People with PCOS can take birth control to alleviate symptoms without increasing heart disease

Birth control pills, taken alone or paired with the drug metformin, do not raise the risk of metabolic syndrome, a precursor of heart disease and diabetes in women with polycystic ovary syndrome (PCOS) even if those women were overweight, according to researchers at the Perelman School of Medicine. The findings allay persistent worries about potential risks of these drugs and could mean fewer medications, fewer side effects, and better overall well-being for PCOS patients. The study is published in PLOS Medicine.

“Our results can help guide treatment decisions right away,” says first author Anuja Dokras, director of the Penn Polycystic Ovary Syndrome Center and the Founder’s Professor of Women’s Health in the Department of Obstetrics and Gynecology. “Oral birth control remains a safe and effective first-line option for managing PCOS symptoms, and our research showed providers can prescribe it alone with greater peace of mind knowing that it’s safe and effective for these higher risk patients. Patients should also know birth control helped improve emotions and did not cause weight gain.”

In PCOS, a hormonal disorder affecting millions of women and the most common cause of female infertility, there is a disruption between brain hormones and the ovaries. This leads ovaries to overproduce the male hormone androgen. People with PCOS can experience irregular or missed periods, weight gain, acne, excess facial and body hair, and an elevated risk of metabolic syndrome, a set of conditions like high blood pressure and high glucose levels that signal a risk of diabetes or prediabetes and cardiovascular disease.

Dokras and her colleagues enrolled 240 participants (women with PCOS and elevated body mass index) who were randomly assigned participants to receive birth control pills, metformin, or both for 24 weeks. At the end of the study, the prevalence of metabolic syndrome, a cluster of conditions that raise the risk of heart disease and diabetes, was similar across all three groups.

The team also found that women taking birth control pills saw small reductions in weight, waist size, and body fat around the stomach compared to baseline. Metformin alone did not lower metabolic syndrome risk, and was associated with frequent gastrointestinal side effects, including diarrhea. Participants taking metformin, either alone or with birth control, were also more likely to skip doses of the medication due to side effects.

Read more at Penn Medicine News.