Oral contraceptives are commonly used to treat symptoms associated with hyperandrogenism, such as acne, hirsutism, and hair loss. An estrogen-progestin combination suppresses LH, which, in turn, decreases androgen levels and increases SHBG levels. Increasing SHBG decreases the amount of bioavailable testosterone. Estrogen also suppresses sebaceous cell function directly. The form of progestin is an important consideration because some forms are more androgenic than others. Desogestrel and norgestimate are both low androgenic forms of progesterone and are commonly used for women with PCOS.45
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