Dr. Betty Murray explains how hormonal birth control masks polycystic ovary syndrome and other metabolic disorders by suppressing the hormone fluctuations that signal these conditions. Women on contraceptives may have regular periods without actually ovulating, hiding elevated testosterone, abnormal LH levels, and other biochemical red flags that would otherwise prompt diagnosis.
So what you see is you don't see the hallmarks of what's really happening metabolically behind the scenes through the shifts of ovarian hormones. However, the metabolic activity is still there. So if we were to look at somebody who has polyendocrine metabolic syndrome, I mean ovarian syndrome, what you would see in somebody who's, let's say, in their 20s and 30s, not on suppressive hormone therapy like birth control, is you would see luteinizing hormone elevated. You would often see androgens also elevated. You would see estrogen relative to progesterone low. You may or may not ovulate, right? But you may have periods, right? So one of the things that gets missed is you may have normal periods, but still have the hallmarks of what's going on because you're not necessarily developing ovarian cysts. And you may or may not be ovulating on a regular basis. We've known that about postmenopause or perimenopause for a long time. Women still have periods, but often aren't truly ovulating. Right? So if you're on birth control, that's all being hidden behind the scenes, but the metabolic derangement's still there.
