Choosing happiness or choosing to look like an acne covered werewolf: the downside to birth control for PCOS
I’ve been on the pill since I was 14 when I started showing polycystic ovary (PCOS) symptoms, and 9 years later, I’ve been on and off it more times than I can count. I’ve probably been prescribed every single kind of pill there is.
Something that surprisingly is not common knowledge but really should be is that the birth control pill is not just used for birth control. Birth control is health care. I wasn’t sexually active when I was 14. The birth control pill is used to help treat acne, endometriosis, irregular periods, and PCOS.
That said, there’s no shame in using the pill for birth control. However, it can definitely be frustrating if I’m venting about not liking the pill and get met with “you should get the coil, like me”. Just because the pill is a contraceptive, doesn’t mean it’s right to assume everyone who takes it is using it for contraception.
So, what is PCOS:
Polycystic ovary syndrome is a hormonal disorder that affects women & people with a uterus of reproductive age.
Those with PCOS experience infrequent or long periods, and may have excess androgen (typically thought of as a male hormone), their ovaries can also have follicles full of fluid, and not always release eggs when they’re supposed to.
Symptoms of PCOS include; depression, anxiety, skin tags, extremely painful and heavy periods, irregular periods, excess hair growth, acne, thinning of hair on the head, and more. The cause is unknown, and there isn’t a cure. So the ways to manage it are to maintain a healthy weight due to the increased risk of type two diabetes and heart disease and use to the pill to manage acne and irregular cycles.
For me, it means my period shows up whenever it feels like it. I get skin tags on my neck, my hair starts thinning on my head but getting thick and dark on my body, and my skin breaks out. I feel like a werewolf with acne.
So, what’s wrong with the pill?
The pill is pretty controversial. A lot of people find that it messes up their mood too much to be worth being on, some struggle to remember to take it at the same time every day, some people just don’t like putting hormones into their body. All of these reasons are valid. Some people are perfectly happy being on the pill, and that’s great for them!
For me, I’m a hypochondriac, so my brain turns “the increased risk of breast cancer or a blood clot”, into something inevitable. There’s also the fact that the pill absolutely can trigger depression or at the very least, lower your mood and cause mood swings. I often wonder if my low mood is triggered by the pill, but more often than not, after being on it consistently for a few months, I have a bit of a breakdown and take a break.
Within weeks my skin starts breaking out, the hair on my head gets thinner while the hair on my body gets darker, and my period just decides to show up whenever it feels like it. I always hoped that maybe my symptoms weren’t PCOS and were just puberty; after all, the first few years of your period are the worst as your body tries to adapt to its new normal. When I go back on the pill my PCOS symptoms ease up considerably; until I get freaked out about being on the pill, and the cycle repeats itself.
I’ve gone to my GP time and time again about it, and her answer is always the same; the treatment is the pill.
What do I do to find a balance?
I make sure to eat healthily and exercise to prevent things from getting worse, but if I lose any more weight I’ll be underweight, so weight loss isn’t going to make things any better for me. Adopting a healthier lifestyle did wonders for my mood, but depression is more complex than just going for a walk and eating some vegetables. Being active and eating well was a big help, but it can’t “cure” depression, or PCOS.
When it comes to managing excess body hair, I bleach what I can only describe as sideburns, and use a cream that prevents hair growth on what would literally become a moustache and beard if I let it go. It’s exhausting, stray hairs still manage to grow, and I spend a considerable amount of time plucking my upper lip in the bathroom.
What lockdown has proven to me is that my adult acne is the result of hormones, and not make-up or my skincare regime like some people suggest. Even after going vegan, the lack of dairy in my diet didn’t make a difference to my skin. People suggest so many face washes and creams as if people with acne haven’t already tried everything. Topical solutions never fully clear up my skin, but they help. Even on the pill, I’ve never had crystal clear skin, and I’ve had to accept that I probably never will.
I’m not a doctor, but I have noticed that it takes roughly 3 months after I go off the pill for all the PCOS symptoms to come back so in a way to find the best of both worlds I tend to just go on the pill, and when I’m feeling overwhelmed by it, taking a month or two off before going back on it.
Of course, you should consult your GP if you’re on the pill and want to follow my lead. I’m just doing what works for me.
So what does this all mean? First, I would say don’t assume everyone on the pill is on it for contraception. I’d love to be able to just stop taking it and get the coil, but I can’t. I feel like I’m stuck on the pill or stuck having my hormones all over the place. Sometimes you need to let people vent and not give unsolicited advice. It’s frustrating having two choices which both have massive drawbacks; I can be happy, or I can live with uncomfortable PCOS symptoms; there’s no winning. I’m trying to thread the middle ground.