I am currently on the depo shot to control the PCOS. I cannot take estrogen based pills due to pulminary emboli (yes, there were multiple clots) back in 2012. I like the depo shot but it is getting harder and harder to schedule a good time. I'm considering getting Nexplanon but wanted to hear from others first.
Nexplanon - Anyone using it to help control PCOS?
Question posted by jamjam424 on 27 Sep 2014
Last updated on 18 September 2015
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Answers
I'm sorry that no one answered your question before now.
I have used both the implant & Depo. I do not have PCOS,
However, I have found a paper written by the Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit, at the NHS in Glasgow & Clyde, Scotland. In it, the question being asked is:
'Which contraceptive method provides suitable endometrial protection for women with polycystic ovary syndrome (PCOS) and does the method differ by age?'
The response they have given is as follows:
'Polycystic ovary syndrome (PCOS) occurs in 5-10% of women and is characterised by obesity,
hyperandrogenism, chronic anovulation and insulin resistance, which results in hirsutism, irregular
menses, and infertility. PCOS results in elevated oestrogen levels thus increasing the risk of
endometrial hyperplasia and eventually endometrial cancer. Elevated luteinizing hormone (LH)
levels are also common features of PCOS and the syndrome is associated with an increased risk of
type II diabetes, cardiovascular and cerebrovascular disease.
UK guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) includes oral
contraceptive pills or the Mirena® intrauterine system as treatment options for oligomenorrhoeic
women with PCOS. RCOG guidance does not specifically mention progestogen-only pills (POP) or
other contraceptives.
American College of Obstetricians and Gynecologists (ACOG) guidance on PCOS states that
combination oral contraceptives (COCs) are the most frequently used primary treatment of
menstrual disorders in women with PCOS. ACOG guidance also states that no long-term studies
have been undertaken which examine the use of depot medroxyprogesterone acetate (DMPA) by
women with PCOS. Again the guidance states that there is insufficient evidence on the use of
progestogen containing intrauterine devices (LNG-IUS) in women with PCOS. However, the
guidance states that progestogen-only contraceptives or progestogen containing intrauterine
devices (LNG-IUS) provide an alternative for endometrial protection but cautions that abnormal
bleeding patterns are experienced by 50-80% of users.
There is a paucity of evidence in the literature on the use of contraceptives by women with PCOS. It
is accepted that women with PCOS who develop or experience amenorrhoea or oligomenorrhoea
should have an artificial withdrawal bleed induced, in order to prevent endometrial hyperplasia, and
should shed their endometrium at least every three to four months. There is scant evidence in the
literature examining the use of progestogen-only pills (POP), combined oral contraception (COC) or
DMPA and PCOS, however there is consensus that COCs are an effective first line methods. DMPA
is thought to be the most efficacious contraceptive method8
as its use confers a prolonged protective
effect against endometrial cancer. POPs have been shown to confer protection against endometrial
cancer risk which persists after ceasing use in the general population however no evidence is
available on their effect in women with PCOS. No evidence was identified which examined the use
of the contraceptive implant (Nexplanon) in women with PCOS. Similarly, no evidence was identified
which examined the use of different contraceptive methods for treatment of PCOS in women of
different ages.'
There is quite a bit more information on that same paper, which you may find useful. I will provide the route to it, in a comment, to prevent a further delay in this post being replied to. I think you may find some of the info useful.
Hope that helps.
Just in case you don't see my last comment on this post:
'... UK guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) includes oral contraceptive pills or the Mirena® intrauterine system as treatment options for oligomenorrhoeic women with PCOS.4
RCOG guidance does not specifically mention progestogen-only pills (POP) or other contraceptives.
American College of Obstetricians and Gynecologists (ACOG) guidance5 on PCOS states that combination oral contraceptives (COCs) are the most frequently used primary treatment of menstrual disorders in women with PCOS. ACOG guidance5 also states that no long-term studies have been undertaken which examine the use of depot medroxyprogesterone acetate (DMPA) by women with PCOS. Again the guidance states that there is insufficient evidence on the use of progestogen containing intrauterine devices (LNG-IUS) in women with PCOS.
However, the guidance states that progestogen-only contraceptives or progestogen containing intrauterine devices (LNG-IUS) provide an alternative for endometrial protection but cautions that abnormal bleeding patterns are experienced by 50-80% of users.5
There is a paucity of evidence in the literature on the use of contraceptives by women with PCOS. It is accepted that women with PCOS who develop or experience amenorrhoea or oligomenorrhea should have an artificial withdrawal bleed induced, in order to prevent endometrial hyperplasia, and should shed their endometrium at least every two to three months.6
There is scant evidence in the literature examining the use of progestogen-only pills (POP), combined oral contraception (COC) or DMPA and PCOS, however there is consensus that COCs are an effective first line methods.4;5;7
DMPA is thought to be the most efficacious contraceptive method8 as its use confers a prolonged protective effect against endometrial cancer.6
POPs have been shown to confer protection against endometrial cancer risk which persists after ceasing use in the general population however no evidence is available on their effect in women with PCOS.6
No evidence was identified which examined the use of the contraceptive implant (NEXPLANON) in women with PCOS. Similarly, no evidence was identified which examined the use of different contraceptive methods for treatment of PCOS in women of different
ages... '
To help with the drug names:
Mirena® intrauterine system - The Mirena Coil
Oligomenorrhoeic women - Infrequent or light menstrual periods in women of child-bearing age
Combination oral contraceptives - The combined pill
Medroxyprogesterone acetate - Provera/Depo Provera
Intrauterine Devices - Coils
Amenorrhoea - Missed periods
Endometrial Hyperplasia - A condition of excessive proliferation of the cells of the endometrium, or inner lining of the uterus.
DMPA - Depo Provera
POPs - Progesterone only pills
I was wondering if you ended up switching to Nexplanon? I was just diagnosed with PCOS and can't be on certain birth control pills because of migraines. I decided to cut out the pain of oral contraceptives, since my choices were limited anyway, and get the Nexplanon implant. I just got it last week so I wanted to hear if you are having any positive results if you have been using it.
If not, I can be a resource for how it effects me and my PCOS. If you haven't gotten it already and are still on the edge, I will say the process of getting it in my arm wasn't nearly as bad as I thought it would be.
Related topics
depo-provera, polycystic ovary syndrome, nexplanon, estrogen, pill
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