After Birth: Birth Control and PCOS

I’m back for a bit to update you on the recent information I’ve gathered regarding my lovely PCOS and my future birth control plans.

I have my six week checkup on Thursday (has everything healed?  Are my goodies permanently deformed??), but before I go in I decided to gather some information from my RE.  (I absolutely adore this doctor and wish I could pay him to be my doctor for everything).  I asked his opinion on what I should do for future birth control, both for my PCOS and for the future (if we choose to do an FET).  I want my body to be both healthy for now, and healthy for a possible second child.  Since I am on the cusp of menopause (already peri-menopausal) I wanted to also verify that menopause would not deter a future FET.  Turns out it won’t!  It won’t even hurt the chances of success!  Science is on the ball, guys.

So, the birth control options are an IUD, progestrin only pills (refered to as a “mini pill” by the RE), a combined pill with progesterone and estrogen (he is not 100% sure they will still do this for a breastfeeding mother, but they used to ten years ago when he did his residency), and good ol’ condoms.

Condoms are out.  Those are so not fun to deal with.

The mini pill is most likely the way my OB/GYN will have me go.  I already know a girl who was put on this from the same practice.  She said they recommended this as the only option for a breastfeeding mother.  I may not have an option.

The combined pill is what I want the most.  I am worried about remembering to take a pill at the moment, since I am quite tired most days, but it is best for me because of the estrogen.  The estrogen will help keep my not-so-fun PCOS symptoms under control.  I’m just not sure they will let me take a pill containing estrogen while breastfeeding.  We shall see!

IUD is an option, of course, but it worries me that I do not know one person who has successfully had an IUD placed and kept it longer than a couple months.  Constant pain seems to be the biggest complaint, and who wants to live with that?  Only upside?  My RE believes that it will prevent any future periods.  This is good for convenience sake, but I was quite worried about the risk factor for endometrial cancer.  For those of you with PCOS, we have a very high risk of endometrial cancer due to our lining not shedding enough.  The lining stays in and basically rots.  Awesome.  But rest assured, if you go with the IUD, the hormone that is released by the IUD keeps the endometrium from forming, which prevents the risk of the cancer.  Hoorah!

So, these are my options.  I will update and let you all know which I’m going with.  IUD, combined pill, or mini pill??