Metformin: basic information

18 Mar

Many PCOS patients are prescribed Metformin for the treatment of their condition. It can be a bit confusing, because it is only FDA approved for treatment of diabetes; however, there are a lot of good reasons for using this drug to treat PCOS. Here’s a general overview of some things you should know.

How It Works

Metformin improves your body’s sensitivity to insulin. If you read my post about insulin resistance, you’ll remember that an insulin resistant person produces a lot of insulin, and her body is not very good at recognizing and using it to control blood sugar. Metformin improves the body’s ability to do this; it resensitizes the cells to insulin, so that your body doesn’t have to produce as much.

What It Does
From your perspective, you might see the following results from Metformin:
* Lower risk of developing diabetes.
* Easier weight loss (this varies from woman to woman, but many feel that Metformin makes it easier to drop pounds).
* Drop in testosterone production–this is directly related to the drop in insulin production. This can also mean less hirsutism, acne, and hair loss.
* Improved menstrual cycle regularity. Many women on Metformin have more consistent or frequent cycles. That is why it is often prescribed for women who are trying to get pregnant. (I took Met when I was trying to conceive my second child, and it did regulate my cycle very well.)
* Reduced risk of miscarriage. This is why many reproductive endocrinologists recommend that PCOS patients continue to take Metformin through the 12th week of pregnancy or later.

Side Effects
Metformin can have some major side effects for some women. These include GI symptoms (nausea, diarrhea), which can be bothersome, but not usually dangerous, at least in the short term (see below for suggestions on minimizing these problems). However, Metformin is also associated with liver and kidney problems; usually, this won’t be an issue for you unless you have a liver or kidney function problem already.

Metformin can also cause (or contribute to) a problem called lactic acidosis. This is rare (3 in 100,000 Metformin users), but it is a serious problem, so you should be aware of the symptoms: weakness, slow pulse, muscle pain, deeper and more labored breathing, and sleepiness. This is more common if you have liver/kidney problems, dehydration, diabetes, or a great deal of chronic stress. It is very important that you NOT take Metformin while fasting (for example, before a medical procedure) or if you are dehydrated, for this reason.

How to Minimize Side Effects
If you do have unpleasant GI symptoms while taking this medicine, there are a few things you can do to try to make them less severe. Make sure that you eat when you take your medication; break up your dose over the course of the day; and, at least at first, avoid very fibrous foods such as salads. Some people also find that the name brand (Glucophage) causes them fewer side effects.

The Bottom Line
Should you take Metformin? That’s a question you’ll want to discuss with your doctor. It’s worth considering, though, if you have many symptoms of insulin resistance. The side effects (which, by the way, I never experienced) are manageable for most people who use it, and it may be protective against diabetes over the long term.

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