5 Reasons the Pill May NOT be the Answer to PCOS - PCOS Diva
5 Reasons the Pill May NOT be the Answer to PCOS

the-pillI find it so frustrating that most doctors feel that the first line of defense against PCOS is the birth control pill.  Just the other day I went to the Endocrinologist for a thyroid check.  When the Dr. sat down and looked at my chart she saw that I had PCOS and asked if I was trying to conceive.  I explained that I have 3 children and am not.  So her next question was why I wasn’t taking oral contraceptives for my PCOS?

For years I was on the Pill to control my PCOS symptoms.  I admit,  it did  regulate my cycle and help lower testosterone levels but at what cost?  The pill was merely masking my symptoms and in turn, was making the underlying cause (insulin resistance) worse. I can also attest that I never felt well while taking it.  My hypoglycemia was out of control, I gained weight, had no sex drive.  I don’t want to discount the value of having a regular monthly cycle to help prevent uterine cancer, but  I now can regulate my cycles with diet, exercise and supplements and when I need a little help I use  natural progesterone cream.

If you are currently taking the Pill or are thinking about it, here are some risk factors to consider:

  1. Increased insulin resistance A 2006 study in the journal Fertility and Sterility showed that birth control pills may exacerbate insulin resistance.
  2. Increase risk of heart attack or stroke U.S.-Canadian study has found that even low-dose oral contraceptives appear to increase women’s risk of a heart attack or stroke. Dr. John Nestler and Dr. Paulina Essah of Virginia Commonwealth University and Dr. Jean-Patrice Baillargeon of the Universite de Sherbrooke  determined that women using low-dose contraceptives have approximately twice the risk of stroke or heart disease.Women with polycystic ovary syndrome or metabolic syndrome already have an increased risk of cardiovascular disease.
  3. The Pill lowers levels of valuable nutrients like B-vitamins, folic acid, Vitamin C and E, magnesium and zinc.  You need sufficient levels of zinc to maintain a healthy hormone balance.  Weight gain, fluid retention, mood changes, depression and even heart disease can all arise from nutrient imbalance.
  4. The Pill lowers libido Irwin Goldstein, Claudia Panzer and their colleagues at Boston University studied 125 young women who attended a sexual dysfunction clinic. Sixty-two of them were taking oral contraceptives, 40 had previously taken them and 23 had never taken them. The team measured levels of SHBG in the women every three months for a year, and found that in pill users they were seven times as high as in women who had never taken them. SHBG lowers libido.
  5. The Pill can kill off friendly bacteria in your gut which can lead to digestive problems and candida (yeast).  Estrogen, the major ingredient in the Pill, is known to promote the growth of yeast. Too much yeast causes sugar and carb cravings among many other problems.

It is important  to remember that there is no instant pill to make the PCOS symptoms go away.

If you want to come off the pill but still need a contraceptive, I highly recommend the Creighton Model Fertility Care System (CrM). It uses the science-based modality of NaPro Technology (NaPro), a women’s health science that evolved from interpreting the biomarkers of the menstrual and fertility cycle, mainly, all the stages of cervical mucus and the length and intensity of the menstrual flow.  For more info visit http://www.naprotechnology.com/index.html

(1) Mastorakos G et al, Effects of two forms of combined oral contraceptives on carbohydrate metabolism in adolescents with polycystic ovary syndrome, Fertil Steril. 2006 Feb;85(2):420-7

(2) Source: Baillargeon, JP et al, Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab. 2005 Jul;90(7):3863-70

(3) Nutrition and The Pill J Reprod Med. 1984 Jul;29(7 Suppl):547-50.

(4) New Scientist May 27 2005

Note: I am not a medical professional. You should always consult your doctor on your health care to find out what is right for you.

 


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  • I am currently on nuvaring which i was told was mild on the hormones and although i yo-yo because i’ve given up on my diet and exercise routines in the past, I’ve been able to lose weight before and right now on my current weight loss blogging adventure. i’d like to go off birth control when it’s possible too but i’m worried because the last time i went off for a month, my weight sprung up about 5-8 pounds. I guess I would have to ask a doctor but would you have any idea at what weight (BMI, whatever) it would be safe to go off nvaring– i mean, is there a point in weight loss when the cycle become at least somwhat normal? I vaguely remember a somewhat regular cycle when i was more active in high school about about 150-160 pounds (now i’m 183 and I’ve been all the way up to about 210 in my adult life).

    Anyways, great to find another blogging PCOSer! Is it all right if I link and follow you? My blog is http://pcos532.wordpress.com

    • Amy

      Thanks for your comment. As I state in my post I am not a medical professional. I can only say that I am now at a 21 BMI and I still need help with my cycles from time to time and I now use natural progesterone cream. I will post about it soon. I will tell you that I did experience hair loss after stopping the pill. Don’t be alarmed, it is just like post-partum and does come back. If you are taking spironolactone or even saw palmetto it may not be as much loss. The absolute best thing you can do for your PCOS is exercise and eat clean. Check out my posts about both. Thanks for linking to me. Keep up the good work with your weight loss!

  • Andrea Bijou

    I tried Yaz for about a year or two and it did regulate hormones/cycles. I was also on spironolactone which lowered my testosterone even more. I noticed the same type of symptoms on the pill as PCOSDiva. Libido was down, I was really dehydrated and sensitive to hot environments, and my blood sugar was completely out of control. I gained weight in my chest (not necessarily a bad thing) and had a great complexion, as well as less body/facial hair.

    Now I’m off of both of those because I just traded one set of symptoms for a different set and spironolactone blocks your good hormones too.

    I am only taking a small dose of progesterone morning and night, which helps hair loss, skin, and cycle pain. I’m exercising as much as I can and eating very well. I do give myself one cheat day a week. I’m also trying to detox from sugar by taking a fungal defend tincture.

    I still have major depression around my period and during, so I’m still searching for more helpful things.

    • Amy

      Thanks for sharing. I have found that SAM-e helps me with my mood. It increases seretonin and beta-endorphins which many of us with PCOS are low on. I am also finding that if I don’t eat gluten I emotionally feel more joyful/radiant if that makes sense. Read my post about food journalling. It has helped me identify the foods that effect my mood. I also just started acupuncture. The acupuncturist said that it is really helpful for depression because it releases endorphins. I just went for my first visit last week and really felt great afterwards. I am curious about the fungal defend tincture. I assume it is for candida?

  • Hi Amy¡¡
    i love your blog¡¡¡ i will put it in my blog list¡¡
    Regarding the pill only to tell you that i asked my gyn the other about this, as i was taking the pill during 16 years, i lowed down my weight till 59 kilos and one year after leaving the pill to go for babies i put 30 kilos more¡¡ my hair in the face was awful, you know…
    i told him that pill was not the best treatment then why they still prescribe it?? his answer was the following: “it is the easiest way..”¡¡¡ incredible¡¡¡ they do not advise you to go to an endo for having a good diet and exercise, they do not teach to have a healthy life because this takes more time to explain and follow¡¡ this is the real true¡¡ i do not say not take the pill as i took it, it could be ok when you are young but meanwhile you are taking it you have to prepare your body to the following steps…
    i had with the pill, lack of libido, and a bit of depresion…so now with a normal diet and a bit of exercise and taichi i feel great¡¡¡
    regards from sunny Spain¡¡¡

    • Amy

      Thanks for sharing your story. That is my whole point of this blog – to inform women that there is another way! Glad you found it!

      • Yes, of course there is another way, i took the pill during 16 years, and after that nothing, now my menses are very regular as i am now 46 years and i am now in my premenopause, i know a lot of Spanish ladies who do not want the pill, but doctors still prescribe it as the best way to control PCOS, it is important to remark that you can not be more than 3 month without your menses to prevent having an endometrial cancer, but with a good diet, exercise, some relaxation techniques, such yoga or taichi, or acupunture and reflexology can do the trick to regulate your body, if with this your menses do not return then you can try progesterone, natural or on cream.

  • Josie

    Hi Amy,

    I just wanted to thank you for your blog, which I stumbled upon, and for this article in particular.

    I am 24 years old and found out two weeks ago that I likely have PCOS, after bloodwork revealed that I have very elevated levels of free testosterone. I also have glucose levels on the high end of normal (although my doctor didn’t even mention this, I just noticed on the lab report), and abnormal hair growth on my chin and chest. My cycles have remained normal, despite these other symptoms.

    My doctor told me I have two choices: spironolactone or birth control. I have made huge strides physically in the past six months–losing 40+ lbs and becoming an avid runner/exerciser. I have a lot of reservations about using birth control, especially at a time when I feel like I’ve made such natural progress in my health. However, I don’t want jeopardize my longterm health by leaving my condition untreated.

    All this is to say how wonderful it was to find out through you that I do have a choice, and that there are other treatment options. I have felt so much pressure to pursue pharmaceutical intervention from my doctor and also from friends and family. I feel so empowered by the information you provide on this site. My journey with PCOS is just beginning, but I know this will be a resource I keep coming back to. Thank you for that!

    • Amy

      Josie-
      Great job taking control of your health. I would not go on the birth control pill. After a lot of agonizing over the decision to use spironolactone, I started in September. I had all of my symptoms under control except for hair loss which can be very hard to reverse. I am happy to say that the spiro has worked extremely well and I have had no side effects. Keep up the good work!
      -Amy

  • Cara

    What does the progesterone cream help with?

  • Christine

    Hi Amy,

    I just found your Facebook page and then found my way to your blog. I was diagnosed with PCOS in early 2006 and have been struggling with symptoms ever since (probably before, too, but I didn’t recognize it as clearly). I’ve been to several gynecologists whose only remedy was to throw different types of birth control pills at me – despite my protests that a) it didn’t work (in fact it made my cycle worse!) and b)I didn’t like the way it made me feel. My sister suggested Metformin, but I’m not entirely comfortable with that idea. I’ve scheduled an appointment to see a reproductive endocrinologist who I hope can help, but I have to say I am so thrilled to have found someone who is managing their PCOS in an alternative, healthy way. So thank you 🙂

  • lindsay

    Hi Amy!
    I’m excited that I found your website! I was just told yesterday that I have PCOS, but my doctor literally just told me that’s what I have and then said she’d give me some birth control and to come back in a couple months. I came home feeling very frustrated and a little scared because I’ve never heard of PCOS and didn’t have a clue what I was in for! My sister has the same issues so we are looking into what we can do but the information is so overwhelming! The main issue for me is learning what and how to eat. I have tried very hard to make changes to my diet because I am a mother and wife and want my whole family to eat healthy, but it turns out that some of the things I thought were healthy are terrible for PCOS. I am hopeful that I will find some great information on your site and just want to say thank you for the time you take to do this! Also, my doctor prescribed the generic version of yaz (yazmin) but I hate how birth control makes me feel. Is it a bad birth control to be on for hormones?

    • Amy

      Welcome to PCOS Diva Lindsay! I am not a fan of birth control. Do your own research of yaz. See what the risks are.

  • Megan

    Hi!

    I went to a specialist finally and the first thing he asked, “Are you trying to get pregnant” and I said not right now and he’s like why don’t we try birth control. I will not do it. It messes me up so bad. I’m so glad I read this thank you.

    One thing he did say was if you are trying to get pregnant spironolactone is a bad thing for the baby. So I am off of it because it hasn’t helped me. Thanks for writing this!

    Megan

  • Amanda

    Dear Amy,

    I would just like to start by saying that this is an insightful and refreshing post. As a student, I find myself bouncing between doctors as I travel from city to city in pursuit of (some kind of) education ;). As such, I have had the ‘pleasure’ of experiencing the expertise of many doctors. To this day, I have always been shocked about the extent to which all doctors have pushed the pill on me after learning that I have PCOS. Although I am a strong advocate and supporter for women to have a choice regarding these matters, I have never felt that this was an option for me.

    I understand that using the pill to regulate the menstrual cycle could have a positive correlation in the reduction of cancers and other feminine complications. However, these methods often bring about a spectrum of other sometimes dangerous and adverse side-effects. I personally do not believe that this trade-off is justified. For me, the pill has only caused more frequent menstruation (and really, who truly wants that?), breast tenderness, increased acne and skin disorders, and severe emotional, psychological, and temperamental disorders due to hormonal implications. After discussing these symptoms with the physicians, they are quick to perscribe another brand of the same junk. This has led to me to experiencing over 10 forms of birth control in my 20 year life, a fact that I find upsetting and controversial.

    Seeing work like yours that encourage critical thinking, research, and the consideration of alternatives is motivating. I believe that our bodies have a way of regulating themselves given the proper tools (in the form of diet, exercise, and more healthy lifestyle choices). In fact, I have taken my PCOS diagnosis as a motivator to improve the quality of my own life and to strive for internal well-being.

    I hope that other women (with and without PCOS) will see your contributions and consider them with an open mind, a critical attitude, and a strong desire to commit to forming life enhancing habits. I have just found your blog today, and I am excited to embark on a journey through it!

    Here’s to internal discovery and life improvement, one battle at a time!

    • Amy

      Amanda-
      You are a DIVA! Thanks for your eloquent and inspirational comment. Look for a functional medicine MD. I think you will find that they are more aligned with my philosophy.
      Be well,
      Amy

  • Amanda

    I am bummed that I missed the start of your most recent program, I think it started yesterday! I was diagnosed with pcos in 2004 and my guess is my problems went back years before then. I am almost 30 and taking bcp and metformin and I just feel awful all the time. Including horrible back pain. I feel very lost and it seems like I will never have control of all of these horrible symptoms. The hair growth is especially depressing. But after looking though your blog I see a glimmer of hope. I am going to be starting some supplements tomorrow and am thinking that stopping my prescription meds is whats best. Do you think it’s better to get a prescription for progesterone cream or is there not really a difference? Thanks for your site!

    • Amy

      Hi Amanda-
      Be sure to sign up for the Priority List at http://www.pcosdiva.com/jumpstart. You’ll be the first to know when I run the next program. I really like the compounded progesterone cream from Medicine World Pharmacy in Nashua, NH -you don’t need a prescription.

  • Alice

    Hello all

    Does anyone take Metformin for insulin resistance? Just started taking it and feeling quite sick on it but will adjust soon hopefully. Does anyone else take this?

    The pill wasn’t suggested to me at all so I thought Metformin was the standard treatment for insulin resistance/PCOS?

    Keep up the wonderful work you do with this site, Amy – much appreciated 🙂

    Alice

    • Amy

      Hi Alice – some of us (including me) can’t tolerate Metformin. But you can manage PCOS without it too. Thanks for your kind words!

  • Rebecca

    I’ve been on Metformin for several years as part of my PCOS treatment plan. I utilize the extended release (ER) form of the medication, which alleviates some of the side effects but most importantly taking the dose consistently at the same time every day and with a bit of food smoothes out the rough start of starting the medication. Once I was on it for a few weeks the symptoms subsided and I rarely have an issue now. For me, the benefits outweighted the side effects.

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  • You are so fantastic!!! I’ve become obsessed with your website and I spend most of my days reading all your archives. And I made a blog account JUST to post comments. I wish I had found out about sooner, and I wish you posted as much as you once did! You must be always busy now though because you are so famous!!

  • Sekhmet

    Birth control + Synthroid is very effective for me. The Synthroid (plus diet and exercise) was working pretty well for the insulin and weight problems, but the irregular periods and hirsutism persisted, so my endocrinologist added the Pill. On the other hand, my friend (also has PCOS) reacted quite badly to the Pill… treating the insulin resistance alone proved to be the solution for her. I think it depends on the individual, but certainly us Cysters should always be aware of our options, and should always have a good running dialogue with our doctor(s) about them.

  • Ashley

    Amy,
    I am a 22 year old woman who was diagnosed withing the last 2 years with PCOS and I have had a frustrating go at it. When I was 18 after 2 years of weight loss I was happy where I was. And then out of no where my belly started protrudinf and I gained 60 pounds in 4 months. Nothing had changed in my diet I was super depressed and chalked it up to what was going on in my life. Originally everyone thought I was pregnant. That was the last time I would have a regular period… After a few years of going without a single period I went to my doctor who sent me to a fertility specialist. She asked me if I wanted to get pregnant (yes, but my mother was in the room so I said no.) She told me to start on alese. And when I wanted to get pregnant to come and see her and she would give me metformin and get me pregnant. Since I’ve been on the bcp my belly just keeps getting bigger and bigger. I’m getting hair on my face and the hair on my head which used to be thick and curly is thinning and lying flat and dead. I am so frustrated I cry every day. I’ve been having temperament issues and have even lost my job because I can’t control how I react to things. I’m scared to stop the birth control because I’ve read other women with PCOS stopped and gained even more weight. Lately I’ve made changes to my diet and I haven’t eaten fast food in over a month. I don’t have a scale but everyone can tell my belly is going down. My doctor is also concerned about my liver and my blood sugars are high. I feel trapped though. Like nothing I do can change the way I feel. My depression and anxiety are getting worse day by day. Sorry for my rant I’m having a pretty tough day today 🙁

  • lifemaidsimple1

    I’m 44 soon to be 45 I was told that I had PCOS at age 16 and a massive cyst was removed off of my ovary well it was such a shock to what was left of my ovary that it died and I was left with one ovary I was able to go on and have 3 living children with the loss of one twin all conceived with the help of Clomid for many years I used the Depo Shot and had no cycle for 8 years but the weight gain was so bad after my last child I had my tubes tied and let nature run it’s course I continued to have weight gain, crazy hair,mood swings,and everything else that comes with having PCOS and then I cut out all of the sugar and processed foods from my diet my insulin went normal and my cycyle is now every 28 days I dropped from a weight of 155 to 122 I’m only 4’10 I need to lose maybe 10 more pounds I walked into my Dr. and he looks at my chart and can’t believe I have PCOS because of how normal everything looks he is used to seeing obese insulin dependent people he told me to keep doing whatever I’m doing because it’s working the Metformin dropped my sugar to low and depleted me of B vitamin so I felt tired all the time I refuse to put anymore drugs into my body to many side effects I hope all of you ladies find your way to good health and the children u wish to have.

  • Nóra Sárga

    I’m 28 and I was diagnosed with PCOS 10 years ago. I’ve been taking the pill ever since. I have just found a new doctor who suggested me to stop taking the pill and start taking Metformin. We are not planning a baby yet, I am just afraid of risks of taking the pill. Before I started taking the pill I had sever hair problems. I am frightened that I will get hairy again when I stop the pill. Can I avoid getting hairy if I keep my diet and do sports regular? Does anyone have any experience?

  • Gianna

    Ugh…Yeah, I’ve done my research. It just seems to me the risks outweigh the benefits, big time. I had always suspected something was wrong with my hormones. I’m 21 and was just diagnosed with PCOS by my doctor (who specializes in endocrinology). He decided to give me a prescription for Yaz. My only noticeable symptoms of PCOS have been [worsening] acne, irregular periods, and moodiness (though I have a history of depression & anxiety). I’ve worked out and made better food choices in the last 6 months – went from 160 lbs to 123 now, so weight gain has not been an issue and neither has high blood sugar and excessive hair growth or hair loss. But I’m so scared about this prescription and feel like not all of my questions were answered or that I was not given enough information as a patient. Is it worth it to risk depleting myself of nutrients, gaining weight, of getting blood clots even though I don’t smoke, only to become severely depressed again and have my libido plummet and possibly take on new health conditions during and after BC? I just don’t know what to do. I have 1-2 weeks until my next period starts and I start birth control for the first time in my life. I mean, if I don’t want to become pregnant and treat my PCOS at the same time- particularly the acne, are there not other options? Like an IUD, hysterectomy, the implant? And why would my doctor not talk to me about Metformin (which I just learned about)…perhaps because blood tests conclude my insulin levels are fine? I just feel like doctors are always in a rush to even disclose everything…

  • PrincessKLS

    I hate BC pills but I was recently put on a Nexplanon implant and I’m not bleeding at all 🙁

  • Tiffany

    Amy, my cousin came off the pill and became very sick with stomach problems. these symptoms lasted for several months (the whole time never having a period). Could this be caused by a loss of good bacteria in her gut? She is back on the pill now but wants to come off to ttc. What would you recommend so she doesn’t suffer those symptoms again?
    Thank you!
    Tiffany

  • Elle Castile

    I was diagnosed with PCOS, hasimotos hypothyroidism and adrenal insufficiency about two years ago now and have been taking Metformin to manage it and I believe it has really helped me. In January I decided to start taking the pill due to having outrageous periods and becoming sexually active.My periods were basically non existent after that which was such a relief, until about halfway through February I noticed I was gaining weight. Fast forward to now. I have gained almost 60 lbs, I have stretch marks covering my whole body, I have facial hair now in places I never have before. I’m only 18 years old and I don’t even recognize myself anymore. I want

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