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Birth control pills, which contain the hormones estrogen and progesterone, can help regulate your menstrual cycle. They may also help mitigate many of the symptoms of excess androgen production, such as acne and unwanted facial and body hair. 

Birth control pills that contain a combination of estrogen and progesterone are commonly prescribed and are generally safe for women who do not smoke or have a blood-clotting disorder. The pill does carry a risk of blood clots, especially in smokers. Talk to your doctor about whether it’s right for you.

Our experts may prescribe anti-androgen medications, such as spironolactone, to block the action of male hormones, or androgens, such as testosterone. Anti-androgen medications may also cause irregular menstrual cycles. If you become pregnant while taking them, they may harm your unborn child, so doctors often prescribe the medications in combination with birth control pills. 

Although rare, some anti-androgen medications have potentially serious side effects, including electrolyte problems, liver disease, or low white blood cell counts, which can increase your risk for infection. Your doctor may recommend having regular follow-up visits and blood tests to ensure your body is responding to the medication.

Many people with PCOS have insulin resistance, which can cause excess androgen production, irregular periods, obesity, and diabetes. Metformin is a type 2 diabetes medication prescribed to treat people with these problems. It belongs to a class of medication known as biguanides, which decrease the liver’s production of glucose and helps the muscles and body use insulin more efficiently. 

Metformin is taken by mouth, usually once or twice a day, and works best when used in combination with a healthy diet and exercise. Metformin can help regulate the menstrual cycle and even promote weight loss. A common side effect is upset stomach, but most people can cope with this by gradually increasing the dose and taking metformin with food.