Polycystic Ovary Syndrome And Pregnancy: Is Metformin The Magic Bullet?
This article reviews the literature regarding the effects of metformin therapy in pregnant women with polycystic ovary syndrome on weight loss, fertility, early pregnancy loss, malformations, gestational diabetes mellitus, perinatal mortality, placental clearance, lactation, and early childhood development. The pharmacology of metformin is also presented. Preliminary data suggest that metformin for this population may be both safe and effective. Large blinded, randomized clinical trials are underway to confirm the preliminary safety data. History of Polycystic Ovary Syndrome Although the first description of polycystic ovary syndrome (PCOS) is generally credited to Stein and Leventhal in 1935, it may have been observed as early as 1721, when the Italian scientist Antonio Vallisneri observed “young married peasant women, moderately obese and infertile, with two larger than normal ovaries, bumpy and shiny, whitish, just like pigeon eggs.”1 This depiction sounds strikingly similar to the subfertility and obesity commonly found in PCOS. It was not until 1921 that Achard and Theirs2 noticed a relationship between hyperandrogenism and insulin resistance in their study of the “bearded diabetic woman.” And in 1935, Stein and Leventhal3 made the connection between amenorrhea and polycystic ovaries. In addition, they also noticed the occurrence of masculinizing changes, such as hirsutism and acne, in many patients with polycystic ovaries. Several, but not all, of Stein and Leventhal's original case studies involved women who were overweight. In all seven of their case reports, attempts to treat ovulatory dysfunction with estrogenic hormone failed, and wedge resection was employed. All of their patients gained normal menstruation, and two became pregnant. Surgery for PCOS Continue reading >>
Metformin And Pcos: Everything You Need To Know
Metformin is a type of medication used to treat Type 2 Diabetes. Because there is a strong link between diabetes and PCOS, metformin is now commonly proscribed to treat PCOS. But should it be? What is the real relationship between metformin and PCOS? Can Metformin used for PCOS help lessen PCOS symptoms? Metformin used for PCOS: The Science PCOS is an infertility condition that often causes acne, facial hair growth, balding, low sex drive, weight gain, difficulty with weight loss, and mental health disturbances such as depression and anxiety in approximately 15% of women. It is also associated with a myriad of health conditions, spanning from diabetes to hypothyroidism and to heart disease. PCOS is, in short, not a condition to sneeze at. PCOS is a condition of hormone imbalance. With PCOS, male sex hormones such as testosterone and DHEA-S rise relative to the female sex hormones estrogen and progesterone. (…Roughly speaking – it’s complicated. For a full-blown account of the science of PCOS and how it affects you, see here.) Elevated testosterone is very often the primary culprit in causing PCOS. (But not always! For one of my most thorough accounts of other things that can cause PCOS, see here.) Insulin causes testosterone levels to rise because insulin tells the ovaries to produce testosterone. Basically, elevated insulin causes elevated testosterone, which causes PCOS. This is where metformin comes into play. Metformin lowers blood sugar levels below what they would otherwise be after a meal. This is because it intervenes with the liver’s interaction with and production of glucose. Insulin is the body’s way of dealing with blood sugar. If blood sugar is lower, then insulin will be lower, and thus testosterone will be lower. Metformin decreases blood sugar, Continue reading >>
Metformin For Pcos And Getting Pregnant
Metformin and other insulin-sensitizing medications lower excess levels of insulin in the body.Besides metformin, rosiglitazone and pioglitazone are other insulin-sensitizing drugs that may be used to treat PCOS. There are several reasons why your doctor may prescribe metformin when treating your PCOS, some of them fertility related: As stated above, insulin resistance is common in women with PCOS. Metformin may be prescribed to treat insulin resistance, which may then help regulate the reproductive hormones and restart ovulation. Some research on metformin and PCOS shows that menstrual cycles become more regular and ovulation returns with the treatment of metformin. This may happen without needing fertility drugs like Clomid . However, some larger research studies did not find a benefit to taking metformin. For this reason, some doctors are recommending that metformin be used only to treat women who are insulin-resistant and not all women with PCOS regardless of whether or not they are insulin-resistant. While Clomid will help many women with PCOS ovulate, some women are Clomid-resistant . (This is a fancy way of saying that it doesn't work for them.) Some research studies have found that taking metformin for 4 to 6 months before starting Clomid treatment may improve success for women who are Clomid-resistant. Another option for women with Clomid resistance may be metformin combined with letrozole . If Clomid doesnt help you get pregnant, the next step is usually gonadotropins or injectable fertility drugs . Research has found that combination injectables with metformin may improve ongoing pregnant rates. One study found that combining metformin with injectables improved the live birth rate when compared to treatment with injectables alone. In this study, if the live Continue reading >>
Metformin Side Effects For Pcos
Metformin side effects for PCOS need to be understood as potential side effects of metformin may impact a woman’s chances of getting pregnant. What kind of metformin side effects can I expect to see if I have PCOS? When sufferers of Polycystic Ovarian Syndrome endeavor to rebel against the disease that has greatly compromised their reproductive potential, many turn to metformin for PCOS. While Metformin was originally conceived to help diabetes patients better manage their blood sugar levels, the properties that help these people also do a number on the destructive capabilities of Polycystic Ovarian Syndrome (a). Metformin decreases the destructive effects that androgen and insulin has on the ovaries of PCOS patients by reducing the production of the former and increasing the body’s sensitivity to the latter (1). It accomplishes this by reducing the production of glucose in the liver via gluconeogenesis, thereby reducing the aggressive insulin response in the bodies of PCOS patients that then gives rise to androgen production (b). With any compound that has been shown to work well against any given medical condition, it is always important to keep in mind the potential side effects, which are factors that are often swept by the wayside when folks clamor over the latest wonder drug. Similarly, those using metformin for PCOS need to be armed with the knowledge of the symptoms that mark the potential side effects that they might experience, which ones are relatively harmless, and most important of all, the ones that denote a life-threatening reaction that requires immediate medical attention. While incidents of this magnitude are typically rare, it is vital that you are aware nonetheless, as it is better to switch to a PCOS treatment that is more suitable for you than Continue reading >>
Side Effects Of Metformin: What You Should Know
Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range. Metformin needs to be taken long-term. This may make you wonder what side effects it can cause. Metformin can cause mild and serious side effects, which are the same in men and women. Here’s what you need to know about these side effects and when you should call your doctor. Find out: Can metformin be used to treat type 1 diabetes? » Metformin causes some common side effects. These can occur when you first start taking metformin, but usually go away over time. Tell your doctor if any of these symptoms are severe or cause a problem for you. The more common side effects of metformin include: heartburn stomach pain nausea or vomiting bloating gas diarrhea constipation weight loss headache unpleasant metallic taste in mouth Lactic acidosis The most serious side effect metformin can cause is lactic acidosis. In fact, metformin has a boxed warning about this risk. A boxed warning is the most severe warning from the Food and Drug Administration (FDA). Lactic acidosis is a rare but serious problem that can occur due to a buildup of metformin in your body. It’s a medical emergency that must be treated right away in the hospital. See Precautions for factors that raise your risk of lactic acidosis. Call your doctor right away if you have any of the following symptoms of lactic acidosis. If you have trouble breathing, call 911 right away or go to the nearest emergency room. extreme tiredness weakness decreased appetite nausea vomiting trouble breathing dizziness lighthea Continue reading >>
Can Metformin Help Women With Pcos?
Home / Fertility / Boosting Fertility We asked doctors whether the drug Metformin really helps women with PCOS conceive, reduce miscarriage risk and increase milk supply. Here's what they say. If you have polycystic ovary syndrome (PCOS), you're not alone. According to the National Center for Biotechnology Information , this hormonal disorder affects between 5 percent and 15 percent of women of reproductive age in this country. In polycystic ovary syndrome, cysts develop on the ovaries, and the body produces excess hormones called androgens, which cause an irregular menstrual cycle. As a result, ovulation can be unpredictable, and getting pregnant can be challenging. "Since puberty, I've averaged one menstrual cycle per year," says Carrie, a mother from the Midwest who has PCOS. "I always wondered if I could have children." Carrie tried getting pregnant for several months, but wasn't able to because she wasn't ovulating. After evaluating her bloodwork, her OB/GYN suggested she go on either Clomid or Metformin to help balance her hormones to promote ovulation. "Because I had a very slight imbalance in my hormones, my doctor suggested trying Metformin before going straight to Clomid. Since I heard horror stories about Clomid causing multiples, I was happy to try Metformin first," Carrie says. Metformin is a diabetes medication that is sometimes used to regulate hormones in women with PCOS by balancing their insulin level. This effect leads to more regular menstruation and ovulation cycles , according to WebMD . Carrie got pregnant the first month she took Metformin. But not all women with polycystic ovary syndrome have such good results. In fact, experts say more evidence is needed to prove that Metformin helps conception in PCOS patients . "When putting all the data tog Continue reading >>
Metformin (glucophage) For Pcos: What Are The Benefits And Side Effects?
Have PCOS or Diabetes? Is Metformin (Glucophage) Your Best Choice? Should you take metformin -- nor not? Is there a better alternative? This page will answer your questions. It's an anti-diabetic drug sometimes used to treat PCOS (polycystic ovary syndrome), although it is used chiefly to help control Type 2 diabetes. This drug offers both benefits and significant risks. The FDA has approved it only for the treatment of Type 2 diabetes. Because of this limitation, some physicians don't have much clinical experience using Glucophage to treat PCOS and don't always feel comfortable using it unless you have diabetes. 13 Side Effects of Metformin Your Doctor Didn't Tell You About Did you know that metformin has at least 13 under-recognized side effects? Some of them can be serious. Read more about the side effects . Medical research is now showing that there are natural alternatives to this and other drugs for treating PCOS, diabetes or metabolic syndrome. So if you're uncomfortable with the idea of taking Glucophage for years to come, or you've tried it but can't tolerate its side effects, take a look at the natural alternatives that are just as effective as metformin . Some medical guidelines say it is not the first thing you should try for controlling PCOS. However, it may be helpful IF you have insulin resistance. Read more... Recent research is showing that you will develop a vitamin B12 deficiency if you take this drug for over a year or so. A deficiency in vitamin B12 could have undesirable consequences if for fetal development if you're pregnancy or trying to become pregnant. Read more... As girls and teenagers start to have trouble with their weight, irregular periods, early appearance of public hair, hirsutism, or various indications of insulin resistance, physici Continue reading >>
Pcos: Insulin And Metformin
Young women with PCOS often have elevated insulin levels and are more likely to develop diabetes. Metformin is a medication often prescribed for women with PCOS to help prevent diabetes. A lifestyle that includes healthy nutrition and daily exercise is the most important part of a PCOS treatment plan. What is insulin? Insulin is a hormone made by an organ in the body called the pancreas. The food you eat is broken down into simple sugar (glucose) during digestion. Glucose is absorbed into the blood after you eat. Insulin helps glucose enter the cells of the body to be used as energy. If there’s not enough insulin in the body, or if the body can’t use the insulin, sugar levels in the blood become higher. What is insulin resistance? If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. Certain medical conditions such as being overweight or having PCOS can cause insulin resistance. Insulin resistance tends to run in families. What can insulin resistance do to me? High insulin levels can cause thickening and darkening of the skin (acanthosis nigricans) on the back of the neck, axilla (under the arms), and groin area. In young women with PCOS, high insulin levels can cause the ovaries to make more androgen hormones such as testosterone. This can cause increased body hair, acne, and irregular or few periods. Having insulin resistance can increase your risk of developing diabetes. How can I lower my insulin levels? You can help lower your insulin levels naturally by eating fewer starches and sugars, and more foods that are high in fiber and low in refined carbohydrates. Low glycemic foods, on the other hand, don’t raise your blood sugar or insulin levels as much as foods that are high in sugar or refined carbohydr Continue reading >>
What Is Metformin? And Is It Right For You?
Are you one of the millions of women who’ve been diagnosed with PCOS or high blood sugar? Do you struggle every day with symptoms like excessive weight, mood swings, infertility, facial hair or acne? When you’re dealing with such terrible symptoms, finding a solution becomes your top priority. Hi, I’m Robin Nielsen, the Chief Wellness Officer here at Insulite Health. I’m so glad you’re here. I’ve personally experienced symptoms of polycystic ovary syndrome or PCOS, and I know the difficult challenges you face. Perhaps you’re wondering if prescription drugs might be that solution. In fact your doctor may suggest the drug Metformin, also known as Glucophage. What is Metformin, and is it right for you? Metformin is a drug originally used to treat high blood sugar in people with type 2 diabetes. It’s sometimes prescribed to women with PCOS because both diabetes and PCOS share an underlying cause. Insulin is a hormone produced by the pancreas to help get sugar into our cells to burn for fuel. I call insulin the key that unlocks the cell. Insulin resistance occurs when your body’s cells resist the effects of insulin, causing you to produce even more insulin and actually store the sugar in the blood as fat, here around your middle. Too much insulin leads to an imbalance of hormones, especially sex hormones. Metformin can improve your body’s response to insulin at the cellular level, so your body produces less insulin, which can stabilize your hormonal levels and lower blood sugar. Women who take Metformin for PCOS may see improvements in some of their symptoms, such as hirsutism, irregular menstrual cycles, and weight gain, but not without a price. Metformin’s use is associated with many side effects, some potentially serious or even life-threatening. Dig Continue reading >>
Metformin For Pcos Symptoms: 5 Challenging Cases
Metformin for PCOS symptoms: 5 challenging cases Dr. Barbieri is chief of the department of obstetrics and gynecology at Brigham and Womens Hospital in Boston, Mass, and Kate Macy Ladd Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School. He is editor-in-chief of OBG Management. This inexpensive and versatile drug broadens the choices for treating polycystic ovary syndrome. An expert describes its efficacy for common manifestations of PCOS. 1. Barbieri RL. Metformin for the treatment of the polycystic ovary syndrome. Obstet Gynecol. 2003;101:785-793. 2. Pugeat M, Ducluzeau PH. Insulin resistance, polycystic ovary syndrome and metformin. Drugs. 1999;58 (suppl 1):41-46. 3. Kirpichnikov D, McFarlane SI, Sowers JR. Metformin: an update. Ann Intern Med. 2002;137:25-33. 4. Knochenhauer ES, Key TJ, Kahsar-Miller M, et al. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83:3078-3082. 5. Diamanti-Kandarakis E, Kouli CR, Bergiele AT, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84:4006-4011. 6. Asuncion M, Calvo RM, San Millan JL, et al. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434-2438. 7. Arroyo A, Laughlin GA, Morales AJ, et al. Inappropriate gonadotropin secretion in polycystic ovary syndrome: influence of adiposity. J Clin Endocrinol Metab. 1997;82:3728-3733. 8. Taylor AE, McCourt B, Martin KA, et al. Determinants of abnormal gonadotropin secretion in clinically defined women with polycystic ovary syndrome. J Clin Endocrinol Continue reading >>
Role Of Metformin In The Management Of Polycystic Ovary Syndrome
Go to: Background Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting 4–12% of women [Diamanti-Kandarakis et al. 1999; Farah et al. 1999; Knochenhauer et al. 1998]. It has also been the most controversial medical condition and every aspect has received a lot of attention from the nomenclature to the management. Several descriptions of similar conditions took place in the 20th century and it was named Stein—Leventhal Syndrome in 1935 after the authors who described polycystic ovarian morphology in patients suffering from hirsutism, amenorrhoea and infertility [Leventhal, 1958; Stein and Leventhal, 1935]. PCOS was also called polycystic ‘ovarian’ syndrome implying that the primary pathology lies in or triggered by the ovary. Others have called it polycystic ovary disease (PCOD), which is the least used term for obvious reasons. Currently, PCOS refers to a disorder with a combination of reproductive and metabolic characteristics. This has evolved over time with controversy over the definition culminating in the latest consensus [ESHRE/ASRM, 2004] which instead of solving the issue created more controversy [Azziz et al. 2006]. In the European Society of Human Reproduction and Embryology/American Society of Reproductive Medicine (ESHRE/ASRM) consensus, at least two of the following features are needed to make the diagnosis; oligo/anovulation, hyperandrogenism, and polycystic features on ultrasound scan [ESHRE/ASRM, 2004]. The Androgen Excess Society, however, recommended that androgen excess should remain a constant feature of PCOS irrespective of the ovulatory status and morphological features of the ovaries [Azziz et al. 2006]. For almost three decades, PCOS has been regarded as a life course disease which besides its reproductiv Continue reading >>
Metformin Side Effects For Pcos: 6 Things You Need To Know
Insulin resistance is seen in the majority of women with PCOS. Doctors prescribe metformin for PCOS because it is an effective insulin sensitizer. However, the drug comes with its share of side effects. Let’s look at Metformin side effects for PCOS in detail. Metformin Side Effects For 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 may not sound too severe, it is one of the most common Metformin side effect for PCOS. 2. Gastrointestinal Distress Gastrointestinal problems is another common Metformin side effect for PCOS (experienced by nearly a third of women taking the drug.) 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 appetite, especially because eating a healthy diet at the right times is critical for PCOS patients. Heartburn and headaches add to the suffering caused by PCOS symptoms. 3. Anemia Another Metformin side effect for PCOS is a decrease in Vitamin B12 levels because the drug 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 Continue reading >>
6 Reasons Why Metformin Might Not Be Safe For Pcos
Have you been prescribed metformin for PCOS and are wondering what the side affects are? Metformin is often described as a ‘safe’ drug, but read on to find out why this might not be the case. When I was diagnosed with PCOS, the first thing I asked my GP was what I could take to ‘fix’ it. She gently explained that there was no pill or surgery that could cure my condition. However, there was a drug that could help with the elevated insulin levels caused by it. Metformin, she claimed, was a safe drug with no major side effects that would help with insulin resistance and weight loss. Sign me up. At first, I thought metformin was the wonder drug. I lost about 5kg in 4 months, more than I had ever been able to lose previously. I was ecstatic. I had a quick look online to see whether there were any side effects and initially found that diarrhea, loose stools, fatigue, and muscle soreness were commonly experienced. But I thought that it was small price to pay for finally being able to lose some weight. However, when I investigated further I found that that there are some much more sinister side effects of metformin that aren’t so widely publicised. These include: – Depleting our bodies of essential nutrients. – Increasing the risk of having a baby with a neural tube defect by up to 9 times. – Reducing energy levels by almost 50%. – Killing beneficial gut bacteria. This article is not intended to be a case against metformin for PCOS. There is no doubt that metformin helps to reduce weight, lowers blood glucose levels, and promotes ovulation. My concern is the lack of studies about the safety of long-term use of metformin for PCOS, especially in utero. Drugs can help with the associated symptoms of a disease, but they cannot fix the root cause of it. Metformin i Continue reading >>
Metformin For Pcos: How It Works, Side Effects & Health Tips
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 Behind Prescribing Metformin For PCOS Insulin resistance is a common condition in a majority of PCOS patients. 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. Metformin For PCOS – How Does It Work? The USFDA approved metformin in 1994. Metformin for PCOS works 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 prescribing metformin for PCOS helped patients in regularizing their periods. They also found that the drug helped in reducing the levels of male hormones in PCOS patients. PCOS patients have to undergo something called as “ovary stimulation” prior to IVF treatment. Doctors prescribe Metformin for PCOS to reduce the risk of a condition called ovarian Continue reading >>
For Pcos, 13 Side Effects Of Metformin You Should Know About
Did you know that 10%- 25% of women who take Glucophage just don't feel well? They experience a general malaise, fatigue and occasional achiness that lasts for varying lengths of time. Malaise a warning signal for your doctor to closely monitor your body systems, including liver, kidneys, and GI tract. About one third of women on metformin experience gastrointestinal disturbances, including nausea, occasional vomiting and loose, more frequent bowel movements, or diarrhea. This problem occurs more often after meals rich in fats or sugars, so eating a healthier diet will help. The symptoms lessen over time, so if you can tolerate the GI upset for a few weeks, it may go away. Some women have found it helps to start with a very low dose and gradually increase it. Most people think that aside from possible gastrointestinal upset, there are no side effects from taking metformin, and thus you can take it for a very long time. This is not true! The sneakiest side effect of all is a vitamin B12 insufficiency. A substance formed in the stomach called "intrinsic factor" combines with B12 so that it can be transferred into the blood. Metformin interferes with the ability of your cells to absorb this intrinsic factor-vitamin B12 complex.(12) Over the long term, vitamin B12 insufficiency is a significant health risk. B12 is essential to the proper growth and function of every cell in your body. It's required for synthesis of DNA and for many crucial biochemical functions. There is also a link between B12 insufficiency and cardiovascular disease. According to some research, 10%-30% of patients show evidence of reduced vitamin B12 absorption. The Hospital de Clnicas de Porto Alegre in Brazil has shown that one of every three diabetics who takes metformin for at least a year have evide Continue reading >>