From the Guidelines
For women with Polycystic Ovary Syndrome (PCOS), the best form of Oral Contraceptive Pill (OCP) is a combined oral contraceptive containing ethinyl estradiol and an anti-androgenic progestin, such as drospirenone, due to its net antiandrogenic properties and ability to regulate menstrual cycles, reduce androgen levels, and provide contraception. When selecting an OCP for PCOS, it's crucial to consider the type of progestin, as some have more anti-androgenic effects than others.
- Fourth-generation progestins like drospirenone, which is a spironolactone analogue, are preferred due to their antiandrogenic properties 1.
- The daily dose of ethinyl estradiol typically ranges from 10-50 µg, with 20-35 mcg being a common range for PCOS management.
- COCs that are FDA-approved for the treatment of acne, such as norgestimate/EE, norethindrone acetate/EE/ferrous fumarate, drospirenone/EE, and drospirenone/EE/levomefolate, may also be beneficial for PCOS patients with acne symptoms 1. Key benefits of using COCs for PCOS include:
- Regulation of menstrual cycles
- Reduction of androgen levels, which helps alleviate symptoms like hirsutism and acne
- Provision of contraception
- Improvement in quality of life due to the management of PCOS symptoms. It's essential to note that while progestin-only pills are an alternative for women who cannot take estrogen-containing pills, they may be less effective in managing PCOS symptoms 1. Regular monitoring by a healthcare provider is necessary to assess the effectiveness of the chosen OCP and manage any potential side effects.
From the Research
Oral Contraceptive Pills (OCPs) for Polycystic Ovary Syndrome (PCOS)
The choice of OCP for PCOS depends on various factors, including the patient's symptoms, medical history, and lifestyle. Here are some key points to consider:
- Combined oral contraceptives (COCs) are commonly used to treat PCOS symptoms such as hirsutism, acne, and menstrual irregularities 2, 3, 4.
- Drospirenone, a progestin component, has been shown to have anti-androgenic effects and is effective in improving hirsutism and acne in PCOS patients 2, 3, 5.
- Ethinyl estradiol/drospirenone combination has been found to be effective in improving clinical and biochemical features of PCOS, including hirsutism and acne 3, 5.
- Chlormadinone acetate (CMA) containing OCPs have also been found to have similar positive therapeutic effects as drospirenone-containing OCPs in PCOS patients 6.
Comparison of Different OCPs
Some studies have compared the effects of different OCPs on PCOS symptoms:
- A study found that both drospirenone and CMA-containing OCPs provided similar positive therapeutic effects on clinical, metabolic, and hormonal parameters in PCOS patients 6.
- Another study found that Yasmin, a COCP containing drospirenone, provided good cycle control and improved acne scores in PCOS patients, but did not significantly improve hirsutism scores 2.
Key Considerations
When choosing an OCP for PCOS, consider the following: