Birth control pills or oral contraceptive pills are often prescribed for women who are suffering from polycystic ovarian syndrome or women who tend to have hyperandrogenism, which is an excess of male hormones. All women typically have male hormones, such as testosterone, naturally, but in deficient concentrations.
Because of this excess of male hormones, a series of symptoms and complications of PCOS can occur. Treating hyperandrogenism with birth control can alleviate some of the most uncomfortable symptoms of Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Diseases (PCOD.)
Combined Hormonal Contraceptives
By supplying combined hormonal contraceptive pills, the problems of hyperandrogenism are reduced because the pills help in a number of ways:
● By introducing estrogen, the production in the liver of sex steroid transport globulin (SHBG) increases, thereby decreasing the amount of free testosterone.
● On the other hand, the hypothalamus reduces the release of gonadotropin-releasing hormone (GnRH), decreasing the levels of LH which in turn causes the ovary to stop producing androgens.
For these reasons, the administration of hormonal contraceptives is one of the first therapeutic options for women with a polycystic ovarian syndrome.
Choosing the Right Pill for PCOS
Choosing the right contraceptive pill for PCOS can be a challenge because the variety of contraceptive pills available may seem overwhelming. Fortunately, they can be classified into just a few categories, which make it easier to evaluate your options. The choice of the most appropriate contraceptive depends mainly on the general health of the woman, her age, and her doctor’s decision.
There are two main types of birth control pills: combined contraceptive pills, which contain estrogen and progesterone, and the mini-pill, which only contains progestin. Combination contraceptive pills are also classified according to whether the hormone dose remains the same or varies:
● Single-phase: In this type of combination contraceptive pill, each active pill contains the same amount of estrogen and progestin.
● Multiphasic: In this type of combination contraceptive pill, the amount of hormones in active pills varies.
Also, combined oral contraceptives can also be classified according to the concentration of estrogen, with ethinylestradiol being the most widely used estrogen today. The combined oral contraceptives are subdivided into two groups: high dose and low dose.
● The high doses are also called macrodoses and are those in which the concentration of ethinylestradiol is higher than 50 ugs in each tablet.
● Those of low dose are subdivided into microdoses if the ethinylestradiol concentration is between 30 and 35 ugs per tablet.
High doses vs. low doses
It is essential to keep in mind that even the lowest dose of estrogen can be effective in preventing pregnancy and is less likely to cause side effects such as bloating, weight gain and mood swings. On the contrary, high doses increase the risk of irregular periods instead of reducing it. On the other hand, low and very low levels of estrogen are associated with a risk of intermenstrual bleeding that can cause some women to stop taking it.
The progestin-only pill is often called a “minipill.” It may be prescribed for young and adult women experiencing abnormal menstruation, who can’t take estrogen due to an underlying medical condition. Although progestin-only pills can produce side effects, particularly bleeding or spotting between periods, the side effects often improve or disappear after a few months.
The Bottom Line
PCOS can be treated using a variety of options. If you suspect you’re dealing with PCOS or are desperate to figure out how to manage PCOS, you should see a medical doctor as soon as possible. The longer you leave your PCOS untreated, the worse it will become.
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