Metformin for PCOS: How It Works, Side Effects & Health Tips

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Medical doctors have been using Metformin for treating diabetes type 2. Metformin decreases insulin resistance, and helps the body in utilizing insulin effectively. Given that PCOS is also associated with insulin resistance, doctors started prescribing Metformin for this hormonal disorder as well. Let’s understand the role of Metformin for PCOS in detail.

Insulin Resistance: The Reason Why Metformin is Prescribed For PCOS

Insulin resistance is a common condition in a majority of PCOS cases. Experts believe it is a key reason behind this condition. If you’re experiencing insulin resistance, your body fails to respond to normal levels of insulin.  As a result, glucose starts to accumulate in the blood. To tackle excess blood sugar, the pancreas produce more insulin. This condition is called hyperinsulinemia or the presence of excessive insulin in the blood.

High levels of insulin in the body trigger the over-production of male hormones in the female body. Excess male hormones in the female body lead to symptoms of PCOS such as acne, excess body hair,  male pattern baldness, and belly fat.

How Does Metformin Work For PCOS?

The USFDA approved metformin in 1994. Metformin works on PCOS in the following ways:

  • Improving insulin sensitivity of cells, thus helping reduce insulin levels in the blood
  • Curbing the production of glucose inside the liver
  • Increasing the absorption of glucose by cells, and
  • Inhibiting the use of fatty acids for production of energy.

Doctors also figured out that Metformin helped PCOS women by regularizing their periods. They also found that the drug helped in reducing the levels of male hormones in women with PCOS.

Women with PCOS have to undergo something called as “ovary stimulation” prior to IVF treatment. Doctors prescribe Metformin to reduce the risk of a condition called ovarian hyperstimulation syndrome, a medical condition in which the ovaries become painful. Metformin also helps women to produce eggs of a better quality. Some studies suggest that Metformin use can decrease the risks of miscarriage in PCOS women.

Women are also at a risk of developing gestational diabetes during pregnancy. This is a temporary condition that gets better on its own after the woman gives birth. Women who have suffered from gestational diabetes stand a higher chance of developing full-blown type 2 diabetes in the future. Because women with PCOS already are suffering from insulin resistance, they have a higher risk of gestational diabetes. Metformin seems to reduce the chances of gestational diabetes in pregnant PCOS women.

However, there is no research to support that Metformin helps in losing weight. You should use Metformin only with appropriate changes in diet and lifestyle to support weight loss. Metformin should only be used if there is a clear case of insulin resistance. Unfortunately, the connection between Metformin weight loss PCOS is at best unclear.

Does Metformin Have Any Long-Term Health Benefits?

Insulin resistance is central to the advancement of PCOS. The treatment of PCOS revolves around reducing insulin resistance and hyperinsulinemia. This is a key reason why doctors prescribe metformin for patients of PCOS.

However, we should not forget that PCOS is not just a reproductive disorder. It is a life condition that can have serious and sometimes fatal health complications. Heart disease, type 2 diabetes, metabolic syndrome and endometrial cancer are some risks associated with PCOS. All these risks are linked to obesity and insulin resistance. Since Metformin works in reducing insulin resistance and hyperinsulinemia, it can offer long-term disease protection to women with PCOS.

What Are the Side Effects of Metformin?

  • Digestive issues, such as:
    • Stomach or abdominal discomfort
    • Diarrhea
    • Nausea
    • Flatulence
    • Bloating
    • Reduced appetite
    • Anorexia
    • Metallic taste
  • Fatigue
  • Red blood cells becoming too large
  • Cough or hoarseness of voice
  • Tingling or numbness in the palms and feet
  • Pain in the lower back or in the flanks (sides)
  • Muscle pain or cramping
  • Hair loss
  • Shallow breathing
  • Painful or difficult urination
  • Blurred vision
  • Weight gain
  • Anxiety

Although very rare, Metformin can lead to serious condition called lactic acidosis. This condition is common in PCOS women who are also diabetic. This is a life-threatening condition where lactic acid accumulates in the blood and reaches dangerous levels.

Metformin interferes with the way in which our bodies process certain vital nutrients, like vitamin B12. Many of the side effects and complications of Metformin are due to the loss of these nutrients from the body.

How to Reduce Metformin Side Effects?

Due to metformin side effects, women with PCOS should be cautious while using this medication. Most healthy women will not experience the side effects of metformin. However, if you’re taking Metformin, you need to be aware of the potential side effects of Metformin. For example, Metformin depletes vitamin B12 from the body.  A deficiency of vitamin B12 can result in mental illness, heart disease, and even infertility. To deal with this deficiency, you need to include vitamin B12 supplements and foods rich in this vitamin in your diet.

How Much Metformin Should You Take?

Metformin is available as a pill or liquid. Significant responses are not observed at less than 1000 mg metformin dosage for PCOS. Doctors usually start you off with a single dose of 500 mg with your largest meal. This is to avoid digestive issues.

Once you tolerate this dosage, doctors will increase the dosage to 500 mg taken twice, once with lunch and once with dinner. If this dosage is also tolerated well, your doctor will increase it to 500 mg three times – with breakfast, lunch and dinner. The target dose of metformin is in the range of 1500-2500 mg per day.

An extended-release version of the pill is also available. You have to take it once a day. It is long acting and will keep on releasing a constant amount of metformin in your body.

Health Tips If You Are Taking Metformin

Do not take Metformin if you have a liver of kidney problem. Drink enough water to keep yourself hydrated while you are on Metformin. Also, if you’re on Metformin, you should be cautious while drinking alcohol. Both Metformin and alcohol put stress on liver, therefore limit your drinking if you’re on this drug.

If, for any reason, you are not going to eat food for a long time (like before or after a surgery) while on Metformin, you need to consult your doctor. They may advise you to stop taking Metformin until you resume eating again. Also, before undergoing any test that requires the ingestion of a “contrast dye” (contrast X-ray or CT-scan), you need to stop taking metformin for up to 48 hours before and after the test. In general, always consult your doctor before doing anything that is different from your normal.

Metformin For PCOS: Final Thoughts

Metformin is among the most important drugs in allopathic medicines. It does have a wide spectrum of effects on the body, which makes it a great choice for a variety of disorders, including diabetes. However, you cannot ignore its negative effects on the body. As it depletes vital nutrients, Metformin may do more harm than good in the long term.

Remember, Metformin is prescribed for PCOS because of its ability to deal with insulin resistance. However, there are other holistic ways to improve insulin resistance. A combination of diet, lifestyle changes, stress management and regular exercise can help in improving your body’s sensitivity towards insulin. This improvement will go a long way in dealing with the symptoms of PCOS and eventually reversing the condition.

Tags : Metformin

Jitendra Rathod

Jitendra Rathod

Microbiologist and Science Writer
Jitendra is a microbiologist and a passionate student of the human body. He is a firm believer in the power of alternative and holistic medicine. He believes nature holds the key to restore us back to health and balance.

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Medical And General Disclaimer for
This article is intended for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. strongly recommends that you consult a medical practitioner for implementing any of the above. Results may vary from person to person.

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