At 32, which birth control is safe for my PCOS/PMOS?

Question

Hello doctor,

I am a 32-year-old woman with polycystic ovary syndrome (PCOS), now known as polyendocrine metabolic ovarian syndrome (PMOS), diagnosed four years ago. My recent labs show LH (Luteinizing hormone) 12,milli-international units per milliliter, FSH (follicle-stimulating hormone) 5 milli-international units per milliliter, testosterone 72 nanograms per deciliter (elevated), and fasting insulin 25 microunits per milliliter (high).

I have irregular periods and moderate acne. I am considering combined oral contraceptives for cycle regulation, but am worried about risks due to my BMI (body mass index) of 31. Tell me;

Which birth control options are safest for PCOS/PMOS with higher BMI?
How can I manage acne and excess hair alongside birth control?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

PCOS (polycystic ovary syndrome) or PMOS (polyendocrine metabolic ovarian syndrome) symptoms can be managed to improve your quality of life. The cause of PCOS/PMOS and its symptoms can be explained by the insulin resistance found in PCOS/PMOS patients. This insulin resistance is responsible for the weight gain, an increase in your male hormone level, which in turn causes acne, and the hormonal imbalance seen in PCOS/PMOS patients.

That is why long-term management is usually aimed at reducing insulin resistance. Reduction in the insulin resistance would, with time, reverse most of your symptoms. Some of the measures used for you include:

Taking daily supplements rich in Myoinositol.
Reducing intake of complex carbohydrates.
Daily exercise

For now, the best option for you is contraceptive pills, which also help to control some of your PCOS/PMOS symptoms like acne and hirsutism. Combining oral contraceptive pills remains the best option for you.

The newer generation (the ones that contain third or fourth generation progesterone) combine oral contraceptive pills, which do not have significant weight gain as side effects, so they can be used. This would also help to control your acne and hirsutism. It is also safe for you if your BMI (body mass index) is less than 35.

I hope this information helps you.

Feel free to ask further queries.

Thank you.