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 understand the role of these medications in managing the condition and your future fertility plans.
PCOS is a hormonal disorder that can lead to irregular menstrual cycles, weight gain, acne, and excessive hair growth. One of the common treatments for managing the symptoms of PCOS is the use of hormonal contraceptives, such as BCPs. These pills can help regulate menstrual cycles, reduce androgen levels (which can cause symptoms like acne and hirsutism), and provide a level of protection against endometrial hyperplasia due to unopposed estrogen exposure.

Given that you have been on BCPs for a year to regulate your cycles, it seems that they have been beneficial for you in managing your symptoms. However, since you are planning to conceive next year, it's crucial to discuss your options with your healthcare provider. Here are some points to consider:
1. Continuing BCPs: If your primary goal is to regulate your menstrual cycle and manage PCOS symptoms, continuing BCPs may be advisable until you are ready to conceive. However, you should have a conversation with your doctor about when to stop taking them to allow for a return to normal ovulation.

2. Timing for Conception: It is generally recommended to stop taking BCPs at least a few months before you plan to conceive. This allows your body to adjust and for your menstrual cycle to normalize, which can help in predicting ovulation and increasing your chances of conception.

3. Tracking Basal Body Temperature (BBT): While on BCPs, your body does not typically ovulate, as the hormones in the pills suppress ovulation. Therefore, tracking your BBT may not provide accurate information about your ovulation patterns while you are on the pill. Once you stop taking BCPs, you can start tracking your BBT to help identify your fertile window.

4. Impact on Egg Quality: BCPs do not "kill" eggs or affect their quality in a way that would prevent conception later. The hormonal regulation provided by BCPs is temporary, and once you discontinue their use, your ovaries will resume their natural function. However, it's important to note that women with PCOS may experience challenges with ovulation after stopping BCPs, so monitoring your cycles post-BCP is essential.

5. Consulting Your Healthcare Provider: Since every individual’s situation is unique, it’s vital to have a detailed discussion with your healthcare provider. They can provide personalized advice based on your health history, current symptoms, and future fertility plans. They may also suggest other treatments or lifestyle changes that can help manage your PCOS symptoms while preparing for pregnancy.

In conclusion, continuing BCPs can be beneficial for managing PCOS symptoms, but you should plan to stop them in advance of your intended pregnancy. Tracking your BBT is more effective once you are off the pill, and it’s essential to have open communication with your healthcare provider to ensure a smooth transition to conception.