What Is the Best Birth Control Pill for PCOS and Hirsutism?
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic Ovary Syndrome (PCOS) is the most common cause of Hirsutism in women of reproductive age. 70 – 80% of women with PCOS have Hirsutism. PCOS is a chronic hormonal condition, and women affected by PCOS have symptoms such as weight gain, obesity, irregular menstruation, subfertility, acne, anxiety and depression along with hirsutism.
What are the Treatment Options for PCOS and Hirsutism?
If a woman is affected by PCOS and Hirsutism, there are a number of treatments available according to the Treatment Guidelines:
- Using oral contraceptives
- Using anti-androgens such as spironolactone
- Hair removal options such as laser hair removal and electrolysis, which are specialized and costly treatment procedures
- Using creams which reduce new hair growth (Eflornithine)
What your doctor might suggest depends on you and your body. Make sure to share all the symptoms that bother you. It sometimes help to create a list with all the symptoms before you go in for your doctor’s appointment, so you can remember everything. And if you’re taking any supplements or other medications, make sure to mention them too during your appointment.
How do Birth Control Pills Work for PCOS and Hirsutism?
Oral contraceptive pills are the first line treatment for women with hirsutism who don’t want to become pregnant while on treatment. Most birth control pills contain the hormones estrogen and progestin, which will act as anti-androgens. Oral contraceptives should be continued for at least 6 months. The possible side effects include headache, mood changes, nausea, vomiting, dizziness and stomach disturbances. Let your doctor know if you experience any side effects. It is your responsibility to be compliant to treatment for proper control of symptoms.
Birth control pills can lower androgen levels through a number of mechanism, such as:
- Lowering the secretion of Luteinizing Hormone (LH) in the pituitary gland. LH encourages the ovaries to produce androgens, and if there are lower levels of LH, less androgens are produced
- Stimulating the liver to produce more sex hormone-binding globulins (SHBG), which binds hormones such as testosterone in the blood. If testosterone is bound, it is not active anymore and therefore has no effect on the cells
- Slightly reducing the secretion of androgens in the adrenal glands, and the binding of androgens to the receptors
- Increasing the clearance of testosterone by the liver
If there are lower levels of androgens in your blood, the excess hair growth caused by excess levels of androgens are likely to get reduced.
Which is the Best Birth Control Pill for PCOS and Hirsutism?
For most women, there is not one specific preference for one birth control pill over the other according to the guidelines. Your doctor will discuss your options with you based on your body, health status and risk factors you may have. It’s important to make sure you take your birth control pill regularly and long-term, as it may take time until you can see an improvement of your symptoms. If you are experiencing side effects or have any questions or concerns. make sure to get in touch with your doctor and healthcare team to discuss them, and find a solution.
While using hormonal contraceptives you have an active role to play in maintaining your weight by diet and regular exercise. It’s also a good idea to work with a nutritionist to develop an ideal meal plan with balanced nutrients, to further boost your health.