The benefit of metformin on ovulation in women with polycystic ovaries is not seen right away. There is some benefit starting about a month after beginning metformin. Metformin has a more substantial benefit for fertility when the woman has been taking it for at least 60 to 90 days.
Metformin may also produce several other positive effects in women with PCOS such as it helps in reducing weight and their risk of developing diabetes mellitus. It also reduces levels of circulating androgen; thereby, relieving hyperandrogenic symptoms such as hirsutism and acne.
Several effects have been reported as related to metformin in PCOS patients including restoring ovulation, reducing weight, reducing circulating androgen levels, reducing the risk of miscarriage and reducing the risk of gestational diabetes mellitus (GDM).
We start metformin at 500 mg once daily, increase to 500 mg twice a day after one week, then to 500 mg 3 times daily after another week. If the 3 times daily dose cannot be tolerated due to side effects, we remain on the twice-daily dose. The most effective dose of Glucophage for PCOS is generally 500mg 3 times daily.
Because of this, metformin is used to lower insulin levels in women with PCOS. Unlike other drugs used to treat diabetes, metformin does not cause low blood sugar (hypos) and therefore it is safe to use. The target dose of metformin for effectiveness is between 1500-2500mg/day.
Even though metformin may lead to some weight loss, the amount you lose may be far less than expected. On average, weight loss after one year on the drug is only six pounds, according to past research.
Ovulation was recorded in 92 patients (84.40%) in the metformin group compared to 86 patients (85.15%) in the control group (P = 0.88). Clinical pregnancy was found in 50 patients (45.87%) in the metformin group compared to 49 patients (48.51%) in the control group (P = 0.70).
How to check if metformin is working. A medical provider can run a few tests to see how metformin is affecting your health: Blood work can check if your glucose, insulin, and HbA1C levels are in range. If they are, the medication is working.
Risks of stopping metformin
If you stop taking metformin abruptly, your health may suffer. You may experience side effects such as higher blood sugars, an increased A1c, and even weight gain. Over time, higher blood sugar levels can lead to diabetes complications, including: Retinopathy and blindness.
Metformin impacts a person's sensitivity to insulin, a hormone essential in metabolic functioning. Metformin also has the effect of lowering testosterone hormone levels in the blood. 1 Lowering testosterone levels has been shown effective in helping to regulate a person's menstrual cycle in their premenopausal years.
The average weight loss in the group that received metformin was 5.8 kg (12.8 lbs) ±7 kg (± 15 lbs). Untreated controls gained 0.8 kg (1.8 lbs) ± 3.5 kg (± 7.7 lbs) on average. Patients with severe insulin resistance lost significantly more weight as compared to insulin sensitive patients.
Inositol is superior to metformin in how the body uses insulin. While metformin is a very common treatment for PCOS, it is not the only treatment option. Another insulin sensitizing agent class is inositol. Research has shown that inositol improves the way the body uses insulin to help burn sugar.
PCOS medications: Metformin, a drug used to reduce androgens and improve insulin resistance in women with PCOS, is linked with Vitamin B12 deficiency. Lack of B12 causes constant tiredness. Do not stop your medication without advice from your doctor.
Foods to eat while taking Metformin
Eat plenty of protein, and follow a lower-carbohydrate, lower-fat diet to manage blood sugar levels and support a healthy weight. Try and eat the following foods as much as possible: Fresh, whole fruits and berries like blueberries, strawberries, raspberries, and blackberries.
Metformin is a drug that is used in women's health for polycystic ovarian syndrome (PCOS), problems with excessive facial hair (hirsutism) and is also used for diabetes. Metformin reduces circulating insulin, which decreases the concentration of free levels of androgens.
Thus, metformin is capable of accelerating the oxidation of fat in the liver, thereby leading to a decrease of visceral fat or body weight.
Metformin should be prescribed to PCOS women when they are diabetic, in order to prevent their cardiovascular risk, after lifestyle modification. 7. Metformin should not be used in PCOS non diabetic women in order to lose weight. Metformin should not be used in order to treat dyslipidemia in women with PCOS.
Injectable gonadotropins combined with Metformin can boost the birth rate up to 32-60% in women.
It helps improve your blood glucose levels in a few different ways. First, it makes your body more sensitive to insulin. This helps your cells use glucose in your blood for energy. Metformin also decreases the amount of glucose your body makes and absorbs.
How long does it take to work? Metformin does not instantly reduce blood sugar levels. The effects are usually noticeable within 48 hours of taking the medication, and the most significant effects take 4–5 days to occur.
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
Caution with Metformin
Many of my PCOS patients who take metformin find that they don't feel good having alcohol. A very rare side effect of taking metformin is lactic acidosis which is increased with alcohol consumption. For this reason, I don't recommend drinking alcohol while taking metformin.
Metformin has been shown to support hair growth in people who had PCOS and were being treated with it. In general, metformin does not exert a direct effect on hair, but may promote healthy hair by supporting normal glucose and insulin levels.