Why Birth Control Won't Fix Your PCOS - a review of the evidence

Blog Medically reviewed by Sue-Ellen Anderson-Haynes, MS, RDN, CDCES, LDN, NASM-CPT, Women's Health Dietitian, Wellness Practitioner, Certified Diabetes Care and Education Specialist, Women's Fitness Specialist Certified Personal Trainer, & Founder - 360Girls&Women®

September commemorates Polycystic Ovary Syndrome (PCOS) Awareness Month, a time to educate ourselves on one of the most common hormonal conditions out there that affects many girls and women.

Teen girls or women with PCOS may be prescribed hormonal birth control; however, it is key to recognize that it may not cure or actually treat the root cause. It may mask symptoms rather than actually resolve them. In this blog, we will dive into what PCOS is, explore the role of birth control, and discuss why understanding the big picture makes all the difference for your health. 

 

What is PCOS?  

PCOS is one of the most common hormonal conditions associated with systemic inflammation, affecting around 6-20% of women (Siddiqui, 2022). It usually begins around the age of puberty and may affect fertility, period, metabolism, and quality of life.  

PCOS dates back to the year 1935, but there is still some debate about the best way to diagnose it, since PCOS can look different and vary depending on the person. According to the Rotterdam criteria, a diagnosis typically requires 2 out of the 3 signs (Of course, after ruling out other options) (Siddiqui, 2022):  

1. High levels of androgens (e.g., Testosterone, Dihydrotestosterone, Androstenedione), often called “male hormones”, but women also have them too, just in smaller amounts. When levels are amplified in women, it may show up as inflammation, acne, weight gain, excess facial or body hair, or hair thinning. 

2. Irregular or missed periods from disrupted ovulation 

3. Polycystic ovaries, meaning many small, immature follicles on the ovaries 

To say the least, PCOS is very complex.  

Common Types of Birth-Control  

Before we jump into PCOS and possible treatment, let’s briefly go over some common hormonal birth control types and what they do, potential risks, and benefits:  

1. Combined Hormonal Methods  

What do they do?  

These contain two hormones known as estrogen and progestin to stop ovulation. These are synthetic hormones, not the natural ones that our body produces on its own.  

Examples of these include:  

• The pill  

• Vaginal rings  

• Patches  

Risks include:  

•  Increased blood clot risk (especially if you smoke or have clotting disorders) (Teal, 2023)  

Benefits include:  

• About 91% effective (Teal, 2023)  

2. Progestin-Only Methods  

What do they do?  

Thins the mucus of your cervix and the lining of your uterus.  

Examples include:  

• The pill 

• Injections 

• Subdermal implants  

• Hormonal IUDs  

Risks include:  

• Injections (Depo-Provera shot): increased risk of osteoporosis with long-term use, irregular bleeding (Mayo Clinic, 2025), possible mood changes including depression (Civic, 2000) 

• Hormonal IUDs: small risk of the device getting stuck in the uterine wall  

• May cause irregular bleeding  

• Benign ovarian cysts 

Benefits include:  

• Safe for many with medical conditions (Teal, 2023). 

• Often causes lighter or no bleeding (actually not considered “healthy”, it is a potential risk).  

• 99% effective (Bradley, 2023)  

3. Hormonal IUDs  

What do they do?  

They are small T-shaped objects that are inserted into your uterus and release a hormone called progesterone. This method thins your uterine lining, thickens your mucus in your cervix, and reduces ovulation.  

Examples include:  

• Mirena  

• Liletta  

• Kyleena  

• Skyla   

Risks include:  

• May cause spotting during the first 3–6 months (Teal, 2023) 

• Benign cysts  

Benefits include:  

• Often reducing cramps  

• Often reducing bleeding (actually not considered “healthy”, it is a potential risk)   

• 99% effective (Teal, 2023)  

Potential nutrient deficiencies with long-term use of contraceptives: 

Folic acid, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc (Palmery, 2013).

Hormonal birth control also increases your risk for several types of cancers, including breast and cervical cancer.

Is Birth Control Treating the Root Cause of PCOS Or Masking It? 

Many women believe that if they take birth control, their PCOS will go away. I'm sorry to break it to you, but birth control will NOT treat the underlying condition. What it can do is temporarily manage some symptoms. To date, there is no true “cure” for PCOS, only management strategies. PCOS can go into remission, which means symptoms are less noticeable or disappear for a period of time. However, it will resurface if dietary and lifestyle changes are not maintained. Symptoms can also return once the birth control method or medications are stopped. The only key difference is that dietary and lifestyle changes do not have any negative side effects. As Sue-Ellen Anderson-Haynes says, “there are essentially no negative side effects when following a expert guided, personalized, evidence-backed nutrition and lifestyle protocol.”  

PCOS can be driven by several underlying triggers, such as (Woods, 2023): 

• Insulin resistance  

• Chronic inflammation 

• Stress hormone imbalance 

• Environmental factors, including prior contraceptive use  

  
  

What do I mean by this?

PCOS is not a one-size-fits-all condition. The root cause driving your PCOS can shape the symptoms you experience. Here are three stories that you may relate to, and that might help you understand how that works:  

• Gina, a 24-year-old woman, a master’s student, went to her doctor for a routine check-up and said she has high insulin levels and has noticed some hair thinning.  

• Hannah, a 40-year-old woman, has high inflammation, as demonstrated by specific lab values, and has noticed acne and facial hair that she has never had before. 

• Maddie, a 32-year-old woman, has a high-stress job and struggles with severe acne.  

All of them are experiencing excess androgens disrupting ovulation and their cycles. 

Providers may be more prone to recommend birth control to regulate periods, but actually, hormonal birth isn't a cure all. 

Birth control does not miraculously restart ovulation and create regular periods. Instead, what many think of as their “period” while on birth control, it is actually the body reacting to the synthetic hormones. So, in other words, it is not a true menstrual cycle, due to ovulation never occurring. You can call it a “fake period" if you will.  

Birth control may lower levels of androgens,

helping with hair growth or acne symptoms, but it will return if you stop taking it (Woods, 2023). Because once you stop taking birth control, the symptoms come right back … 

The sad truth is that birth control may manage symptoms, but it won’t fix the root cause of PCOS. 

Birth Control and the Gut Microbiome  

Now that we are all on the same page that birth control does not treat the root cause of PCOS, birth control can also disrupt the bacteria in your gut (fancy term is called dysbiosis). Because the gut plays a large role in inflammation, metabolism, and hormones, this might make matters worse for your PCOS symptoms.  

In a study, researchers found that women who took hormonal birth control had less beneficial bacteria that supported both metabolism and gut function compared to those who did not (Brito, 2025). Additionally, birth control has been associated with a smaller variety of beneficial bacteria in our gut as well as larger amounts of not-so-good bacteria that produce gas and bloating (Terrazas, 2025).  

Birth control is a risky game to play; it may manage your symptoms, but it might worsen them and prolong the time you figure out the root cause of it all. 

Non-Hormonal Alternatives to Prevent Pregnancy 

I know, this all might sound overwhelming, but there are other options if you’re looking to avoid pregnancy without synthetic hormones.  Below are some options to consider but always speak with your healthcare provider to weigh the pros and cons.

1. Copper IUD  

   
   

Things to consider:  

• Lasts up to 10 years  

• May cause heavier periods or cramping at first (Teal, 2023)  

• 99.4% effective (Bradley, 2023)  

• Barrier methods 

  
  

2. Barrier methods

Examples:  

• Male/female condoms  

• Diaphragms Spermicide   

Things to consider: 

• May protect against STIs  

  
  

Effectiveness: 

• Male condoms 98% effective (Bradley, 2023)  

• Female condoms 95% effective (Bradley, 2023)  

• Diaphragms with spermicide 84% effective (Bradley, 2023)  

• Spermicide 84% effective (Bradley, 2023)  

  
  

3. Fertility Awareness Methods 

Examples:  

• Track basal body temperature 

• Cervical mucus  

• Cycle patterns  

Things to consider:  

• Requires regular cycles  

• Requires education  

• 95-99.6 effective (Bradley, 2023)  

4. Withdrawal Method  

   
   

Things to consider: 

• Can be combined with other methods, e.g. fertility tracking  

• 96% effective (Bradley, 2023)  

Lifestyle and Dietary Changes You Can Start Today 

Everything good takes time, and so will finding your root cause. Here are some strategies that you can incorporate TODAY to start supporting your PCOS self

1. Avoid skipping meals.  In the long run, this will help you prevent insulin resistance by stabilizing your blood sugar. Meal skipping may also raise your risk of binge eating, which is particularly common in people with PCOS (Krug, 2019). 

   
   

2. Add zinc-rich plant foods to your diet. Because zinc has anti-inflammatory properties, include plant foods high in zinc to help reduce inflammation (Woods, 2023).  

Grocery list of zinc-rich plant foods:  

• Chickpeas  

• Lentils  

• Black beans 

• Pumpkin seeds  

• Chia 

• Oats  

• Quinoa  

  
  

  Add omega-3-rich foods for their anti-inflammatory properties (Woods, 2023).  

Grocery Shopping list for omega-3 rich foods:  

• Extra Virgin Olive Oil  

• Chia  

• Flax  

• Berries  

• Leafy greens  

• Almonds  

• Brazil nuts  

Below you can find a fun addition to your breakfast or snack that incorporates omega-3-rich foods! 

Olive Oil Chia Pudding  

Ingredients: 

• 1 cup of plant-based milk  

• ½ plant-based yogurt  

• 3 tbsp of chia 

• 1-2 tsp of extra virgin olive oil  

• 1 tsp of maple syrup or honey  

• 1 tsp of flax seeds  

• Optional toppings: berries, almonds, brazil nuts, cinnamon, zest of an orange or lemon.  

Instructions:  

• In a jar, whisk milk, yogurt, olive oil, and maple syrup until they’re all combined  

• Then add the chia and flax seeds  

• Let it sit for about 5 minutes, give it another stir, and refrigerate for 4 hours or overnight  

  
  

But remember that while the grocery lists and recipe ideas can be useful tools, they should be used in conjunction with working with your healthcare team for a comprehensive evaluation that considers your medical history, lab results, eating patterns, medications, supplements, stress levels, sleep patterns, and physical activity.  

Wrapping up  

If you are struggling with PCOS, endometriosis, fibrosis, IBS, etc., you are NOT alone.

We all come from different backgrounds, traditions, and cultures, and so does our PCOS. I hope this blog allows you to step away from a one-size-fits-all approach to your health and creates space to find the root cause of it all. It might be easier said than done, but avoid scrolling through TikTok and Instagram to figure it out on your own. Instead, I challenge you to educate yourself on PCOS and ask questions to be able to advocate for yourself when symptoms arise. To learn more about our individualized holistic nutrition and wellness plan or program, book a call.  

You deserve a personalized approach to your symptoms and figuring out your unique root cause. ALWAYS consult with your personal women’s health dietitian about your specific needs. 

Blog Medically reviewed by Sue-Ellen Anderson-Haynes, MS, RDN, CDCES, LDN, NASM-CPT, Women's Health Dietitian, Wellness Practitioner, Certified Diabetes Care and Education Specialist, Women's Fitness Specialist Certified Personal Trainer, & Founder - 360Girls&Women®

Sue-Ellen Anderson Haynes, MS, RDN, CDCES, LDN, NASM-CPT, founder of 360Girls&Women® Award Winning and Nationally recognized nutrition and food expert and leading global expert in Gestational Diabetes. "What makes us different?"

360 represents completion. At 360 G+W we provide personalized insight to help girls and women dramatically improve their wellbeing.​Our mission is to provide evidence-based information and services to help maximize a woman's complete health through the complete life-cycle - preventing, managing, and reversing certain reproductive and chronic illnesses- using nutrition as the foundation along with other innovative holistic practices. Read more. 

References: 

1. Escobar-Morreale H. F. (2018). Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature reviews. Endocrinology, 14(5), 270–284. https://doi.org/10.1038/nrendo.2018.24 

2. Siddiqui, S., Mateen, S., Ahmad, R., & Moin, S. (2022). A brief insight into the etiology, genetics, and immunology of polycystic ovarian syndrome (PCOS). Journal of assisted reproduction and genetics, 39(11), 2439–2473. https://doi.org/10.1007/s10815-022-02625-7  

3. Winner, B., Peipert, J. F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J. E., & Secura, G. M. (2012). Effectiveness of long-acting reversible contraception. The New England journal of medicine, 366(21), 1998–2007. https://doi.org/10.1056/NEJMoa1110855 

4. Trussell  J, Grummer-Strawn  L.  Further analysis of contraceptive failure of the ovulation method.   Am J Obstet Gynecol. 1991;165(6, pt 2):2054-2059. doi:10.1016/S0002-9378(11)90581-X 

5. Teal S, Edelman A. Contraception Selection, Effectiveness, and Adverse Effects: A Review. JAMA.2021;326(24):2507–2518. doi:10.1001/jama.2021.21392 

6. Woods, T. (2023). PCOS repair protocol: The complete manual to thriving with polycystic ovary syndrome by uncovering the root cause of your symptoms. Fire publishing.   

7. Nasiadek, M., Stragierowicz, J., Klimczak, M., & Kilanowicz, A. (2020). The role of zinc in selected female reproductive system disorders. Nutrients, 12(8), 2464. 

8. Ataabadi, M. S., Alaee, S., Bagheri, M. J., & Bahmanpoor, S. (2017). Role of essential oil of Mentha spicata (Spearmint) in addressing reverse hormonal and folliculogenesis disturbances in a polycystic ovarian syndrome in a rat model. Advanced pharmaceutical bulletin, 7(4), 651. 

9. Ebrahimi, F. A., Samimi, M., Foroozanfard, F., Jamilian, M., Akbari, H., Rahmani, E., ... & Asemi, Z. (2017). The effects of omega-3 fatty acids and vitamin E co-supplementation on indices of insulin resistance and hormonal parameters in patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Experimental and Clinical Endocrinology & Diabetes, 125(06), 353-359. 

10. Krug, I., Giles, S., & Paganini, C. (2019). Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies. Neuropsychiatric disease and treatment, 1273-1285. 

11. Brito, J., Grosicki, G. J., Robinson, A. T., Coburn, J. W., Costa, P. B., Holmes, K. E., Lyon, G., Hakonsson, Z., Conti, F., & Galpin, A. J. (2025). Hormonal birth control is associated with altered gut microbiota β-diversity in physically active females across the menstrual cycle: a pilot trial. Journal of applied physiology (Bethesda, Md. : 1985), 138(3), 739–745. https://doi.org/10.1152/japplphysiol.00008.2025 

12. Terrazas, F., Kelley, S. T., DeMasi, T., Giltvedt, K., Tsang, M., Nannini, K., Kern, M., & Hooshmand, S. (2025). Influence of menstrual cycle and oral contraception on taxonomic composition and gas production in the gut microbiome. Journal of medical microbiology, 74(3), 001987. https://doi.org/10.1099/jmm.0.001987 

13. Civic, D., Scholes, D., Ichikawa, L., LaCroix, A. Z., Yoshida, C. K., Ott, S. M., & Barlow, W. E. (2000). Depressive symptoms in users and non-users of depot medroxyprogesterone acetate. Contraception, 61(6), 385–390. https://doi.org/10.1016/s0010-7824(00)00122-0 

14. Mayo Foundation for Medical Education and Research. (2025, February 5). Depo-Provera (birth control shot). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/depo-provera/about/pac-20392204  

15. Palmery, M., Saraceno, A., Vaiarelli, A., & Carlomagno, G. (2013). Oral contraceptives and changes in nutritional requirements. European review for medical and pharmacological sciences, 17(13), 1804–1813. 

16. Bradley, S. E. K., Polis, C. B., Micks, E. A., & Steiner, M. J. (2023). Effectiveness, safety, and comparative side effects. In P. C. Cason, A. Edelman, D. Kowal, J. M. Marrazzo, A. L. Nelson, M. S. Pollicar, & R. A. Hatcher (Eds.), Contraceptive technology (22nd ed.). Jones & Bartlett Learning.