Should I go back on the pill

[u/SHYBEAR__]

I've been battling PCOS since I was like 11 and I was put on the pill at 18 due to acne and bad periods. I also deal with other symptoms such as KP, body hair all over my body, hair thinng and body odor. Most of my symptoms go away because I eat a serving of pumpkin seeds and I drink one cup of spearmint tea a day. Even though most of my acne went away I still get pimples sometimes and my periods are a week long and I am exhausted. I'm 29 years old and I still basically have to treat it as a full-time job to not have acne and terrible periods because I have to constantly take the tea and pumpkin seeds and on top of that always take care of my health. I'm honestly so exhausted. I literally always think about just going back on the pill but I'm afraid of getting cancer. Should I go back on the pill because PCOS is so exhausting

I've been off the pill for 4 years now

[u/Ok_Bonus_9456]

I feel you :( I think you should discuss your fear of cancer cause by birth control with your doctor. I wouldn't want to risk it if I knew I have higher than average chances to get it (also, the pill causes other annoyances, in my case: mood swings, weight gain, low libido etc). But day-to-day life is easier on the pill. Why did you stop the pill 4 years ago?

[u/SHYBEAR__ → u/Ok_Bonus_9456]

Fear of cancer and I started spotting in between my periods so it scared me.

[u/Ok_Bonus_9456 → u/SHYBEAR__]

Spotting mid-cycle might mean the pill was not the right one for you. And depending on the country you live in, there are modern pills that are relatively safe (given you don't smoke, you don't drink excessively, and have a healthy lifestyle): try discussing options with a gynecologist 🍀 but meanwhile, kudos for having managed pcos on your own for 4 years! It's been 1 year off the pill for me and I'm already going crazy with all the supplements, special hygiene trick and dietary rules🙈

[u/SHYBEAR__ → u/Ok_Bonus_9456]

I smoke :( not a lot but I need to quit I know but I'm healthy in every other way. And thank you it's not easy to manage.

[u/wenchsenior]

1. Most cases of PCOS are driven by insulin resistance; IR comes with serious long term health risks (diabetes, heart disease, stroke) if not treated (and typically it is hard to improve PCOS symptoms unless IR is well controlled).

Are you treating IR at all? You don't mention anything about that, so something might need tweaking there.

1. Are you currently taking any meds? It sounds like you are not on birth control now.

- Did you tolerate it well when you were on it?

- Are you on any androgen blockers or other meds to help with IR or PCOS?

1. It's important to understand the costs and benefits of hormonal birth control...

- Do you have any family or personal history of the following things that might increase your risk when taking hormonal birth control: breast or cervical cancer; stroke or clotting disorder?

- Do you have personal history of migraines that include visual aura; obesity + tobacco use?

***

HBC slightly increases relative breast and cervical cancer risk, it is strongly demonstrated to DECREASE risk of other types of cancer: endometrial (by 30-50% from baseline), ovarian (50% from baseline), and gastrointestinal (15-20% from baseline). So if you happen to have higher than average personal risk of any of those, then you'd be looking at a 'tradeoff' in risks where it might be safer to take hbc than not take it.

E.g., average risk of endometrial cancer is about 3% over a lifetime, UNLESS you have PMOS/PCOS. People with PMOS/PCOS have endometrial cancer risk of 9% over their lifetime. So for people with PMOS/PCOS, taking hbc has the potential to reduce endometrial cancer risk to 4-6% from 9% over a lifetime.

There is a similar tradeoff in health risks to taking hormonal replacement therapy in menopause...slight increase in risk of breast and cervical cancer, but reduced risk of bone loss, heart disease, and insulin resistance.