How Do Birth Control Pills Impact PCOS? Endocrinologists Weigh In

Photo: Getty Images / Cris Cantón
If you've dealt with symptoms like irregular periods, heavy bleeding, baldness, acne, facial hair growth, or fertility issues, you've probably heard of polycystic ovary syndrome (PCOS), a hormonal disorder that is particularly challenging to diagnose.

The condition affects around 5 million women of reproductive age, but the exact cause isn't known. However, overproduction of male sex hormones, called androgens, may play a part. The Mayo Clinic suggests that if you're dealing with at least two symptoms—irregular periods, high androgen levels, or polycystic ovaries—PCOS might be the culprit.

Experts In This Article
  • Cary L. Dicken, MD, FACOG, Cary L. Dicken, MD, FACOG, is a reproductive endocrinologist and infertility specialist with RMA Long Island IVF.
  • Ilana Ressler, MD, Ilana Ressler, MD, is a reproductive endocrinologist at Illume Fertility who’s board-certified in both obstetrics and gynecology and in reproductive endocrinology and infertility.

Many people with PCOS don't receive a diagnosis until a few months after they stop hormonal birth control. As a result, there’s a lot of internet speculation about whether birth control pills cause PCOS. To answer your questions and clear up misconceptions, we asked experts to weigh in.

Do birth control pills cause PCOS

The short answer: You don’t need to worry. “Birth control pills do not cause PCOS,” says Cary L. Dicken, MD, FACOG, a reproductive endocrinologist and infertility specialist with RMA Long Island IVF. “Birth control pills are actually an appropriate treatment for many women with PCOS.”

Even though pill-induced PCOS isn’t a thing, Dr. Dicken says that young people are often prescribed birth control for various reasons, and upon stopping the pill later in life, do not resume a regular monthly period. “A work-up at that time may give a PCOS diagnosis, but being on the pill did not cause the PCOS—it was there all along and was unknowingly being treated by the birth control pill.”

Hormonal birth control pills have estrogen and progesterone that regulate menstrual cycles and help you avoid PCOS symptoms. “These hormones help to regulate cycles and decrease the action of the androgen hormones (e.g. testosterone, DHEAS), which are the culprits causing the acne and hirsutism, thereby improving these symptoms as well,” explains Ilana Ressler, MD, a reproductive endocrinologist at Illume Fertility who’s board-certified in both obstetrics and gynecology and in reproductive endocrinology and infertility. (Hirsutism is hair growth on the face, back, and chest.)

How to treat your symptoms

Regardless of what caused your PCOS symptoms, dealing with them is tough—and you have options.

Going on birth control can help in many ways, according to Dr. Dicken, and is a treatment many people have chosen. But birth control may not be for you, and that’s OK, too. “In that case, ovulation induction with medications like Clomiphene Citrate and Letrozole are often used,” she says. You can get them with a doctor’s prescription.

Dr. Ressler agrees birth control is usually the first line of treatment, and lifestyle modifications can also help. Try to exercise consistently (to the extent it’s doable and healthy for you and your body) and incorporate multiple food groups. Some specific PCOS-friendly foods are high-fiber fruits and veggies, fish, chickpeas, eggs, dark chocolate, and tea. Meditation, vitamin B8, and vitamin D can also help your symptoms.

“If you are experiencing PCOS symptoms or are unsure if you have it, please see a reproductive endocrinologist, who is a specialist in PCOS,” Dr. Ressler says. “While there is no cure, the symptoms can be successfully managed so that you can live a healthy, symptom-free life.”

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