Between 4 to 12 percent of women worldwide have polycystic ovarian syndrome (PCOS), one of the most prevalent endocrine system illnesses. The drug metformin is used to lower blood sugar levels and improve insulin sensitivity.
Metformin with PCOS symptoms is a commonly prescribed medication to help manage insulin levels in women with Polycystic Ovary Syndrome (PCOS). This article will discuss the effects of metformin on PCOS and possible alternatives.
Metformin: What is it?
The U.S. Food and Drug Administration or FDA has given metformin the go-ahead to treat type 2 diabetes mellitus. Additionally, the American Diabetes Association has approved it for treating prediabetes, and healthcare professionals may use it to manage PCOS.
The medicine metformin belongs to the biguanides class of medications. Reducing how much glucose the intestines absorb, inhibiting the liver from producing too much sugar, and raising insulin sensitivity normalizes blood glucose levels. It is offered as a generic under several brand names, including Glucophage and Fortamet.
How can metformin be used to treat PCOS?
PCOS is a hormonal condition that frequently affects pregnant or nursing women. It may result in irregular or protracted menstrual cycles or higher levels of androgens (male hormones). Small follicles or cysts, fluid-filled sacs, can form in the ovaries and ovulate irregularly.
An excessive amount of insulin in the body is one of the potential causes that could contribute to the development of PCOS. Insulin aids in using sugar or glucose by the body’s cells. Blood glucose levels may increase due to insulin secretion increasing when the body cells become more resistant to the hormone.
Metformin with PCOS is typically part of a comprehensive treatment plan that includes lifestyle changes like diet and exercise.
Metformin improves the body’s sensitivity to insulin, which helps it treat PCOS. This has a favorable impact on adipose (fat) tissue and lowers circulating insulin levels.
Traditionally, doctors have advised metformin as a PCOS treatment for women with high BMIs. The evidence is mounting that persons with a lower BMI had an even greater response to metformin for PCOS. In non-obese females with anovulatory PCOS, the medication also seems successful in inducing ovulation.
Metformin may also have additional beneficial effects on PCOS-afflicted women, such as lowering weight and diabetes risk. It also lowers testosterone levels in the blood, alleviating hyperandrogenic symptoms, including hirsutism and acne. Metformin use may also lower the chance of developing ovarian hyperstimulation syndrome in women with PCOS who are undergoing IVF (in vitro fertilization).
How safe is metformin? Potential negative impacts to think about.
Some moderate side effects of metformin may disappear when your body becomes used to the medicine. If side symptoms persist or get worse, let your doctor know. Typical metformin side effects include:
Diarrhea: How the intestines absorb glucose is altered by metformin. Lactic acid is produced, which might irritate the intestinal lining. Patients are often started on minimal doses by healthcare professionals so that the body can acclimatize. This may lessen how bad the diarrhea is.
Nausea and vomiting: Although nausea is usual, vomiting happens more rarely. Take metformin with meals to reduce stomach distress.
Bowel discomfort: Due to the ways that metformin alters the body’s response to glucose, bloating, gas, and other intestinal sensations may occur. If metformin is taken with food, these side effects may be lessened and often subside over time.
Head pain: Metformin stops the liver from producing glucose. The first few days of taking drugs that directly affect the liver can result in minor headaches.
Three out of every 100 persons who take metformin can experience a temporary metallic taste in their mouth.
Weight loss: Although metformin is not a weight-loss medication, it may induce some weight reduction since it helps the body balance its insulin and glucose responses. Metformin may help counteract the effect of weight gain that type 2 diabetes and associated illnesses frequently experience due to insulin resistance and high glucose levels.
Less frequently, metformin can result in some severe adverse effects:
Hypoglycemia: Low blood sugar, or hypoglycemia, can happen when metformin is paired with vigorous activity, other diabetes treatments, dietary nutritional imbalances, or increased alcohol consumption. Lightheadedness, exhaustion, physical weakness, nausea, vomiting, and an abnormally fast or slow heartbeat are among the symptoms.
Anaemia: Metformin hinders the body’s ability to absorb vitamin B12. Anemia may develop if B12 levels are low. Extreme fatigue, lightheadedness, and a constant feeling of cold are symptoms. B12 deficiency over time can result in tingling and numbness, mood swings, low energy, hair loss, and brain fog. Your doctor can examine your iron and red blood cell counts to determine if you are anemic. Diets that are vegetarian or vegan may make this risk worse.
Lactic acidosis: The FDA has issued a black box warning about the risk of lactic acidosis for metformin. This occurs when the body accumulates too much metformin, leading to elevated amounts of lactic acid. Dizziness, lightheadedness, chilly, muscle soreness, excessive exhaustion, decreased appetite, nausea, vomiting, problems breathing, an abnormally fast or slow heartbeat, an unexpected reddening of the skin, or feelings of warmth are some symptoms. This medical crisis may be lethal. Immediately seek emergency medical attention if you experience lactic acidosis.
What are some alternatives to metformin?
Alternative drugs for PCOS treatment include:
Letrozole: This breast cancer medication may be utilized to stimulate the ovaries for typical ovulation in PCOS precisely. The common practice is to do this along with fertility treatments.
Gonadotropins: These hormones are delivered via injection and are used to treat PCOS. They are frequently employed in vitro fertilization (IVF) or fertility treatments.
Eflornithine: This drug is used to treat excessive facial hair.
Other medications aid in enhancing the body’s insulin or glucose responses:
Sulfonylureas: These aid in improving insulin synthesis, which can aid in lowering blood sugar levels. Examples include glimepiride (Amaryl), glipizide (Glucotrol), and gliburide (DiaBeta, Micronase, among others). However, they are less frequently used than metformin because they carry a more significant risk of resulting in low blood sugar.
Meglitinides: These aid in raising insulin levels, and the body produces more insulin in response to food. Repaglinide (Prandin) and nateglinide (Starlix) are two examples.
Thiazolidinediones: These drugs, such as rosiglitazone (Avandia) and pioglitazone (Actos), reduce insulin resistance. These drugs are only one of the options for treating high blood sugar because they may have more severe side effects.
Metformin for PCOS is typically advised to help patients lose weight and lower their chance of developing gestational diabetes. Infertility caused by anovulatory cycles in PCOS in non-obese individuals may also be successfully treated.
Metformin may be used by PCOS patients undergoing IVF to lower their risk of ovarian hyperstimulation syndrome. It’s important to consult with a healthcare professional before starting Metformin with PCOS to determine the right dosage and monitor its effectiveness in managing the condition.
Frequently Asked Questions
How long is metformin prescribed for PCOS?
For PCOS, metformin may be taken for a long time. While some patients use it long-term to maintain health, others use it for a few weeks or months to bring their symptoms under control.
Does PCOS metformin cause weight loss?
Although metformin is not a weight-loss medication, it may aid in weight loss because it normalizes the body’s reaction to insulin and glucose.
How soon does metformin start treating PCOS?
Most doctors start their patients on metformin at lower doses to lessen the severity of the adverse effects. The time it takes to get up to an effective dose may range from 1-2 weeks, although every person reacts differently.
If I stop taking metformin for PCOS, what will happen?
With the help of your healthcare physician, stop taking metformin. The medication metformin alters how glucose is absorbed in the intestines and aids in reducing the amount of glucose produced by the liver. Stopping metformin without finding a replacement medication may result in a rise in blood sugar and insulin resistance.