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The Best Birth Control for PCOS: Contraceptive Pills Guide for Women

The Best Birth Control for PCOS: Contraceptive Pills Guide for Women

By Kire Stojkovski M.D
Editor Jonathan Hoarau Published 03 May 2023
Time to read 15 min

Polycystic ovary syndrome (PCOS) is a common yet debilitating hormonal disorder that affects millions of women worldwide. As someone with PCOS, you may experience irregular periods, excessive hair growth, acne, and weight gain.

These symptoms can be both physically and emotionally distressing. However, when you find the best birth control for PCOS, you can manage your symptoms and improve your quality of life.

Birth control is often prescribed to women with PCOS to help regulate their menstrual cycles and control other symptoms, such as acne and excessive hair growth. But with so many options available, how do you know which one is right for you?

This comprehensive guide will help you understand PCOS, the role of birth control in managing the condition, and how to choose the best birth control for your unique situation.

Find the best birth control for PCOS here

The Best Birth Control for PCOS

  • Hers – Best birth control for PCOS with acne
  • Medzino – Best birth control pills for PCOS to prevent weight gain
  • Nurx – Best birth control pills for PCOS with the least side effects

Every woman with PCOS is different, and so are the best birth control pills for PCOS. That’s why our top picks aren’t any singular brand of pills, but instead, three telehealth services that give you a wide range of options after convenient online consultations. 

  1. Hers – Best Birth Control for PCOS with Acne

Hers

Hers provides a wide range of the best birth control for PCOS, especially for women with acne. Better yet, Hers also sells skincare products, so you can treat your acne from the inside and out.

Who Should Try Hers?

Hers not only has good birth control for PCOS, but also for clearing up your skin. Enquire about the formulations featuring norgestimate and ethinyl estradiol (EE/NGM), as well as ethinyl estradiol with desogestrel (EE/DSG).

These are best suited for women with PCOS. Ethinyl estradiol reduces the effects of testosterone, which targets a key underlying disease process of PCOS: high testosterone. Additionally, desogestrel and norgestimate do not stimulate testosterone pathways as severely as older synthetic forms of progesterone.

As a result, these forms are our top choice for relieving acne and oily skin. There was a 74.4% reduction in acne severity with EE/NGM formulations, and 65.5% for the EE/DSG pills, in a clinical study of more than 200 women If you struggle with oily skin the most, EE/NGM pills are best [2].

Many of the PCOS symptoms come from high or low levels of female sex hormones, too. Thanks to the triphasic design of EE/NGM pills, their resemblance to a natural menstrual cycle could mean the relief of other symptoms [2].

Pros of Using Hers

  • The cheapest prescriptions are only $12 per month
  • Find the best birth control pills for PCOS without having to worry about driving to an appointment or waiting times in a doctor’s office
  • Hers was developed by OB/GYNs

Cons of Using Hers

  • The best birth control for PCOS depends on a range of individual factors, which may not be captured by a short telehealth consultation.

Find the best birth control for PCOS at Hers 

  1. Medzino – The Best Birth Control Pills for PCOS to Prevent Weight Gain

Medzino

Medzino offers the best birth control pills for weight loss, relieving one of the most distressing PCOS symptoms. It’s caused by excessive levels of insulin and IGF-1, especially when you aren’t physically active so their effects won’t be diverted to muscle.

To make things worse, PCOS and birth control can both cause weight gain, even though modern formulations only trigger water retention in most women.

Who Should Try Medzino?

Medzino has the best birth control for PCOS, weight loss, and bloating. With progestin-only minipills and low-estrogen combination pills, you don’t have to worry about water retention. This is caused by taking high doses of estrogen, which isn’t found in minipills and is present in minimal amounts in low-dose options [3].

Weight gain in PCOS is partly caused by higher levels of luteinizing hormone (LH), as it triggers more production of insulin-like growth factor-1 (IGF-1). However, if you take sex hormones as a medication, your body may perceive less need to generate LH, as it helps to stimulate estrogen and progesterone production [4].

Pros of Using Medzino

  • Includes fillers and additives under the information for all birth control pills
  • A real physician will review your quiz answers
  • With all contraindications listed, you’ll know right away which pills are off-limits, if any

Cons of Using Medzino

  • The consultation is predominantly a two-minute quiz; this may be too short to identify all safety issues or pointers to the right pill for you.

Find the best birth control for PCOS with Medzino

  1. Nurx – Best Birth Control for PCOS with the Least Side Effects

Nurx

You’re dealing with enough symptoms as it is, but Nurx offers some of the best birth control pills for PCOS with the lowest side effect profiles.

Who Should Try Nurx?

PCOS involves a number of complex hormonal feedback loops, but the best birth control for PCOS can break some of the cycles and possibly reduce cyst formation.

For this to be possible, you need to take the contraceptive pill consistently, which calls for a formulation with little to no side effects. As teenage girls are at their most fertile, these are also the best birth control for teens.

Fluid retention, bloating, and swollen or tender breasts can appear as part of PMS or after taking a pill with too much estrogen. Drospirenone is in some of the best birth control for PCOS, as it’s a diuretic, so you’ll pass built-up fluid through urine instead of holding onto it [5].

If you don’t want to deal with menstruation at all and want to completely block your menstrual cycle, 35 micrograms of ethinyl estradiol is your best bet [5].

Pros of Using Nurx

  • You can use health insurance to pay for your prescriptions.
  • There are over a dozen choices available
  • If you need the morning-after pill, you can access it through Nurx. Irregular menstruation in PCOS can mean you don’t know your fertile window, so the risk of a missed pill or broken condom is unpredictable.

Cons of Using Nurx

  • The birth control pill service is unavailable in Alaska, Arizona, Arkansas, Delaware, the District of Columbia, Hawaii, Kansas, Mississippi, New Hampshire, New Mexico, North Dakota, Oklahoma, Puerto Rico, Vermont, or West Virginia.

Find the best birth control for PCOS with Nurx

Understanding PCOS: Symptoms and Causes

PCOS is a complex hormonal disorder that occurs when the ovaries produce an excess of androgens, or male hormones. This hormonal imbalance can lead to a variety of symptoms, including:

  • Irregular periods or no periods at all
  • Heavy or prolonged menstrual bleeding
  • Excessive hair growth on the face and body (hirsutism)
  • Acne and oily skin
  • Weight gain and difficulty losing weight
  • Thinning hair on the scalp
  • Darkening of the skin in certain areas, such as the neck and groin
  • Formation of multiple small cysts on the ovaries

The exact cause of PCOS is still unknown, but it is believed to be a combination of genetic and environmental factors. Exposure to high androgen levels in the womb can raise your risk of developing PCOS, meaning there is more than one way you can “inherit” the condition.

Insulin resistance, where the body does not respond effectively to insulin and results in higher insulin levels, is also thought to play a significant role in the development of PCOS.

Dysregulated insulin signaling increases androgen production, which in turn worsens insulin resistance. This leads to a nasty cycle of excessive androgens, insulin resistance, and weight gain.

Get the best birth control pills for PCOS from Hers

PCOS and Birth Control

One of the primary goals in managing PCOS is to regulate the menstrual cycle and reduce the risk of endometrial cancer, which can be increased in women with PCOS due to long periods of unopposed estrogen exposure.

Birth control can help achieve this by providing the body with a steady supply of hormones, which can help regulate the menstrual cycle and reduce the severity of PCOS symptoms.

In addition to regulating your menstrual cycle, birth control can also help manage other PCOS symptoms, such as:

  • Reducing excessive hair growth by suppressing the production of androgens
  • Improving acne and oily skin by reducing the amount of oil the skin produces
  • Lowering the risk of ovarian cysts by preventing ovulation

It is important to note that while birth control can help manage PCOS symptoms, it does not cure the underlying hormonal disorder. If you stop taking birth control pills, your symptoms will return.

Discover your best birth control pills for PCOS at Nurx

Types of Birth Control for PCOS

There are several types of birth control available, each with its own set of benefits and potential side effects. When considering the best birth control for PCOS, it’s essential to weigh the pros and cons of each method and discuss your options with your healthcare provider.

Combined Oral Contraceptives (COCs)

These birth control pills contain both estrogen and progestin and are often considered the best birth control pills for PCOS. They work by suppressing ovulation, regulating the menstrual cycle, and reducing androgen levels, leading to an improvement in acne and excessive hair growth.

If you’re worried about side effects, don’t despair. New research now shows us that the estrogen dose in birth control pills can be reduced by 90%, and the progestins by half [6]. This means you can choose from the low-dose options available from providers such as Hers without worrying about reduced efficacy.

Some combined formulations are safe for extended use, especially low-dose options, so you don’t need to worry about having a period. These may be the best birth control for endometriosis and PCOS, as endometriosis leads to heavy, painful menstruation.

Progestin-Only Pills (POPs)

Also known as the “mini-pill,” these birth control pills contain only progestin and do not contain estrogen. They are sometimes recommended for women with PCOS who cannot take estrogen due to certain health conditions, such as a history of blood clots or migraines. However, they may not be as effective at controlling androgen-related symptoms as COCs.

Intrauterine devices (IUDs): Both hormonal and non-hormonal IUDs can be used for women with PCOS. Hormonal IUDs release a small amount of progestin, which can help regulate the menstrual cycle and reduce heavy bleeding. Non-hormonal IUDs, such as the copper IUD, do not contain hormones but can still provide effective contraception.

Vaginal Rings and Contraceptive Patches

These methods release a combination of estrogen and progestin and can be effective in managing PCOS symptoms, similar to COCs. However, they may not be suitable for all women and should be discussed with your healthcare provider.

Get the best birth control pills for PCOS at Medzino 

How to Choose the Best Birth Control for PCOS

When choosing the best birth control for PCOS, it is essential to consider your individual needs, preferences, and health history. Some factors to consider include:

  • The severity of your PCOS symptoms and how well they are managed by different birth control methods
  • Your risk factors for certain health conditions, such as blood clots, which may influence the type of birth control you can use
  • Your lifestyle and how it may impact your ability to consistently use certain methods, such as remembering to take a pill every day
  • Your plans for having children and how soon you would like to conceive after stopping birth control

Your healthcare provider can help you determine the best birth control for your unique situation and provide guidance on how to use it consistently and effectively.

Find the best birth control for PCOS at Hers

Popular Birth Control Pills for PCOS

Several birth control pills are considered the best birth control pills for PCOS due to their effectiveness in managing symptoms and low risk of side effects. Some popular options include:

  • Yasmin: This COC contains a progestin called drospirenone, which has anti-androgenic properties that can help reduce acne and excessive hair growth.
  • Ortho Tri-Cyclen: Another COC, Ortho Tri-Cyclen has been FDA-approved for the treatment of acne and can be beneficial for women with PCOS who struggle with this symptom.
  • Desogen: Containing desogestrel, a progestin with low androgenic activity, Desogen can be a suitable option for women with PCOS who want to manage androgen-related symptoms.

It is important to remember that every woman’s body is different, and what works for one person might not work for another. Be sure to discuss your options with your healthcare provider to determine the best birth control pills for your specific needs.

Non-Pill Birth Control Options for PCOS

While you may think of finding the best birth control for PCOS as searching for the perfect pill, there are other non-pill options that may be suitable for some women. These include:

  • Intrauterine devices (IUDs): As mentioned earlier, both hormonal and non-hormonal IUDs can be used for women with PCOS. They offer long-term, reversible contraception and can be an excellent option for women who do not want to take a daily pill.
  • Vaginal rings and contraceptive patches: These methods release a combination of estrogen and progestin and can be effective in managing PCOS symptoms, similar to COCs.
  • Implants: Progestin-only implants, such as Nexplanon, can be used for contraception in women with PCOS. However, they may not be as effective at managing androgen-related symptoms as COCs.

Find the best birth control pills for PCOS at Nurx 

Lifestyle Changes to Complement Birth Control for PCOS Management

In addition to finding the best birth control for PCOS, implementing healthy lifestyle changes can help improve your overall health and manage your symptoms more effectively. These changes may include:

  • Maintaining a healthy weight: Weight loss, even as little as 5-10% of your body weight, can help improve insulin resistance and regulate your menstrual cycle.
  • Eating a balanced diet: Focus on consuming whole, unprocessed foods, such as fruits, vegetables, lean proteins, and whole grains, to help manage insulin resistance and maintain a healthy weight.
  • Exercising regularly: Aim for at least 150 minutes of moderate-intensity exercise per week to help improve insulin sensitivity and support weight management.
  • Managing stress: Chronic stress can worsen PCOS symptoms, so it’s essential to find healthy ways to cope, such as practicing yoga, meditation, or deep breathing exercises.

Talking To Your Healthcare Provider about PCOS and Birth Control

Before starting any birth control method, it is crucial to have an open and honest conversation with your healthcare provider about your PCOS symptoms, health history, and personal preferences. They can help guide you in finding the best birth control for PCOS and ensure that you are using it safely and effectively.

Be prepared to ask questions and discuss any concerns you may have about the different birth control options available. It may also be helpful to keep a symptom diary to help you and your healthcare provider better understand your specific needs and monitor your progress over time.

FAQ: PCOS, Birth Control, and Precautions

What are people asking on the web about the best birth control for PCOS?

Is Birth Control Worth It for PCOS?

Although it isn’t a cure, women can enjoy a dramatic reduction in symptom severity. If you find the best birth control pills for PCOS in your unique situation, you may see your symptoms disappear entirely.

What Happens When You Have PCOS And Go Off Birth Control?

If you quit birth control, your symptoms will likely return, with the most noticeable often being irregular periods.

What Is the Best Birth Control Pill for Weight Loss?

The best birth control pills for PCOS, if you struggle to lose weight, are those with drospirenone, such as Yaz and Yasmin. As a diuretic, you can enjoy the relief of fluid retention.

Conclusion: Finding the Best Birth Control for Your Unique PCOS Journey

Living with PCOS can be challenging, but finding the best birth control for your unique situation can help you manage your symptoms and improve your overall quality of life.

By understanding the different types of birth control available, considering your individual needs and preferences, and working closely with your healthcare provider, you can make an informed decision and take control of your PCOS journey. Remember, finding the right birth control may require some trial and error, so be patient and remain open to adjusting your treatment plan as needed.

Find the best birth control for PCOS here

Related Articles

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References

  1. Bansode OM, Sarao MS, Cooper DB. Contraception. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536949/
  2. Jaisamrarn, Unnop et al. “A comparison of multiphasic oral contraceptives containing norgestimate or desogestrel in acne treatment: a randomized trial.” Contraception vol. 90,5 (2014): 535-41. doi:10.1016/j.contraception.2014.06.002
  3. Giersch, Gabrielle E W et al. “Estrogen to Progesterone Ratio and Fluid Regulatory Responses to Varying Degrees and Methods of Dehydration.” Frontiers in sports and active living vol. 3 722305. 14 Oct. 2021, doi:10.3389/fspor.2021.722305
  4. Liao, Baoying et al. “Central Regulation of PCOS: Abnormal Neuronal-Reproductive-Metabolic Circuits in PCOS Pathophysiology.” Frontiers in endocrinology vol. 12 667422. 28 May. 2021, doi:10.3389/fendo.2021.667422
  5. Stewart, Mary, and Kirsten Black. “Choosing a combined oral contraceptive pill.” Australian prescriber vol. 38,1 (2015): 6-11. doi:10.18773/austprescr.2015.002
  6. Gavina, Brenda Lyn A et al. “Toward an optimal contraception dosing strategy.” PLoS computational biology vol. 19,4 e1010073. 13 Apr. 2023, doi:10.1371/journal.pcbi.1010073