If you’re looking for an embodiment of the term ‘frustration’ then your answer is Polycystic Ovarian Syndrome. PCOS can be difficult to live with and it doesn’t help that the medical community is largely clueless about how to address the problem.
I find many conventional medicine experts prescribing some kind of band-aid solution to help mask symptoms for PCOS patients. However, the patient’s misery doesn’t meet an end with the regular medications.
Androgen blockers are quite commonly prescribed. Many women are told by their doctors that the root cause of their PCOS lies in the excess free testosterone floating in their bodies and while that technically is true, it’s unfair to view the situation so one-dimensionally.
In my years of functional medicine practice I have learned the importance of a holistic vision. Androgen excess admittedly, is a cause of PCOS but so is insulin resistance and ovulation dysfunction. It’s reductionist to assume causation theory in a scenario that is mired in a web of interconnections.
Many women with PCOS get in touch with me and tell me that their doctors told them they will never be able to conceive naturally. However, after sometime of working with my office, they learn that a natural pregnancy is possible with PCOS! I have addressed the misconception of infertility in PCOS in my previous article here.
However, those who don’t realize that there’s a way around their PCOS infertility let the rumor take a toll on their mental health. Then if she’s going through depression or anxiety she’ll be asked to take up anti-depressants, just like the rest of the 1 in 4 women already have.
What we’re left with is birth control pills. These are, at least in my opinion, the worst type of drugs that can be administered to PCOS patients. Many women take contraceptive drugs with the hope that once their irregular menstrual cycle is fixed, they’ll ovulate properly and be able to conceive. Let me tell you the magic of the birth control pill is a myth. I have written several articles and made some videos on the side effects of the pill. You can check them out to get a better idea of what I’m talking about.
However, today I’d like to discuss the pill in terms of your PCOS condition. I’m going to walk you through the basics of PCOS just so you have a better idea of how the pill exacerbates your symptoms. Then I’ll provide you with some explanation on how the pill reacts with your core PCOS symptoms and give some recommendations on how you can maintain a healthier life that doesn’t involve drugs. Let’s begin!
What is PCOS?
PCOS is a case of hormonal imbalance in women. It’s often called the silent killer because most women don’t even know if they have the disorder. Although, statistics show that nearly 1 in 10 women of childbearing age are susceptible to PCOS.
The diagnosis for PCOS can be pretty tricky, mainly because the symptoms can be so generic it never appears to the mind that a specific disorder is serving as the trigger.
Mostwomen with PCOS will go through a condition called androgen excess, which basically refers to the overproduction of male hormones in their body. This condition is often accompanied by a series of clinical and biochemical symptoms that are detected via a diagnosis of elimination method.
The core problem arises in the woman’s ovarian system. Ovaries contain hundreds of eggs that enter the uterus every month in hopes of getting fertilized. Note that these are only mature eggs and are fully developed to carry out reproductive functions.
In the case of PCOS though, the ovaries begin releasing immature eggs into the uterus which stick to its outer-walls and formulate tiny cysts. Don’t worry, these cysts aren’t cancerous. However, this does implicate problems in the ovulation cycle.
Women with PCOS have problems keeping a regular menstrual cycle.Some women undergo oligomenorrhea, which is a case of delayed or irregular periods. Others go through amenorrhea which involves the absence of periods for several months.
If you want more detail on PCOS and its symptoms you can go through some of my recent power articles that cover this topic comprehensively. For now, I’ll just stick to providing you with this short checklist of symptoms:
- Irregular periods
- Thinning hair or hair loss
- Hirsutism—an abnormal growth of hair on the body
- Dark patches on the back of your neck
- Chronic inflammation
- Adrenal dysfunction
- Irregularities in blood sugar levels
Do We Know the Exact Causes of PCOS?
Not really. There was a time when medical professionals believed that PCOS was only a hormonal imbalance issue and that all its symptoms were also hormone-related. However, insight from new research studies tell us that PCOS does not just revolve around androgen excess—it also has metabolic repercussions.
You see, we’re now learning that alongside androgen excess; insulin resistance plays a huge role in determining the severity of PCOS. And that explains why the use of birth control pills is so problematic for women with PCOS.
Should Women with PCOS take Birth Control Pills?
Most women with PCOS choose to take contraceptivesto deal with two core symptoms: acne and irregular periods.
Birth control pills do have the capacity to make your periods lighter, more regular and less painful. However, a major drawback of using them is that they increase insulin resistance. Let’s talk about this and other symptoms in a little more detail.
Insulin Resistance &the Pill
Insulin resistance is a situation where your body no longer reacts to insulin the way it’s meant to. The hormone insulin is responsible for breaking down the sugar molecules in the blood so they can be used for energy by the body. In the case of insulin resistance, the body becomes unable to break down the sugar molecules. To counter this effect, the pancreas releases more insulin but it remains incapable of bringing the blood sugar spike down. If sugar is left to float freely in your bloodstream it will eventually eat away at your tissues. A consistently high blood sugar also leaves you prone to developingType 2 diabetes.
Now here’s the interesting bit; the side effects of insulin resistance bring about pretty much the same symptoms that I outlined above for PCOS. An increased secretion of insulin in the body signals the overproduction of androgens like testosterone in the ovaries. This explains Hirsutism—the growth of excess hair in places where women don’t normally have hair such as the chest, back and abdomen, male pattern baldness and cystic acne.
Ovulation & the Pill
Taking the pill significantly boosts the concentration of the Luteinizing Hormone (LH). This stops the ovulation process and makes it unlikely for you to get pregnant. Now most women who take birth control expect this result if they’re not looking to conceive any time soon. But here’s the side effect you need to notice. An increase in LH brings about a decrease in Follicle-Stimulating Hormone (FSH). Both these hormones control ovulation. An imbalance in these hormones can trigger the release of immature eggs into the uterus, thereby leading to cystic ovaries and a potential to develop PCOS if you didn’t have it in the first place!
Menstrual Cycle & the Pill
Nearly 42 percent of American women use birth control pills for reasons not related to pregnancy. The most commonly cited reason is to help regularize their menstrual cycle.
However, we need to dispel this myth now.
The pill isn’t capable of regulating the menstrual cycle!
An organic period happens when the lining of the uterus wall sheds due to the activities of progesterone and estrogen hormones. Periods occurring on the pill are stimulated by chemicals like levonorgestrel, drospirenone and ethinylestradiol.
This might seem like a minor side effect compared to not having your period at all. Some women are actually willing to take the risk. In fact, in my years of practice, I’ve seen some pills work for women with PCOS.
But here’s the catch. Their issues with menstruation, infertility and ovulation come raging back once they’re off the pill.Synthetic chemicals cannot fix something that is organic in nature. If you had irregular periods before taking the pill, you will have irregular periods when you’re off the pill.
So this is what I mean when I say the pill masks your PCOS symptoms. It doesn’t solve the problem—just suppresses it and once you’re off the pill you’re back to ground zero. Some studies even say that once you stop taking the pill, any chances of fertility are delayed by a year.
High Testosterone& the Pill
There’s scientific evidence that shows birth control pills have the ability to reduce testosterone levels. As we have learned over the course of our discussions on PCOS, high levels of testosterone are a major cause of the disorder. So if the pill is giving you relief from excess androgens isn’t that good news? Well, yes and no. Many people fail to look beyond the immediate effects of birth control pills.
As I mentioned above, taking the Pill increases yourinsulin levels.
High levels of insulin reduce the production of sex hormone binding globulin i.e. SHBG. This is a protein that links with sex hormones to make sure there isn’t any excess testosterone left wandering in the body.
So, taking the pill increases SHBG concentration, thereby ensuring that there’s no free testosterone roaming in the body. However, a sharp decrease in testosterone levels eats away at your libido. Now that’s a major problem for women seeking to conceive.
Additionally, take a look at this from a functional medicine perspective. The high testosterone and insulin levels are having a reciprocal effect on one another. If we want to treat the excess androgens issue we need to reduce insulin levels too. Without it, we cannot arrive at a meaningful solution to the PCOS dilemma.
Are there any other cautions for pill takers?
Studies show that women who frequently take birth control pills are at a slight risk of developing blood clots. The pill doesn’t cause a blood clot per se but it does increase the chances of such an incident by 3 to 4 times.
The problem lies in the composition of oral contraceptives. Most pills contain progestin—a synthetic version of progesterone, and some estrogen. These hormones are important for regulating the menstrual cycle, sustaining ovulation and leading a pregnancy to full term. Balancing out your progesterone and estrogen levels via pills leaves you at risk of blood clotting.
Contraceptive medication is often the first line of intervention for women with PCOS.I understand why many doctors prefer giving their patients birth control pills—they do have some benefits. For example:
- They reduce the free testosterone levels in the body
- They diminish the appearance of PCOS acne
- They decrease the severity of menstrual cramps
- They reduce the risk of endometrial cancer
- They lower the risk of anemia
However, these are benefits that don’t touch the heart of your PCOS issue.
The pill does not address the underlying chronic inflammation that is theroot cause of your PCOS acne. Plus, the menstrual cycle is being synthetically pushed to behave in predictable ways but it goes back to its irregular ways once the pill is taken away. Perhaps more importantly, the pill continues to increase insulin resistance leaving you prone to developing Type 2 diabetes. So while you thought the reduction in testosterone would rid you of your underlying inflammation, it continues to sting as insulin resistance thrives.
Interested in Working With My Office?
That’s great! Just fill out these health questionnaires and help me get to know about your health condition. The questionnaire should give me a fair idea of your personal health goals and the kind of assistance you’re interested in.
Once you’ve submitted your answers, my office will get in touch with you via email and we’ll guide you step-by-step on how to begin your journey to recovery.
I look forwarding to hearing from you!