus, before initiating treatment with OCPs, thorough counselling is essential and this should be backed up by stringent monitoring at every follow-up visit"

If you would rather not take the pill, you can ask your doctor to investigate what is causing irregular ovulation, which can be things such as:

Insulin resistance

Elevated prolactin

Stress

Inflammation

Rapid LH pulsatility

Hypothalamic amenorrhea

Hypothyroidism

Whether of not you feel the pill is right for you is your own choice. But it's always good to have as much information as possible to make an informed decision.

Ailish 🌻