Role of Contraceptives in Managing PCOS

[article]Almost everyone you know would be aware of or dealing with Polycystic ovarian syndrome (PCOS) - a relatively common hormonal disorder, when a woman’s body starts producing excess amounts of Androgen (a male hormone) and insulin which obstructs the ovary from producing eggs, leading to cyst formation and later infertility.

While PCOS has become an often used term, let’s understand what the scale of the problem is.

Did you know that 1 in 5 women in India have PCOS? In fact, almost 5% to 10% of women between ages 15 and 44 have PCOS. Most women find out they have PCOS in their mid-20s and 30s, when they have uncomfortable periods, unexplained weight issues or problems conceiving. PCOS can happen at any age after puberty. Your risk of PCOS may be higher if you have obesity or if you have a mother, sister, or aunt with PCOS.

PCOS Symptoms

The symptoms are universal: irregularity in the menstrual cycles, increased presence of male hormones (androgens), excess facial or body hair (hirsutism), weight gain, acne, mood swings or in some extreme cases, infertility. While the symptoms may present themselves from mild to severe depending on one’s body, there are solutions to managing PCOS effectively.

Contraceptives is the most common prescriptions for PCOS. It helps regulate a woman's menstrual cycle, making it more predictable. But research shows about a 2-3% risk of infertility after stopping the pill in women who experienced regular periods prior to starting it. This statistic has been estimated to be as high as 30-40% in women with irregular periods.

Contraceptives – The Easy Answer

Women with PCOS generate high level of male sex hormones, which results in the imbalance of ovary functioning. It is widely accepted amongst PCOS patients to switch to contraceptive pills as it contains both Estrogen and Progesterone.

To state in layman terms, Progesterone and Estrogen are the two hormones that women’s bodies produce and the lack of which leads to PCOS. Hence, Oral Contraceptive pills, which are made of these synthetic hormones can bring the balance and result in Ovulation in women making it a widely used and common treatment for PCOS.

Birth control pills:
-Correct the hormonal imbalance

-Lower the level of testosterone (which will improve acne and lessen hair growth)

-Regulate your menstrual cycles

-Lower the risk of endometrial cancer (which is slightly higher in young women who don’t ovulate regularly)

While combination Contraceptives might look like an easy answer, it actually is not! Though it does regulate women’s period cycles to some extent, the repercussions in the long run can be much, much worse.

How Do Contraceptives Work in Your Body?

The estrogen and progesterone in hormonal contraception act to override the body's normal hormonal control of the menstrual cycle and ovulation. The oral contraceptive pill works by 'switching the ovaries off', which means that when a woman is taking the pill the production of hormones such as testosterone is greatly reduced. The pill also increases the body's production of sex hormone binding globulin (SHBG), which binds to the main androgen testosterone in the blood. This reduces the activity of testosterone and reduces the symptoms of male hormone or androgen excess.

If you decide to stop using hormonal birth control, you may experience some disruptions to your body and menstrual cycle. Any type of hormone-based birth control can have an effect on your body, and common side effects of stopping birth control can include bleeding, irregular periods, and cramps.

What Happens When You Start the ‘Pill’?

While it’s safe to assume that Contraceptive pills help women with irregularities and PCOS situation to get back to a normal menstrual cycle, there’s much more to it than meets the eye. So, what exactly are the side effects if you switch to Contraceptives aiming to regularise your menstrual cycles?

While the side effects vastly vary, Contraceptives can lead women to gain weight excessively, and put them at a greater risk of diabetes, cardiovascular issues (including dangerous blood clots in the legs). Women with PCOS who are obese may have an elevated risk. If they smoke, the risk rises. It can put women on a greater risk of diabetes (this is a consideration for women with PCOS who are already at risk for diabetes).

Other common side effects are:

-intermenstrual spotting
-nausea
-breast tenderness
-mood changes
-missed periods

While we are not negating the positives that Contraceptives bring for women (there must be some truth to its benefits when so many women swear by it!), we are just presenting to you the grey side of the matter and urge you to not turn a blind eye before jumping into it.

The Solution for PCOS- Go Natural!

There has been no confirmed analysis or test that can confirm PCOS yet, and hence determining what kind of medicine or aid will help you becomes a tricky question. Contraceptive pills or Diabetes drugs have been a remedy for women, but they only improve the symptoms. It is not the most natural way to cure it.

Rather going natural and switching to a better, healthier lifestyle can prove much more beneficial in treating PCOS.

-Eat a well balanced diet

-Try Ayurveda: Ashwagandha helps balance cortisol levels, which could improve stress and symptoms of PCOS. Holy basil, also called tulsi, addresses chemical and metabolic stress. It helps reduce blood sugar, prevent weight gain, and lower your cortisol levels

-Start working out, go for a run, exercise - especially practice yoga which has specific asanas addressing PCOS, turn around your drinking, smoking pattern and focus on getting a cleaner body. Since PCOS puts you at high risk of Type 2 Diabetes, start working on getting the sugar levels down.

Read here for a more detailed view on how to manage PCOS holistically.

With a condition of hormonal imbalance like PCOS, which necessarily isn’t hereditary, choose your therapies wisely. Consult your gynecologist and opt for a medical discourse that fits your body needs. It’s vital to share with your medic what are you looking to achieve - pregnancy or the regular period cycle, to go better in your diagnosis.