Oral contraceptive pills or birth control pills are often recommended to women with PCOS. Since PCOS is a result of hormonal imbalance, using these pills that have female hormones – estrogen and progesterone – makes sense. While most women with PCOS get the hormonal pills from the doctor, it is not the real cure. What’s more, the long list of side effects of birth control pills can make anyone think twice. That’s why we recommend women consider safer options. Herbs, changes to diet, and a bit of exercise can do wonders for PCOS.
PCOS is a very complex disorder. No two women with this condition are alike. Since women use birth control pills quite normally, to prevent conception, we often think of them as being completely safe. However, women with PCOS may find that pills make things worse for them. In PCOS-support forums, women often complain that birth control pills make things worse for them. Weight-gain and insulin resistance are not uncommon. The topic screams “Don’t Take The Pill (BC) If You Have PCOS.”
Why Do Birth Control Pills Cause Side Effects?
Birth control pills raise the levels of estrogen in a woman to unnatural levels. This creates a hormonal imbalance in your body. Remember the pill is taken throughout the month. So when you continuously raise estrogen levels over an extended period of time, it is bound to have side effects that are neither pleasant nor desirable.
Short Term Side Effects of Birth Control Pills
1. Nausea :
This is one of the first side effects of the pill. You can continue feeling queasy for around three months, after which it may subside. Taking birth control pills on an empty stomach can make this worse. Most doctors ask women to take the pill with a meal.
2. Mood changes :
Many women complain of feeling depressed on the pill. Oral contraceptive pills increase the levels of estrogen in the body. Estrogen helps in cell growth. While this helps with cell growth in the uterus, it has another, unintended effect. It also thickens of a part of the brain that is responsible for the “reward response.” This is an extremely important response linked to our mood. The expectation of a “reward,” however small it might be, is what drives us to do things all day. It is what keeps us curious and happy. If this part of the brain is disturbed, it can affect mood and lead to depression.
3. Soreness in breasts :
This is a real downside of the pill and effects can persist for a long time. Breasts can swell up and become so tender that even wearing a bra hurts. Dropping your salt and caffeine intake and wearing a soft, supportive bra can help reduce this side effect.
4. Headaches :
Headaches usually start within a month of starting oral contraceptive pills. They can resolve within a few weeks once the body gets used to the pill. The severity of headaches is dependent upon the ratio of hormones used in the pills.
5. Spotting between two periods :
More than 50% women taking the pill experience vaginal bleeding between menstrual periods. This usually begins within three months of starting the pill and resolves within another three months. Contact your doctor if this persists for longer.
6. Missed periods :
Birth control pills can make you skip a period. This can happen especially if you’re also ill or stressed or have thyroid issues at the time you start the pill.
7. Vaginal discharge :
While some women have more wet discharge, other may feel dry. The nature of the lubrication may also change from what you normally experience. If your discharge is abnormal or has a foul smell, contact your doctor.
8. Weight changes :
Many women complain of gaining weight on oral contraceptive pills. This can be due to fluid retention in the breasts and hip areas. High levels of estrogen also can change the distribution and size of the fat cells. Also, remember: Insulin, which almost directly controls weight gain and loss, is also a hormone. Hormones like estrogen and progesterone are all intricately connected to hormones like insulin and leptin. When you influence one through a hormone pill, you can also influence the other.
9. Lowered sexual drive :
This can be a real dampener. While this may not be a direct result of hormonal changes, which woman feels ready for sex when her breasts hurt and she has a bad tummy? This problem usually gets resolved when other symptoms subside.
10. Changes in shape of cornea :
Hormonal changes can cause fluid retention. Fluid can fill up in the eyeball causing the cornea to change shape. Due to this swelling, your contact lens won’t fit as comfortably as before. You may want to start wearing glasses.
11. Bloating :
Blame fluid retention again. Women who already suffer from digestive issues may experience this more. Birth control pills also affect your gut bacteria. If the number of gas-producing bacteria increase, you feel bloated.
12. Skin problems :
Birth control pills often clear up skin since they help balance out excess male hormones, that can cause acne. At the same time, in some women, they make acne worse. They can also cause brown pigmentation on the skin, especially on the face.
13. Skin irritation, redness and swelling :
Women using contraceptive patches feel this. You could be allergic to the contents of the patch.
14. Irritation and discomfort in the vagina :
You may experience these symptoms if you use a vaginal ring. If the symptoms are bad, you may shift to either a patch or a pill.
15. Blood clots in the legs or lungs :
This is a rare, yet serious side effect of birth control pills. If not addressed on time, it can become a medical emergency.
Long Term Side Effects of Birth Control Pills
There is increasing evidence that using oral contraceptives for PCOS might not be a good idea. While they do help reduce excess male hormones fast, the big positive effects being to wear out in six months or so of starting. What’s more, some studies have found that using oral contraceptives long term for PCOS can actually make the PCOS worse. Here are the long term side effects of birth control pills in women with PCOS.
1. Diabetes :
There have been cases where non-diabetic women developed diabetes through long term use of oral contraceptives.
2. Oxidative stress :
A study found that women who take pills for a long term have “oxidative stress.” This means that their body is not able to get rid of waste efficiently. This leads to damage to cells and more rapid aging. This also increases the risk of heart diseases in the women. The study further advised women to take vitamins C and E along with their BCPs to reduce this side effect.
3. Weight gain :
Long-term use of contraceptive pills was found to increase weight significantly in PCOS women.
4. Risk of cancer :
Oral contraceptives increase the risk of liver and breast cancer.
5. Gallstones :
If you have gallstones, contraceptives will make these stones bigger much faster.
6. Yeast infections :
The estrogen in the oral contraceptives can reduce the helpful bacteria in the digestive tract. This, in turn, can cause an overgrowth of a yeast called candida infection. Women with a candida infection crave sugar, which can lead to binge eating and weight gain.
7. Deep vein thrombosis :
Long term use of oral contraceptives doubles the risk of deep vein thrombosis (DVT), stroke and heart disease. Women with PCOS are already at high risk of these conditions. Birth control pills make the condition worse.
8. Nutrient depletion :
Birth control pills deplete women of vital nutrients. You could be working hard to get these by eating healthy and organic, but the pills don’t let them stick to your body. Folic acid, B vitamins, vitamins C & E, zinc and magnesium are some of the nutrients lost. Serious health complications like weight gain, mood changes, fluid retention, depression and heart disease can be caused as you have low levels of these vital nutrients.
9. Shrinking of pituitary gland :
Studies also show that long term use of birth control pills leads to shrinking of the pituitary gland, a master hormone-producing gland in the brain.
How Do You Minimize the Side Effects of Birth Control Pills?
There are different types of pills available, each with different amounts of hormones. They also have different types of the hormone progestin. Your doctor will help you pick one. After you start, if you experience side effects, your doctor may change the brand of the pill. For example, if you experience breast tenderness, it could be because the dose of estrogen and progestin in your pill is lower than your body needs it to be. Your doctor may recommend a brand like Alesse or Levlite to reduce these symptoms.
Your doctor may also suggest that you try other forms of birth control, like patches or rings, if pills just don’t work for you.
You must contact your doctor immediately if you have:
- Pain or swelling in the legs
- Abdominal pain
- Shortness of breath
- Pain in the chest
- Blurred vision or loss of vision, and
- Severe headaches
While birth control pills are the most widely prescribed drugs for women with PCOS, their potential risks seem to outweigh the benefits. PCOS is now being widely acknowledged as a lifestyle issue that needs a lifestyle solution. Just because birth control pills seem to make you have a normal period, it does not mean your problem is really solved. PCOS goes beyond just the ovaries and the irregularities of the menstrual cycle. It is a whole-body, multi-system disorder. The only way to treat PCOS is through a holistic approach that includes diet, lifestyle changes, stress management and exercise.