Can birth control cause PCOS: Distinguishing the facts from myths

Can birth control cause PCOS? Although this is a common concern among women planning to start or withdraw from birth control, post-pill PCOS is just a myth. In reality, starting or stopping birth control cannot trigger the development of PCOS. However, this myth exists not without a reason.

It has emerged from the post-pill cycle irregularity and other PCOS-resembling symptoms reported by many women who stop birth control. And this phenomenon can be explained by two things:

1. A hormonal reset. Your body needs time to restore its normal hormonal balance after birth control, which can cause side effects that resemble PCOS.
2. An undiagnosed PCOS. Although it can start anytime, PCOS often becomes noticeable in your 20s or 30s. So, if you’ve started birth control rather early, it’s possible that you’ve always had this condition and didn’t know about it until it showed post-pill.

What can you do? In most cases, you just need to wait. The normal post-pill symptoms should disappear within 3 months after you stop taking birth control. If this doesn’t happen, you might want to see a doctor.

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Birth control is an important part of not just pregnancy prevention but also general reproductive health. It’s commonly used to treat a variety of health issues, including heavy periods, acne, endometriosis, etc. And it’s not uncommon to use it. According to the 2017–2019 National Survey of Family Growth, 65.3% of reproductive-age women in the US were using some form of birth control.

On the flip side, despite a large number of benefits, birth control is also associated with a variety of unwanted side effects. These can include irritability, headaches, and others.

When you are just thinking about starting birth control or, on the contrary, considering stopping pill intake, one of the possible side effects that can come up in the process of research is the so-called “post-pill PCOS.” But can birth control cause PCOS in reality? Or is it just a myth? 

Let’s figure it out!

What Is PCOS?

PCOS is short for polycystic ovary syndrome. It’s a chronic hormonal condition that affects women in their reproductive years. In a nutshell, PCOS leads to the formation of multiple fluid-filled sacs (cysts) on the female ovaries. As a result, it undermines the normal ovulatory function and hormone production, and can cause the following symptoms:

• Hormonal imbalance
• Irregular or abnormal menstruation
• Anovulatory cycles
• Excessive hair growth
• Acne
• Hair loss
• Weight gain

What Causes PCOS?

Despite being a rather widespread condition, PCOS is still not fully understood. There is not enough research to understand what exactly causes this condition. However, there are a few data-driven assumptions.

Experts believe that the following factors can contribute to the development of PCOS:

• Insulin resistance
• Chronic, low-grade inflammation
• Excess androgen production

On top of these possible contributing factors, current studies are mainly focused on the environmental and genetic factors that can contribute to PCOS as well. By this time, researchers have found 19 possible changes in genes that can increase the likelihood of developing this condition.

Can Birth Control Cause PCOS?

Although the exact causes of PCOS are still undiscovered, as you can see, birth control is not listed among the contributing factors. Thus, the short answer to the question “Can birth control cause PCOS,” is “no.”

In fact, the opposite is true. Starting hormonal birth control, especially combined with anti-androgenic progestins, is often considered one of the most effective ways to counteract the primary PCOS symptoms.

In particular, birth control pills can provide the following benefits to women with PCOS:

• Improved hormonal balance
• Regular menstrual cycle
• Lower androgen levels
• Better skin and hair health
• Decreased risk of endometrial cancer

Why Does the Post-Pill PCOS Myth Exist?

Since birth control can’t cause PCOS and, on the contrary, is used to improve the symptoms of this condition, it’s natural to wonder why the myth about post-pill PCOS even exists.

Experts believe that this myth is associated with frequent reports about cycle irregularity from women who stop taking birth control. So, can getting off birth control cause PCOS?

The answer to this question is also “no.” Indeed, the majority of females who cease taking pills can experience changes in their cycles. However, that’s not because birth control triggers the development of PCOS. Instead, it might be due to two reasons:

1. Normal Body Adaptation

Hormonal birth control pills work by altering your essential hormone levels and suppressing ovulation. When you take them for a long time, your body gets used to a particular hormonal balance. Respectively, when you come off the pill, it needs to do a hormonal reset.

Your body will take time to restore hormone levels to normal. In at least 80% of women, this reset happens within three months after you stop taking birth control. During this time, it’s absolutely normal to notice cycle irregularities.

2. Previously Undiagnosed PCOS

PCOS is one of the common hormonal conditions. According to the World Health Organization, it affects roughly 6-13% of women in the world, with up to 70% of cases remaining undiagnosed.

Given the huge share of women who didn’t have their PCOS diagnosed, it’s quite possible that a woman starts noticing PCOS symptoms for the first time after stopping birth control. But it’s not because it has developed because of the pill. It’s because she didn’t know she had PCOS in the first place. This is especially common in girls who start taking birth control early. Although PCOS can develop anytime, most often, it becomes noticeable around the 20s or 30s. Thus, it’s possible that some women just didn’t have the condition fully developed when they started birth control. Respectively, they only notice it after stopping it.

How to Tell If It’s PCOS or Post-Pill Symptoms

So, as you already know, your body will need to do a hormone reset once you come off birth control. This can affect your menstrual cycle and overall well-being. In particular, you may find that your periods are now longer or shorter than before. They can also become more painful or heavier. And you may notice other symptoms that feel worse than before you stopped birth control, including:

• Worse premenstrual symptoms
• More severe mood swings
• Headaches
• Acne
• Bloating
• Breast tenderness
• Hair loss
• Weight fluctuations
• Fatigue

Many of these symptoms do resemble PCOS. However, they are normal and, in most cases, should go away within several months.

How to tell if it’s PCOS? In most cases, you just have to wait. If your menstrual cycle doesn’t return 3 months after you stop birth control, this might be a sign to see your healthcare provider for a full diagnostic. 

In the meantime, you can try the following management tips to ease your post-pill symptoms and help your body restore its hormonal balance faster:

• Stay hydrated.
• Follow a healthy diet.
• Exercise regularly.
• Use over-the-counter pain relievers for headaches and cramping.
• Consider topical solutions if your symptoms include acne.

FAQ

Can birth control cause PCOS symptoms?

No, neither starting nor stopping birth control can trigger the development of PCOS. On the contrary, birth control is commonly used as a remedy to treat PCOS symptoms. However, it’s possible to notice cycle irregularity and other symptoms that resemble PCOS after you stop taking the pill. Often, these side effects disappear within several months, once your body does a hormonal reset.

Can birth control cause weight loss for PCOS?

Yes, it can. If you’ve been diagnosed with PCOS, starting birth control can offer a number of benefits. Apart from helping restore a hormonal balance and regulate your menstrual cycle, the right type of birth control can also help you manage hormone-related weight gain and eventually lose excess pounds.

When should I see a doctor with my post-pill symptoms?

In most cases, the symptoms you experience after coming off the pill should disappear within 3 months. If this doesn’t happen and menstrual irregularity persists, there is a chance that you have an undiagnosed PCOS. In this case, it’s recommended to see your healthcare provider for an accurate diagnosis and personalized treatment plan.

Conclusion

Birth control is a common and effective tool for preventing unwanted pregnancy and ensuring overall reproductive health. Still, despite being used by over half of women, this topic is still surrounded by many misconceptions and myths.

So, can hormonal birth control cause PCOS? As you now know, the answer to this common myth is “no.” Birth control pills cannot trigger the development of PCOS. On the contrary, they can help manage the majority of PCOS symptoms and support your health. Yet, coming off the pill often causes a hormone reset, accompanied by a number of symptoms that can resemble PCOS. Luckily, in many cases, these symptoms go away after a few months.

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