The Pill and PCOS: What You Need to Know


Here’s an in-depth look at the complex relationship between oral contraceptives and polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects up to 10% of women of reproductive age. 

One of the most common treatments prescribed for PCOS is combination birth control pills, which contain both estrogen and progestin. 

But could being on the pill with PCOS do more harm than good? Also, you can check the side effects with the medication side effect checker

How The Pill Impacts PCOS?

Birth control pills work by supplying synthetic hormones that help regulate menstrual cycles and reduce androgen levels. This can help treat common PCOS symptoms like irregular periods, excess hair growth, and acne.

However, some research suggests that the synthetic progesterone in birth control pills may also worsen insulin resistance – a key factor in PCOS. 

One study found that women with PCOS who took the pill had significantly higher fasting insulin levels compared to those not on the pill.

Higher insulin levels can exacerbate PCOS symptoms and may increase the risk of even more serious health issues like diabetes and heart disease down the road. 

This is especially concerning since women with PCOS are already predisposed to insulin resistance.

Weighing the Pros and Cons of The Pill

Given the potential risks, is it bad to take birth control pills if you have PCOS? Not necessarily.

While some studies highlight the possible drawbacks, there’s also plenty of research showing the benefits. Let’s take a look:


  • Regulates menstrual cycles
  • Reduces excess hair growth
  • Improves acne
  • Lowers risk of endometrial cancer


  • May worsen insulin resistance
  • Potential side effects like nausea, headaches, etc.
  • Doesn’t address underlying metabolic issues

Many doctors still consider the pill a first-line treatment for PCOS when lifestyle changes alone aren’t enough. But it’s not necessarily the only option.

medication side effect checker

Alternative Treatments to Consider

If you’re concerned about taking the pill with PCOS, there are a few alternatives worth discussing with your doctor:

  • Metformin: The diabetes drug metformin can help lower insulin levels and reduce androgen production. It may be an option for treating PCOS symptoms without the risks of the pill.
  • Anti-androgens: Medications like spironolactone can block male hormones and improve acne, excess hair growth, and hair loss. They directly target one of the main issues in PCOS.
  • Progestin-only options: Methods like the progestin IUD or implant provide the benefits of progesterone without the estrogen that may exacerbate insulin resistance.

The right treatment depends on your individual symptoms and medical history. Tracking your cycles and symptoms while making medication changes can help you determine what works best for your body long-term.

The Bottom Line

There are valid concerns about taking birth control pills when you have PCOS. But for many women, the benefits still outweigh the potential risks.

The key is working closely with your doctor to find the best treatment plan for you. Tracking your symptoms, getting regular check-ups, and being open to adjusting course if needed can help optimize your health.