Should I Continue Taking Birth Control Pills with PCOS? - Obstetrics and Gynecology

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When considering whether to continue taking birth control pills (BCPs) with polycystic ovary syndrome (PCOS), it's essential to weigh the benefits and potential drawbacks of this approach, especially as you plan for pregnancy in the near future.

PCOS is a common hormonal disorder that can affect a woman's menstrual cycle, fertility, and overall health. One of the primary treatments for managing the symptoms of PCOS is the use of hormonal contraceptives, including birth control pills. These pills can help regulate menstrual cycles, reduce androgen levels, and manage symptoms such as acne and excessive hair growth.
In your case, since you have been on BCPs for a year to regulate your menstrual cycle, it seems that they have been effective in managing your symptoms. However, you mentioned that you experienced irregular periods again after a month of stopping the pills. This is not uncommon in women with PCOS, as the condition can lead to hormonal imbalances that affect the regularity of menstrual cycles.

As you are planning to get married and conceive next year, it’s crucial to discuss your birth control options with your healthcare provider. Here are some considerations:
1. Continuing BCPs: If your primary goal is to regulate your menstrual cycle and manage PCOS symptoms, continuing BCPs may be beneficial. They can help maintain a regular cycle and reduce the risk of endometrial hyperplasia, which can occur due to unopposed estrogen in women with PCOS.

2. Timing for Pregnancy: If you plan to conceive within the next year, you may want to discuss with your doctor when to stop taking the pills. Typically, it is recommended to stop taking BCPs a few months before trying to conceive to allow your body to adjust and for your menstrual cycle to normalize. However, some women may conceive shortly after discontinuing BCPs, while others may take longer.

3. Monitoring Basal Body Temperature (BBT): While on BCPs, ovulation is suppressed, which means that tracking basal body temperature may not provide accurate insights into your ovulation patterns. Once you stop taking the pills, you can begin tracking your BBT to help identify your fertile window.

4. Impact on Ovulation: Birth control pills do suppress ovulation, which is their primary mechanism of action. However, this does not "kill" eggs; rather, it prevents them from being released. When you stop taking the pills, your body should return to its natural cycle, and ovulation may resume, although it can take some time for this to normalize, especially in women with PCOS.

5. Consulting Your Healthcare Provider: It is essential to have an open discussion with your healthcare provider about your desire to conceive and how to best manage your PCOS. They may suggest alternative treatments or lifestyle changes that can enhance your fertility, such as weight management, dietary changes, and exercise, which can help improve insulin sensitivity and hormonal balance.

In summary, continuing birth control pills can be beneficial for managing PCOS symptoms, but as you approach your goal of pregnancy, it’s crucial to have a plan in place for discontinuing them. Regular follow-ups with your healthcare provider will help ensure that you are on the right track for a healthy conception and pregnancy.