Metformin is one of the most commonly prescribed drugs in the world. It is very effective in regulating blood sugar levels in people with type 2 diabetes.
However, metformin is increasingly being prescribed to people with polycystic ovary syndrome (PCOS).
This article will tell you everything you need to know about using metformin for PCOS.
Why would someone with PCOS be prescribed metformin?
Polycystic ovary syndrome (PCOS) is the most common hormonal problem affecting young women.
PCOS can cause amenorrhea or irregular periods, fertility problems, and can cause excessive hair growth, acne, and weight gain. Metformin is increasingly being used to treat the symptoms of PCOS.
Metformin is available in many brands and is taken daily (or twice a day), usually as an oral pill.
Metformin helps control blood sugar levels and fight insulin resistance, and may even help with weight loss.
If you have PCOS, you may be prescribed metformin as it has been shown to stabilize hormone levels and help many women return to regular menstrual cycles.
There is also evidence that the longer you take metformin, the more regular your cycles will be and the less severe your PCOS symptoms may be.
If you have PCOS and are struggling with weight gain, irregular periods, acne or infertility, your doctor or healthcare provider may prescribe metformin to help manage these symptoms.
Is metformin safe for PCOS?
Metformin is widely accepted as a safe drug, regardless of the reason it was prescribed.
However, it should be noted that metformin for the treatment of PCOS is not officially approved by the Food and Drug Administration (FDA). Any doctor’s prescription of metformin to treat PCOS will be written off-label.
There are risks of side effects that you should be aware of when taking your PCOS medication.
The most common side effects of metformin include gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
These symptoms are usually mild and most doctors recommend taking the medicine with food to reduce the severity of these gastrointestinal symptoms. Your doctor or health care team may also recommend starting on a low dose of metformin and gradually increasing your dose over time to make sure you don’t get severe stomach upsets or other side effects.
There are also very rare – and more serious – side effects such as lactic acidosis, which is an increase in lactic acid in the blood. This is much more likely to occur in people with kidney or liver problems, so your doctor will likely ask you about your medical history before prescribing metformin.
Long-term use of metformin is also known to increase the risk of vitamin B12 deficiency in some people, so supplementation or a blood test is sometimes recommended.
Metformin too NO has undergone rigorous clinical trials in pregnant and lactating women, although there is reason to expect it to be effective.
If you’re trying to conceive and have PCOS, your doctor may prescribe you off-label metformin, as it can help restore regular menstrual cycles and ovulation. It’s important to discuss whether it’s safe to continue taking your medicine if and when you become pregnant.
Can PCOS go away with metformin?
Unfortunately, polycystic ovary syndrome is a chronic disease for which there is no known cure. However, the symptoms of PCOS can be treated with medications, including metformin.
Metformin works by reducing insulin resistance, which is a common symptom of PCOS. By improving insulin sensitivity, metformin may help regulate menstrual cycles, reduce symptoms such as hirsutism (excessive hair growth) and acne, and improve fertility.
While metformin can be an effective treatment for PCOS symptoms, it’s important to remember that it’s not a cure for the condition. Women with PCOS may need to continue taking metformin or other medications to relieve symptoms in the long term.
Lifestyle changes, such as eating a healthy, balanced diet and exercising regularly, can also help manage PCOS symptoms.
If you have PCOS, it’s important to work with your doctor or healthcare provider to develop a care plan that works for your health history, minimizes symptoms, and meets your goals.
How exactly does metformin help people with PCOS?
To understand how metformin may affect people with PCOS, it is important to understand some of the biological changes that occur with PCOS.
While the underlying cause or “trigger” of PCOS is not well understood, scientists know that PCOS involves a series of interrelated changes between the ovaries, pancreas, insulin levels, and the body’s sex hormones (among other hormones).
All of these complex hormonal changes cause the ovaries to develop extra follicles or cysts (“cysts” in “polycystic”) and insulin resistance. Insulin resistance leads to higher blood sugar levels and puts a strain on the pancreas as it has to produce more insulin to lower blood sugar to normal levels.
Metformin works in several different ways simultaneously, many of which can help with PCOS symptoms.
Metformin lowers the amount of sugar produced by the liver, reduces the absorption of sugar in the intestines, and enables individual cells in the body to consume more sugar and use it more efficiently.
Together, these three changes reduce the amount of sugar (in the form of glucose) circulating in the blood. This makes the body more sensitive to insulin, meaning the pancreas has to produce less insulin in the first place.
These changes can lead to more regular menstrual cycles, reduce sex hormone imbalances, and can help reduce both acne and hirsutism (excessive hair growth, especially on the chest and face) that occur with PCOS.
Large clinical trials also show that metformin helps people lose the weight they may have gained with PCOS.
Frequently asked questions
Metformin doses for treating PCOS will vary, and your doctor is more likely to start with a lower dose (e.g., 500mg with a meal) to manage unwanted side effects of the drug, such as nausea and upset stomach.
A meta-analysis found that 1500 mg – 2550 mg per day is generally sufficient to address the main symptoms of PCOS.
But as with all prescription medications, your doctor can evaluate your health goals and history, as well as any underlying symptoms you’re experiencing to determine the right starting dose.
Research has not definitively shown any way to prevent PCOS. However, PCOS symptoms can be alleviated or managed with medications (including metformin) and a healthy lifestyle, including maintaining a balanced diet and getting enough exercise.
While the drug is generally safe and often effective, metformin unfortunately doesn’t work for everyone with PCOS.
Metformin is highly effective in lowering blood sugar levels in women with PCOS.
Most – but not all – women also experience significant improvement in acne and unwanted hair growth related to sex hormones.
While many women see their periods become more regular with metformin, only about 40% will experience a “completely normal” period.
The weight loss effects of metformin also vary greatly from person to person.
Metformin takes time to build up in the body. Often, the doctor starts treatment with a lower dose of the drug to avoid unpleasant gastrointestinal side effects.
Most people will notice an improvement in their blood sugar levels after a few weeks. However, long-term studies of metformin use for PCOS show that it can take up to 6 months for the drug to start menstruating regularly.
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