Oral Contraceptives Increase Insulin Resistance in Teenagers

If you're a teenager without a regular cycle or have other symptoms of PCOS, your doctor may have told you to just take birth control pills and everything will work itself out. However, successful treatment of polycystic ovary syndrome isn't always that simple.

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For one thing, birth control pills are synthetic hormones that have unintended consequences. The Athens University School of Medicine recently assessed the effect of two different ingredients of birth control pills on 36 adolescent girls with polycystic ovary syndrome.

Eighteen girls took a birth control pill containing cyproterone acetate, which is an anti-androgen, i.e., it suppresses the actions of the male hormone testosterone on tissues. The other 18 girls took a pill containing desogestrel, which is a synthetic mimic of progesterone.

After 12 months of treatment, insulin resistance increased significantly in both groups. In addition, cyproterone acetate is associated with an increase of insulin secretion and higher blood levels of insulin.

There is an increasing body of evidence to show that elevated insulin and the resulting insulin resistance are a primary cause of polycystic ovary syndrome in some women. If this is the case, what is the long term benefit of taking birth control pills if they tend to worsen insulin resistance?

It's not wise to blindly accept the simplistic concept that any pill will magically make your PCOS go away. If you're taking oral contraceptives, we suggest that you take care to consume a very wholesome diet, get plenty of exercise and find effective ways to deal with chronic stress. These measures will reduce insulin resistance and offset possible side effects of oral contraceptives.

Source: Mastorakos G et al, Effects of two forms of combined oral contraceptives on carbohydrate metabolism in adolescents with polycystic ovary syndrome, Fertil Steril. 2006 Feb;85(2):420-7

Birth Control Pill Could Make You Fatter

Birth control pills are not the panacea for PCOS that some people think. For example, the above study showed that birth control pills made insulin resistance worse. Since insulin resistance is now thought to be a primary cause of polycystic ovarian syndrome, you have to wonder whether long term use of birth control pills is the answer to your health problems.

More recently, a study has revealed a link between weight gain and the use of the oral contraceptive Diane 35.

Diane 35, a combination of the synthetic hormones ethinylestradiol and cyproteroneacetate, is widely used in the treatment of PCOS in many countries. In this study, 19 non-obese women with PCOS were evaluated before and after using Diane 35 for about 7 months. The researchers noted that the women gained a significant amount of weight during the 7 months. Their cholesterol levels also increased.

Be careful when taking the Pill, and discuss insulin resistance and alternative treatments with your doctor.

Source: Vrbikova J et al, Weight change and androgen levels during contraceptive treatment of women affected by polycystic ovary, Endocr Regul. 2006 Dec;40(4):119-23.