A 25-year-old woman presents to the GP with heavy, irregular menstrual bleeding since stopping the combined oral contraceptive pill 6 months ago. Prev...

Question

A 25-year-old woman presents to the GP with heavy, irregular menstrual bleeding since stopping the combined oral contraceptive pill 6 months ago. Previously, her cycles were regular at 28 days before starting the COC at age 18. Her recent bloods show normal thyroid function and prolactin. She has a BMI of 30 kg/m². Pelvic ultrasound shows bilateral polycystic ovarian morphology. What advice should the GP give about the relationship between the COC and her current symptoms?

Accepted Answer

The COC likely masked pre-existing PCOS by providing regular withdrawal bleeds - the underlying condition was not caused by the COC but was concealed by it

Answer

The COC caused her PCOS

Answer

Her symptoms will resolve spontaneously now she has stopped the COC

Answer

She should restart the COC immediately to cure the heavy bleeding

Answer

PCOS always develops after stopping the COC

uk-drcog MCQ (SBA): PCOS Unmasked After Stopping COC