Insulin resistance is seen in the majority of women with PCOS. Doctors prescribe metformin for PCOS because it is an effective insulin sensitizer. However, metformin comes with its share of side effects. Let’s look at them in detail.
Metformin Side Effects PCOS
1. Malaise Or Physical Discomfort
As many as 1 in every 4 women on metformin just does not feel well. There is a feeling of fatigue even without much physical exertion. Sometimes, this fatigue is accompanied with aches that can last for a varying degree of time. While this side effect of meformin may not sound too severe, it can be a huge dampener for any woman with PCOS.
2. Gastrointestinal Distress
Nearly a third of women taking metformin experience gastrointestinal problems. These problems include abdominal pain, nausea, occasional vomiting, loose motions, irregular bowel movements or diarrhea. Bloating and flatulence can be a major source of embarrassment. Anorexia and a sharp metallic taste can play havoc with your appetite when eating a healthy diet at the right times is critical for a woman with PCOS. Heartburn and headaches add to the suffering caused by PCOS symptoms.
Metformin is known to decrease your B12 levels because it affects the absorption of this vitamin. Vitamin B12 is vital for red blood cell formation. When levels of vitamin B12 go down, you can suffer from anemia. Common symptoms of anemia include tiredness, lightheadedness, and dizziness. Vitamin B12 also plays an important role in many bodily processes. For example, there is evidence of a relationship between low levels of vitamin B12 and an increased risk of heart diseases.
4. Accumulation Of Homocysteine
Long-term use of metformin f0r PCOS causes a decrease in the levels of folic acid (vitamin B9). This causes an increase of an undesirable compound called homocysteine. The accumulation of homocysteine is linked to increased risk of colon cancer, stroke, recurrent miscarriage, Alzheimer’s disease, depression and heart disease. Low levels of vitamin B12 and folic acid along with high levels of homocysteine are also harmful to the health of a developing baby.
5. Lactic Acidosis
One of the rare, yet serious, metformin PCOS side effects is lactic acidosis. This condition occurs when lactic acid accumulates in the body. As a result, the blood becomes highly acidic. If the acid levels go too high, it is a medical emergency and the patient has to be moved to an ER. They need to be treated right away failing which she can go into a coma and probably die.
Symptoms of lactic acidosis include
- Extreme tiredness
- Loss of appetite
- Trouble breathing
- A fast or slow heart rate
- Muscle pain
- Stomach pain
6. Low Blood Sugar
Taking metformin alone for PCOS does not cause hypoglycemia or low blood sugar. However, metformin, when accompanied with an unhealthy lifestyle, can lead to hypoglycemia. If you eat a poor diet, consume excessive alcohol, or perform strenuous exercises, you are at a risk of becoming hypoglycemic.
Symptoms of hypoglycemia include
- Stomach pain
- Abnormally slow or fast heartbeats
Metformin was introduced as a “miracle drug” for diabetes a few decades back. In studies on women with PCOS, it also showed an impact on other than what it was intended for. This sparked interest in the use of metformin for treating the various symptoms of PCOS. However, its side effects profile, though small, can be a cause for worry.
The best way to treat PCOS from its roots is a change in diet and lifestyle along with effectively managing stress and a targeted exercise regimen. Medications will only help mask the symptoms and come with their own side effects. Treating PCOS through a holistic treatment strategy is the best way forward.