Can birth control fix my PCOS?

Dealing with polycystic ovary syndrome (PCOS) can sometimes feel like you’re navigating a maze with no clear way out. When symptoms like irregular periods, acne, and unwanted hair growth pile up, it’s natural to look for solutions. Birth control is often suggested as a way to manage these symptoms, but can it really fix PCOS? Let’s dive into what birth control can—and can’t—do when it comes to managing this condition.

If you have PCOS and want to talk through your birth control options with a supportive and knowledgeable provider, Hey Jane offers 100+ birth control options including the pill, the patch, the shot, and non-hormonal methods. Fill out our quick intake form to get compassionate and personalized recommendations from our clinicians without having to leave home.

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What is PCOS?

Polycystic ovary syndrome, or PCOS, is a common hormonal disorder that occurs when the ovaries produce excess hormones. It affects about 8-13 percent of people assigned female at birth (AFAB) worldwide. However, PCOS is more common than you might think, and a lot of people don’t even realize they have it until they start experiencing symptoms. While many people self-diagnose after a quick Google search, getting a professional diagnosis is vital for managing the condition effectively.

The most common symptoms of PCOS include:

• Irregular, light, very heavy, or missed periods
• Bleeding but no ovulation 
• Infertility 
• Excessive hair growth—typically on the face, belly, chest, upper thighs, or back
• Oily skin
• Late-onset, severe, or persistent acne that doesn’t respond well to usual treatments
• Weight gain, or trouble losing weight, particularly around the abdomen

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How does birth control help PCOS symptoms?

Birth control is often recommended as a first-line treatment for PCOS symptoms. Birth control pills, in particular, contain synthetic hormones that prevent ovulation, regulate menstrual cycles, and reduce the production of androgens (sex hormones that can be attributed to masculine reproductive tissues) that are typically elevated in people with PCOS. Some combined (estrogen and progesterone) methods can help keep those androgens in check a bit, but the primary use of birth control for PCOS patients is to help establish a regular bleeding cycle.

The reason this is so important is to protect your uterus. When you have PCOS and do not have regular menstrual bleeding, the lining of the uterus doesn't shed the way it is supposed to, and it can cause endometrial hyperplasia, a precancerous condition. One of the ways that birth control works is by keeping the lining of the uterus thin so it does not need to shed in the same way and does not build up and add to a risk of cancer. In fact, it can reduce your risk of cancer in your uterus and ovaries!

While birth control can be a game changer for many symptoms, it’s not a cure-all. It won’t directly address issues like insulin resistance–in fact, it may worsen it. Plus, once you stop taking it, the symptoms often return.

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Potential side effects of birth control

It’s also worth noting that birth control isn’t a one-size-fits-all solution. Some people may experience side effects like sore breasts, nausea, spotting or bleeding between periods, or headaches. Others might find that certain types of birth control don’t relieve pre-menstrual symptoms, pelvic pain, blood pressure fluctuations, excessive body hair, insulin resistance, or weight gain. In fact, some methods can make certain PCOS symptoms like acne, excessive hair growth, and irregular periods worse.

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Best birth control options for PCOS symptoms

Hormonal birth control options are usually the go-to for managing PCOS symptoms because they help regulate hormones, control symptoms effectively, and encourage regular menstruation. Here’s a look at the two types of hormonal birth control a health care provider may recommend for treating your PCOS:

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Combination birth control pills and PCOS

These pills contain both estrogen and progestin, making them a popular choice for people with PCOS. They help reduce androgen levels, regulate menstrual bleeding, clear up acne, and reduce excessive hair growth. Some popular brands include Ortho Tri-Cyclen, Yaz, and Estrostep. 

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IUDs and PCOS

Hormonal intrauterine devices (IUDs), like Mirena and Kyleena, may also help manage PCOS symptoms. According to research, hormonal IUDs release a small amount of progestin, which can help reduce the severity of periods and manage endometriosis and pelvic pain. Despite their benefits, IUDs may not be as effective in controlling all PCOS symptoms as they contain levonorgestrel—a hormone with androgenic effects that can make acne or hair growth worse.

If taking a daily pill isn’t your thing, the ring (Annovera and NuvaRing) or patch (Xulane and Twirla) could be great alternatives. They work similarly to combination pills but offer a bit more flexibility in terms of how often you need to think about your birth control.

Birth control options to avoid if you have PCOS 

While hormonal birth control may be beneficial for managing PCOS symptoms, some options might not be ideal. Progestin-only pills may not be the best choice for PCOS because they can sometimes increase androgenic effects, potentially worsening symptoms like acne and excessive hair growth. Methods that contain levonorgestrel (including some pills, implants, and hormonal IUDs) can also result in these side effects.

Also, certain forms of birth control, like the Depo-Provera shot, may lead to weight gain or other side effects that aren’t ideal. 

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Can you take Plan B if you have PCOS?

If you have PCOS and find yourself in need of emergency contraception, it’s essential to know your options. There are three primary options: Plan B, Ella, and the copper IUD.

Below are some considerations for using emergency contraception while managing PCOS:

• Plan B is generally safe for PCOS because it is a one-time dose taken within 72 hours of unprotected sex, but it may be less effective if you weigh over 165 pounds. While taking levonorgestrel (the primary hormone in Plan B) long term can worsen certain PCOS symptoms, taking a single dose of Plan B when you need to should not impact your symptoms. 
• Ella is another option that might be more effective for PCOS, especially if taken within 120 hours after unprotected sex. However, like Plan B, Ella may be ineffective if you weigh over 195 pounds.
• A copper IUD (Paragard) can be inserted as emergency contraception within five days of unprotected sex and offers long-term birth control afterward. But this type of IUD is non-hormonal, so it won’t help manage PCOS symptoms.

So, can birth control fix PCOS? Not quite. But it might help manage symptoms and make life with PCOS a lot more bearable and protect your uterus from possible precancerous issues . If you’re seeking birth control that can help with PCOS symptoms, you can speak with your health care provider to discuss the best birth control methods for you or connect with a compassionate provider at Hey Jane who can guide you through different options to try based on your medical history, lifestyle, and personal preferences.