PCOS and Birth Control Pills

What does PCOS do to your menstrual cycle?

A common symptom of Polycystic Ovarian Syndrome (PCOS) is amenorrhea, or the absence of a menstrual period. Some women who suffer from this disorder, which is also called Stein-Leventhal Syndrome, Chronic Anovulatory Syndrome, Sclerocystic Ovarian Disease, Polycystic Ovary Syndrome, Polycystic Ovarian Disease, and Ovarian Disease, may experience sporadic menstrual periods. In an effort to regulate the menstrual cycle, healthcare professionals are likely to prescribe birth control pills.


The Real Culprit: Insulin

No discussion of Polycystic Ovary Syndrome (or PCOD – Polycystic Ovary Disorder) is complete without talking about insulin. In fact, it’s insulin that ultimately causes these problems with the hormones—though this relationship is not yet fully understood.

Actually, it isn’t insulin itself that’s the problem, but rather Insulin Resistance, the underlying effect that lies at the heart of PCOS (Polycystic Ovarian Syndrome). This condition basically means that your body can no longer break down and absorb glucose as well as it once could. This in turn leads to the hormonal imbalance that is PCOS (Polycystic Ovarian Syndrome). The ovaries, you see, are particularly sensitive to insulin—and when the insulin is thrown off balance, the ovaries may try to compensate by producing an abundance of certain hormones, something that can throw the entire hormonal system off balance.
And that’s really just the beginning of the trouble with Insulin Resistance. This insidious condition, when untreated, can result in a wide number of health problems, including not just PCOS (Polycystic Ovarian Syndrome), but also things like diabetes, obesity and Metabolic Syndrome (Syndrome X).

PCOS and Your Hormones

Now let’s look more closely at Polycystic Ovarian Syndrome (PCOS) and hormonal imbalance. To start with: What is a hormone, exactly? Basically, these are substances produced by glands and released into your body, typically into the bloodstream. Hormones are then transported to different bodily tissues, where they regulate different bodily functions. To put it most concisely, hormones are substances that help all of your bodily systems and parts to function properly.

There are many different kinds of hormones, and they are comprised of different building blocks. Some are comprised primarily of proteins; others, amino acids, or fatty acids. Some, however, use cholesterol as a backbone, and it is this group of hormones that is most commonly affected by Polycystic Ovarian Syndrome (PCOS). Specifically, the hormones typically affected include:

  1. Estrogen
  2. Progesterone
  3. Androgens (testosterone, DHEA, and androstenedione- or, the “male” sex hormones)
  4. Insulin is another problematic hormone in PCOS; however, this is not a cholesterol-based hormone. Rather it is a peptide hormone made of amino acids.
  5. Luteinizing Hormone (LH) – This hormone triggers ovulation and certain mutations of LH and LH receptor (LHR) can lead to changes in bioactivity of these hormones (and PCOS symptoms) according to recent studies.

It’s also important to note that excessive production and/or secretion of androgens is a medical condition called Hyperandrogenism. Interestingly, a study by The David Geffen School of Medicine at UCLA, in Los Angeles, California found that approximately three-fourths of patients with PCOS have evidence of hyperandrogenemia.

But if an excess production of certain hormones can cause problems, so, too, can a shortage of certain hormones—another hallmark of PCOS (Polycystic Ovarian Syndrome). For instance, progesterone is a hormone that is closely associated with ovulation; in many women with this condition, however, it is very low. This typically goes hand in hand with PCOS (Polycystic Ovarian Syndrome)-related infertility.


What PCOS Looks Like

But first things first: How do you know if you have PCOS (Polycystic Ovarian Syndrome)? Certainly, the warning signs of this illness are ones that women everywhere should be aware of in their daily lives. This is not at all an uncommon condition; in fact, it is the most common of all women’s hormonal disorders, and affects at least 7% of all women of childbearing age. Millions of women suffer from PCOS in America alone so women should be mindful of this condition.

The condition most commonly presents itself as a disorder of the menstrual cycle. One early indicator or red flag is an irregular period, which is either a cycle that is abnormal in its duration or absent altogether. This disorder can also manifest itself in anovulation or difficulty conceiving. If you see any of these effects you should ask a doctor about PCOS (Polycystic Ovarian Syndrome) immediately.

But there are numerous other effects, as well. The condition can have an impact on the skin; many women will experience acne, and other women have skin tags. PCOS can affect the hair in different ways, leading either to excess hair growth or baldness. PCOS can also lead to obesity and depression.

And again, the reason it presents itself in so many different ways is that PCOS is fundamentally tied to the hormones. Because PCOS affects hormone production, in so many different ways, it can throw off the proper functioning of many different bodily systems, ultimately producing a different set of symptoms from one woman to the next.

Treatment Options

How Birth Control Pills Help Manage PCOS

During a healthy menstrual cycle, the following take place:

  1. The egg follicle, which develops on the ovary, releases estrogen.
  2. The endometrium, or uterus, begins to thicken in anticipation of the implantation of a fertilized egg. The lining of the uterus also thickens.
  3. Ovulation occurs, during which the egg follicle releases the egg into the fallopian tubes.
  4. The corpus luteum, or now empty egg follicle, releases progesterone.
  5. Progesterone levels rise for approximately seven days, further encouraging the preparation of the uterus for implantation.
  6. If fertilization fails to occur, progesterone then stops ovulation from taking place during the next half of the menstrual cycle.
  7. Progesterone also triggers the release of the uterine lining if fertilization does not take place. This release occurs in the form of the menstrual period.

Birth control pills serve two purposes when prescribed for women who have Polycystic Ovary Disease. First, they allow women to enjoy a normal menstrual cycle. An irregular monthly cycle can produce a great deal of emotional stress. By keeping this cycle regular, women can feel more confident about their body’s functions.

But birth control pills also protect women with amenorrhea or anovulation (a lack of ovulation) from endometrial cancer, or cancer of the uterus. If the female reproductive system does not release enough progesterone, which often occurs in these instances, the body will not shed the lining of the uterus on a monthly basis. Because the lining of the uterus becomes thicker over the course of the menstrual cycle, this can result in endometrial hyperplasia, which is the overgrowth of the lining of the uterus. If not addressed, endometrial hyperplasia can develop into endometrial cancer. Birth control pills that contain progesterone provide the hormone that the female reproductive system needs to properly release the uterine lining and avoid more serious health conditions.

Progesterone and Estrogen

Progesterone and estrogen are two of the female sex hormones that control the menstrual cycle. In women who have Polycystic Ovarian Syndrome (PCOS), the work of these hormones is counteracted by abnormally high levels of androgens, or male hormones. Because of excessive amounts of testosterone and other male hormones, progesterone and estrogen are not able to manage the menstrual cycle properly. To balance these hormones, women with Chronic Anovulatory Syndrome are often prescribed birth control pills.

Combined oral contraceptive pills, or COCPs, are birth control pills that introduce progestin and ethinyl estradiol into a woman’s system. Progestin and ethinyl estradiol are forms of progesterone and estrogen. Pills that contain only progestin are available, but are less frequently prescribed and some brands are not legal within the United States.

Different Kinds of Combined Oral Contraceptive Pills (COCPs)

Although all COCPs contain both estrogen and progestin, the amounts and kinds of these hormones may vary. COCPs are categorized based upon how the hormone levels contained within the pills change over the first three weeks of the menstrual cycle. During the fourth week, pill packs usually contain placebo pills that hold no hormones. Currently, there are three different categories of COCPs: monophasic, biphasic, and triphasic.

Monophasic COCPs
A popular choice for women who are using a COCP for the first time, monophasic pills contain an even amount of hormones throughout the pill pack. By maintaining even levels of hormones, these pills often result in fewer side effects. However, there are three different kinds of monophasic pills available:

  1. Low dose: Contains 20 micrograms (mcg) of estrogen.
  2. Regular dose: Contains 30-35 mcg of estrogen.
  3. High dose: Contains 50 mcg of estrogen.

Monophasic pills are often less expensive than multiphasic pills and are as effective as their more expensive counterparts.

Multiphasic COCPs
First released in the 1980s, these pills were developed to more accurately imitate the natural fluctuations of hormones throughout the menstrual cycle. They also, in some cases, provide fewer side effects than monophasic COCPs.

  1. Biphasic Oral Contraceptives: These pills provide a steady level of estrogen throughout the cycle, but increase the amount of progestin halfway through the pill pack. This allows for the lining of the uterus to thicken and shed in a more natural manner.
  2. Triphasic Oral Contraceptives: As their name implies, these pills deliver three different hormonal ratios. The hormonal ratios, which may or may not involve the alteration of the amount of both estrogen and progestin in the pill (depending upon the brand), change every seven days or so.2

Different Varieties of Progestin
In addition to a difference in the amount of hormones used, COCPs also vary depending upon the form of progestin that they contain. Women who are fighting Polycystic Ovarian Syndrome (PCOS) may be prescribed different brands of combined oral contraceptive pills. Although the goals of these pills are, generally, the same, they may use diverse types of hormones to achieve them.

Progestin varieties are categorized by several factors, including generation and their progestational, estrogenic, and androgenic effects. Here are eight different kinds of progestin:

Progestin varieties are categorized by several factors, including generation and their progestational, estrogenic, and androgenic effects. Here are eight different kinds of progestin:

  1. Norethindrone
    1. First generation
    2. Low progestational activity
    3. Minor estrogenic activity
    4. Increases HDL (“good” cholesterol) and decreases LDL (“bad” cholesterol)
  2. Norethindrone Acetate
    1. First generation
    2. Low progestational activity
    3. Minor estrogenic activity
    4. Used in popular COCP brand Estrostep
    5. May improve nausea, migraines, or fluid retention
  3. Ethynodiol Diacetate
    1. First generation
    2. Medium progestational activity
    3. Minor estrogenic activity
    4. Minimal androgenic activity
    5. Derived from norethindrone
    6. High levels may lead to increased spotting
  4. Levonorgestrel
    1. Second generation
    2. Most popular progestin for contraceptive use
    3. High progestational activity
    4. High androgenic effects
    5. Produces negative effect on serum lipoproteins
    6. FDA approved for use in emergency contraceptive pills
    7. Used in Plan B One-Step, Next Choice, Seasonale, Seasonique, and Lybrel
  5. Norgestrel
    1. Second generation
    2. High progestational activity
    3. Strong antiestrogen activity
    4. High androgenic activity
    5. Desogestrel
    6. Third generation
    7. High progestational activity
    8. Minimal androgenic and estrogenic activity
    9. Presents increased risk of venous thrombosis (blood clot) as compared to levonorgestrel
    10. Used in Mircette and Cyclessa
  6. Norgestimate
    1. Third generation
    2. High progestational activity
    3. Minimal estrogenic activity
    4. Minimal androgenic activity
    5. Improves acne
    6. Used in Ortho Tri-Cyclen Lo
    7. Reduces side effects, including nausea and vomiting, without an increase in spotting
  7. Drospirenone
    1. Made from 17a-spirolactoneis
    2. Low androgenic activity
    3. May help reduce premenstrual syndrome symptoms, including water retention, increase in appetite, and negative mood swings
    4. Used in YAZ and Beyaz
    5. Contributes to improvement of premenstrual dysphoric disorder

Fighting Polycystic Ovarian Syndrome (PCOS) can be a difficult task. The physical and emotional stress of the symptoms associated with this condition can be devastating. Women with Stein-Leventhal Syndrome may be overwhelmed by the challenge of regaining control of their health. Although it can be difficult, medications like COCPs can help regulate women’s hormones and jump start their recovery.

Natural Therapies

PCOS Treatment for Insulin Resistance

Since there is no stand-alone cure for PCOS or Insulin Resistance, what can you do? There are two steps actually:

  1. Eating well – Eating well means consuming plenty of vegetables and fruits, while sticking to whole grains. You should also avoid refined sugars and/or foods with sugars added, as well as processed foods.
  2. Healthy Lifestyle – Eating a proper diet means very little without regular exercise. It’s important to keep your body in shape. Your physical well-being plays a large role in how you feel emotionally.

Furthermore, when it comes to exercise, it’s important to start slowly. If you’ve been inactive, be sure you don’t push your body beyond its limits. The purpose is to make strides. That might mean walking rather than running at first or toe touches before jumping jacks. The point is: don’t put too much stress on your body in a quest to be healthy. Grow your exercise plan rather than diving in headfirst. Not only is it safer, but you’ll also find you’re more inclined to continue your plan. When you set smaller goals for yourself, and succeed at them, you’re more likely to raise the bar a little bit higher each week, month, etc.

Now, sometimes you need help and that’s why Insulite Laboratories is here. We’re consistently trying to help women successfully meet these two key steps to fight Insulin Resistance. Our goal is to empower, educate and emotionally support women who are suffering from PCOS with a system of nutraceutical formulas, nutrition plans, exercise plans and emotional support. So, be sure to check out some of the informative resources available here to learn about a more holistic approach to combating PCOS.

“Taking the Pill for PCOS,” About.com, 1 July 2010, http://pcos.about.com/od/pcos101/a/ocp.htm (13 January 2012).

“Types of Combination Pills,” About.com, 4 October 2011, http://contraception.about.com/od/thepill/tp/PillCategories.htm (13 January 2012).

“Different Progestin Types,” About.com, 22 April 2011, http://contraception.about.com/od/thepill/tp/ProgestinTypes.htm (13 January 2012).



Take these simple steps to take control of your PCOS

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