New Risks of Birth Control Medications in Teens with PCOS

Oral contraceptive pills (OCPs) have long been demonstrated as an effective treatment for Polycystic Ovary Syndrome (PCOS). Recognized for their ability to restore menstruation, OCPs can improve hormone levels, thus improving the unwanted side effects having too much testosterone can bring (acne, hair growth and thinning). Despite the benefits, a recent study indicates that OCPs should be used with caution in adolescents with PCOS. The reason? OCPs have been found to increase levels of C-reactive protein (CRP), a marker of inflammation and heart disease, in teens with PCOS. OCPs have also been shown to increase LDL cholesterol (the bad kind) in adolescents with PCOS. Elevated levels of triglycerides (the blood storage form of fat) and a possible increase insulin resistance have already been associated with use of OCPs.

These findings bring cause for concern because young women with PCOS are already at a higher risk for developing heart disease and are insulin resistant. High levels of insulin usually results in higher levels of triglycerides, commonly seen in PCOS. Because OCPs can not only raise triglycerides, but LDL and CRP levels, OCPs may not be the most effective treatment for teens with PCOS.

Looking for an alternative to OCPs? Diet and exercise are the first lines of approach to treating PCOS. Both of these lifestyle changes are effective ways to lower insulin and testosterone levels, sometimes resulting in a more regular menstrual cycle alone. Insulin-sensitizers (Metformin, Actos) are other effective treatments to manage insulin and hormone levels in teens with PCOS. Some women who don't get monthly periods find their periods resume in a few months of consistent use of insulin-sensitizers.
Some young women with PCOS may need OCPs for the treatment for PCOS. Those who want to take OCPs should be aware of the risks they bring and other alternative treatments that effectively improve insulin and hormone levels without the added risk for heart disease.

Source:
Hoeger, K et al. The impact of metformin, oral contraceptives and lifestyle modification, on polycystic ovary syndrome in obese adolescent women in two randowmized, placebo-controlled clinical trials. J Clin Endocrin Metabl. 2008.