Combined Oral Contraceptives

Combined oral contraceptive pills (often simply called 'the pill') contain both synthetic estrogen and progestin and are one of the most commonly prescribed treatments for PCOS in women not actively trying to conceive. They work by suppressing ovarian androgen production, increasing SHBG levels (which binds free testosterone), regulating menstrual cycles, and protecting the endometrium from the risks of unopposed estrogen. Pills containing anti-androgenic progestins (such as drospirenone, cyproterone acetate, or norgestimate) are often preferred for PCOS as they provide additional anti-androgen benefits for symptoms like acne and hirsutism.