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By Courtney Gilbert, PA-C |

Alternatives to Birth Control for Hormone Regulation 

You Have More Options for PCOS, Menopause & Perimenopause

Alternatives to Birth Control for Hormone Regulation

The search for alternatives to birth control for hormone regulation often begins with frustration. Women with PCOS, perimenopause or menopause frequently share their personal stories of being offered birth control as a default solution, even when their symptoms feel more complex than a pill pack.

This approach can leave them with more questions than answers and symptoms that remain unresolved.

Hormone regulation is not universal. Your concerns are valid. And effective care starts with time, education and a personalized understanding of what your body is communicating.

Key Clinical Takeaways

  • Birth control is often prescribed for hormone symptoms; however, it often masks just some of those symptoms and creates potential side effects without addressing underlying hormone patterns.
  • Many women with PCOS, perimenopause and/or menopause have safer, more effective options available including personalized hormone replacement therapy, nutrition supplementation and other lifestyle interventions.
  • Functional medicine focuses on identifying root causes and tailoring interventions to each individual patient, starting with in-depth conversations about health history, diagnostic testing and more natural treatments first.

Why Is Birth Control Often Used as a Solution for Hormone Regulation?

Hormonal birth control is commonly prescribed for hormone-related symptoms because it can suppress ovulation and stabilize hormone fluctuations. This approach can reduce concerns such as irregular cycles, heavy bleeding, acne or pelvic pain in some patients. Peer-reviewed studies show that combined oral contraceptives can effectively manage symptoms associated with conditions like PCOS by regulating estrogen and progestin levels.

While this approach can offer symptom relief for some, it may introduce side effects (such as nausea, bloating, blood pressure increases, etc.) and does not address the underlying drivers of hormone imbalance which can limit its long-term effectiveness. And for patients with fertility concerns, it may be a non-starter.

Why We Don’t Reach for Birth Control First

While it can be effective for symptom management, birth control isn’t always aligned with a woman’s goals, lifestyle or stage of life. This is particularly true for patients with PCOS whose primary concern is fertility. Many patients seek solutions are more targeted to their individual needs, more flexible to their busy schedules and more aligned with the approaches to health that they value.

Perimenopause patient running in Columbus, Ohio

“You read these first-hand accounts of women who have held off on managing their symptoms on their own terms because they’ve been told it somehow made them ‘resistant to care.’ There is nothing selfish … there is nothing stubborn about requesting more intentional care.” 

-Courtney Gilbert, PA-C

Unique Circumstances When It Can Be Employed Effectively

  • Fertility Is Not a Concern: When fertility is not a current or future goal and the patient is seeking symptom control rather than cycle optimization and/or ovulation support.

  • Short-Term Symptom Stabilization: Particularly in cases of severe cycle irregularity, heavy bleeding or pain where immediate relief is clinically appropriate while longer-term strategies are evaluated.

  • Other Options Exhausted: If symptoms remain disruptive to quality of life after foundational interventions have been explored, such as nutrition, supplementation, movement, stress management and targeted hormone support.

  • If It Has Worked Before: When a patient’s personal preferences, lifestyle or medical history make birth control the most practical option, and the decision is made collaboratively with full understanding of benefits and limitations.

A woman patient stretching at the gym in Columbus, Ohio

Alternative Solutions That Can Be Employed Safely & Effectively

Other medical interventions exist because there is no universal hormone protocol. Hormone regulation is most effective when interventions are personalized, iterative and informed by comprehensive testing and clinical insight.

“Your menopause symptoms aren’t the same as your mother’s! Neither are your options. I’ve worked with so many patients who wanted to take a different approach, one without birth control. And they found that relief through functional medicine.”  

-Courtney Gilbert, PA-C

GLP-1s & Weight Management

Improving metabolic health and reducing excess weight can meaningfully improve symptoms like irregular cycles, energy crashes and cravings. GLP-1 medications (commonly used for weight management and type 2 diabetes) may be considered in select cases when lifestyle and foundational interventions haven’t been enough, because they can support appetite regulation, insulin sensitivity and sustained behavior change.

While GLP-1s are not FDA-approved specifically for conditions like PCOS, they have been used off-label as part of a personalized plan when fertility goals, risk factors and long-term health priorities are clearly defined.

Nutrition & Supplementation

Targeted nutrition can be used to improve insulin response, inflammation and the building blocks your body uses to produce hormones. A personalized plan often prioritizes protein and fiber for blood-sugar stability, strategic carbohydrates (instead of blanket restriction), and nutrient-dense meals that support consistent energy and fewer cravings.

Supplementation can be helpful when it’s based on symptoms, labs and tolerance. Support can be fine-tuned to the root cause of symptoms, including insulin sensitivity, cycle regularity, sleep quality or stress physiology.

Movement, Motion & Stress Management

Lifestyle interventions are often the most powerful foundation because they influence cortisol signaling, insulin sensitivity, sleep quality and systemic inflammation — all of which intersect with hormone symptoms.

Stress support matters, too, because chronic stress amplifies symptoms (sleep disruption, cravings, cycle irregularity), so we often employ practical tools like sleep optimization, breathwork, mindfulness and recovery days that help the body stay in a safer, steadier rhythm.

Best Exercises During Your Cycle

2 women patients discussing their exercise routines outside of the gym

“Consistency is so vital when it comes to our hormones, which means routines have to be realistic for a patient’s schedule & energy. I often recommend strength training for metabolic support & low-impact movement for stress regulation, always within the context of their lifestyle. We need to build a plan that you can sustain, whether that’s a few resistance sessions each week or smaller, more frequent movements at home!”

-Courtney Gilbert, PA-C

Hormone Replacement Therapy (HRT)

HRT can be an effective option for some patients, especially when symptoms like hot flashes, sleep disruption, mood shifts or brain fog are significantly affecting quality of life. Hormone support should be approached thoughtfully. It should be informed by comprehensive evaluation, leveraging tools like DUTCH testing to better understand hormone patterns and stress metabolism before recommending a plan.

HRT isn’t a blanket solution, and it isn’t right for everyone, but for the right candidate it can be a targeted, science-backed intervention that supports comfort and long-term wellbeing.

Explore HRT

Gut Health & Insulin Response Optimization

Hormones don’t operate in isolation. Digestion. Inflammation. Cortisol. Bood-sugar regulation. They can all influence symptoms a patient may feel day to day, including bloating, stress, fatigue, cravings, acne breakouts and cycle disruption. Advanced GI Map testing can help identify patterns related to gut microbiome balance, inflammation or infections, especially when symptoms suggest an underlying digestive driver that hasn’t been addressed.

Pairing gut-focused care with insulin-response optimization (nutrition, movement, targeted supplements and sometimes medication support) creates a more stable internal environment where hormone-focused interventions can work more effectively.

How To Heal Your Gut

Functional medicine fertility patient after managing PCOS symptoms

Managing PCOS Symptoms While Supporting Fertility

Symptom management and fertility support go hand-in-hand for many women with PCOS. In fact, addressing these concerns often rely on the same foundational strategies. Approaches like those listed above can help regulate cycles, improve metabolic health, balance hormones and create a more supportive environment for ovulation.

Because fertility is one of the most common concerns for women with PCOS, these interventions are designed to work with the body rather than suppress its signals through the use of birth control. This overlap allows care to feel both proactive and aligned with future reproductive goals, when and if they matter to the patient.

More About Fertility Optimization

Functional Medicine Gives You More Answers — & Effective Solutions

Functional medicine creates space for the alternative solutions above by uncovering the why behind symptoms. It gives greater context to a patient’s health. It allows them to move beyond unanswered questions and pill alarm reminders toward a deeper understanding of their bodies and care that supports the life they’re in today.
“Traditional healthcare providers are so vital to keeping us healthy, but they are limited by hours in the day. Since making the move to functional medicine, I’m able to offer women the time & resources they need to handle it all, on their terms.”
-Courtney Gilbert, PA-C
Courtney Gilbert, PA-C Author Photo

About The Author

Courtney Gilbert, PA-C, is a fertility expert and hormone therapy specialist in Columbus, Ohio. She employs functional medicine interventions to help women regulate their hormones, alleviate symptoms and optimize long-term wellbeing. Courtney prioritizes education-driven care, drawing from specialized experience in urogynecology and a deep understanding of patient needs as both a provider and a mother. She empowers women everywhere with science-backed insights so they can make informed, confident decisions about their health.

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