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When To Stop Metformin During Pregnancy Pcos

Risks Of Metformin During Pregnancy

Risks Of Metformin During Pregnancy

Metformin has become a popular medication for the treatment of women with PCOS and insulin resistance . Numerous studies have found that some women who dont ovulate due to PCOS or insulin resistance, may ovulate when using metformin . Metformin is frequently compared to clomid , a common fertility medication often used for PCOS patients. Although large randomized studies have demonstrated that metformin is far less efficient for producing pregnancy and live births compared to clomid, metformin continues to be prescribed by doctors for PCOS patients. A persistent question about the use of metformin is when it should be stopped. A general principle of obstetrics is to not use a medication during pregnancy unless the medication has been well studied and the benefits outweigh the risks to the fetus. Since metformin is primarily used to treat diabetes (high blood sugar), some have suggested that it may be used to treat diabetes in pregnancy (gestational diabetes). Women with PCOS or insulin resistance do develop gestational diabetes more commonly. Traditionally, gestational diabetes has been treated with diet to help reduce the the blood sugar levels and, when necessary, with a medication called insulin. Insulin is given as an injection up to 3 or 4 times per day. If a once day oral medication was safe and effective, then it would be a welcome change for women with gestational diabetes. In 2009, doctors in the U.K. studied 200 women with gestational diabetes. 100 women were treated with insulin and 100 were treated with metformin. They found that women treated with insulin had greater weight gain during pregnancy than those treated with metformin. There was no difference in how often women in the two groups need to have labor induced or in the rate of cesarean section. Howe Continue reading >>

6 Reasons Why Metformin Might Not Be Safe For Pcos

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 >>

Stopping Metformin During Pregnancy.

Stopping Metformin During Pregnancy.

I have been taking Metformin for 1 1/2 years or so and now that i am 14 weeks pregnant my OB dr told me to stop taking it. Is it safe to stop taking it all together or should i do a step down? I was taking 1500 mgs a day. On the weekends or when i am not working i only take 1000 mgs a day because i do not eat on a normal schdule like i do at work. So since Friday i having been taking 1000 mgs and i went to the dr on tuesday and she said to stop. Well i was afraid to stop all together so i am taking 500 mgs a day until i run out, which will be in a couple days. What do you think? @ccwiser I wonder why they took you off and left me on. Were you onmetformin just while trying to get pregnant or before because of pcos? I was put on metformin 10 years ago for suspected pcos and even through IVF and now that I am 14 weeks pregnant I was told to continue 500 mg twice a day. I dont think it would make a difference taking it or not for the next few days :-) Take care!! @kristyingeorgia I was taking it PCOS because we were trying to get pregnant. But it was not helping by itself so we also used Clomid and i got pregnant on my last cycle of it. I am not sure why she took me of it. @ccwiser my dr left me on metformin but its because i am obese and she said that it could help me to prevent getting gestational diabetes...the pill it self makes me so sick i wish i was in your boat and could be taken off of it :) @ccwiser They left me on the metformin?!? My OB said it would be the 1st drug he would put me on if I developed Gest. Diab. so he left me on!! I'm hoping it will prevent it! @ccwiser Hi there, I am also on Metformin for potential PCOS. My RE said to stay on it until about 28wks, then wean off it. It is proven to reduce the risk of early miscarriage in PCOS pregnancies. I'm sur Continue reading >>

Metformin And Pregnancy: Is This Drug Safe?

Metformin And Pregnancy: Is This Drug Safe?

Whether you're expecting your first child or expanding your family, a safe and healthy pregnancy is crucial. This is why you take precautions before and during pregnancy to keep your unborn child healthy and reduce the risk of birth defects. In every pregnancy, there’s a 3 to 5 percent risk of having a baby with a birth defect, according to the Organization of Teratology Information Specialist (OTIS). Some birth defects can’t be prevented. But you can lower your child’s risk by taking prenatal vitamins, maintaining a healthy weight, and maintaining a healthy lifestyle. Your doctor might recommend that you don’t take certain medications while pregnant. This is because certain medications can cause birth defects. If you're taking the prescription drug metformin, you might have concerns about how the drug will affect your pregnancy and the health of your unborn child. What Is Metformin? Metformin is an oral medication used to treat type 2 diabetes and polycystic ovary syndrome (PCOS). Type 2 diabetes is a condition that increases blood sugar levels. PCOS is an endocrine disorder that occurs in women of reproductive age. It’s important to maintain a healthy blood sugar level while pregnant. This is one way to reduce the risk of birth defects and complications. Although metformin can control blood sugar, you may question whether this drug is safe to take during pregnancy. Before we get into this, let’s discuss how metformin is beneficial prior to pregnancy. Metformin Before Conception If you took metformin before getting pregnant, you might know that this drug can be a godsend — especially if you’ve had difficulty conceiving. Having PCOS makes it harder to become pregnant. This condition can cause missed or irregular periods, and small cysts can grow on your Continue reading >>

Stopping Metformin At 12 Wks..

Stopping Metformin At 12 Wks..

-Any symptoms after coming off? nope, and I just quit cold turkey. I was taking 1500mg XR/day. The MFM told me the reason they don't like to keep you on Met beyond the 1st tri is because it's twice as concentrated in the baby as it is in you. -Did OB monitor insulin levels or any special bw after coming off? kind of.... I did the glucose test early at 15 weeks ( I ended up with GD, but if I hadn't they would have tested me again at the normal 25ish weeks) This pregnancy I just decided to follow the GD diet from the beginning and I declined the Glucose test. -Did you notice anything diff. at all? With you or baby? The only thing I noticed was my inability to poop I started colace 2x a day after I stopped the Met. 6/28/10: Lost our sweet baby Addyston at 18wk 1day to pPROM7/24/11: Michael William born at 24wk 2d due to IC after an emergent cerclage at 18wks, 4wk home BR and 2 weeks hospital BR. Grow strong our little Miracle! 9/17/11: Michael joined his sister in heaven after 8 amazing weeks with us on earth. He fought a very hard fight but NEC was too much for him in the end. Continue reading >>

Does Continuous Use Of Metformin Throughout Pregnancy Improve Pregnancy Outcomes In Women With Polycystic Ovarian Syndrome?

Does Continuous Use Of Metformin Throughout Pregnancy Improve Pregnancy Outcomes In Women With Polycystic Ovarian Syndrome?

Does continuous use of metformin throughout pregnancy improve pregnancy outcomes in women with polycystic ovarian syndrome? Nawaz FH, et al. J Obstet Gynaecol Res. 2008. Department of Obstetrics and Gynaecology, Aga Khan University Karachi Pakistan, Karachi, Pakistan. [email protected] J Obstet Gynaecol Res. 2008 Oct;34(5):832-7. doi: 10.1111/j.1447-0756.2008.00856.x. AIM: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies in women of reproductive age. It is associated with hyperinsulinemia and insulin resistance which is further aggravated during pregnancy. This mechanism has a pivotal role in the development of various complications during pregnancy. In the past few years, metformin, an insulin sensitizer, has been extensively evaluated for induction of ovulation. Its therapeutic use during pregnancy is, however, a recent strategy and is a debatable issue. At present, evidence is inadequate to support the long-term use of insulin-sensitizing agents during pregnancy. It is a challenge for both clinicians and researchers to provide good evidence of the safety of metformin for long-term use and during pregnancy. This study aimed to evaluate pregnancy outcomes in women with PCOS who conceived while on metformin treatment, and continued the medication for a variable length of time during pregnancy. METHODS: This case-control study was conducted from January 2005 to December 2006 at the antenatal clinics of the Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan. The sample included 137 infertile women with PCOS; of these, 105 conceived while taking metformin (cases), while 32 conceived spontaneously without metformin (controls). Outcomes were measured in three groups of cases which were formed according to the dura Continue reading >>

Does Metformin Therapy During Pregnancy Affect Metabolic Health In Pcos?

Does Metformin Therapy During Pregnancy Affect Metabolic Health In Pcos?

Does Metformin Therapy During Pregnancy Affect Metabolic Health in PCOS? Does Metformin Therapy During Pregnancy Affect Metabolic Health in PCOS? Participants in the PregMet study were randomly assigned to metformin (1000 mg twice daily) or placebo from their first trimester through delivery. Metformin therapy has no long-term impact on metabolic health in women with polycystic ovarian syndrome (PCOS), according to research presented at ENDO 2017: the 99th Annual Meeting & Expo , April 1-4, in Orlando, Florida.1 Researchers at the Norwegian University of Science and Technology in Trondheim, Norway conducted a follow-up assessment of data from the PregMet study (Metformin in Pregnant PCOS Women; ClinicalTrials.gov identifier NCT00159536 )2 to investigate the long-term metabolic health of women with PCOS. Participants in the original randomized controlled trial randomly received either metformin (1000 mg twice daily) or placebo from the first trimester of their pregnancy through delivery, with therapy stopped at delivery. Half of the 258 original participants took part in the follow-up study; median follow-up time was 7.6 years (range, 4.9-11.1). Control subjects comprised 48 healthy mothers. At baseline (inclusion in the PregMet study), no difference was noted between women with PCOS who participated in the follow-up study and women who declined to participate; however, women with PCOS had a higher body mass index (BMI, 28.66.6 kg/m2 vs 23.03.6 kg/m2; P <.001) as well as higher systolic and diastolic blood pressures vs controls (11812 mm Hg vs 11410 mm Hg; P =.045 and 7310 mm Hg vs 699 mm Hg; P =.03, respectively). Women in the healthy control group were typically younger (34.43.7 vs 38.24.6 years; P <.001) and had a shorter follow-up time (5.50.8 vs 7.91.7 years; P <.0 Continue reading >>

Effects Of Metformin On Pregnancy Outcomes In Women With Polycystic Ovary Syndrome: A Meta-analysis

Effects Of Metformin On Pregnancy Outcomes In Women With Polycystic Ovary Syndrome: A Meta-analysis

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility worldwide. Many women with PCOS have difficulty in conceiving naturally. Even if patients with PCOS are lucky enough to become pregnant, yet they still have to face the distressing conditions of increased risk of early pregnancy loss (EPL), which is 5-fold higher than for non-PCOS women. [13] Additionally, women with PCOS are at increased risk of developing pregnancy complications, such as gestational diabetes mellitus (GDM) and preeclampsia, which may occur independent of obesity. The babies whose mothers are patients with PCOS are also at great risk of neonatal complications such as premature delivery, prenatal morbidity, and admission to an neonatal intensive care unit. [4] The etiology of this condition in women with PCOS is still uncertain. Some scholars contended that hyperinsulinemic resistance could be an independent risk factor due to its adverse effects on endometrial function and implantation environment. Furthermore, some studies deemed hyperinsulinemic resistance aggravate such a destructive condition through increasing androgen concentration. [5,6] Fortunately, the insulin-sensitizer, like metformin (1,1-dimethylbuguanide hydrochloride), showed the ability to reduce androgen concentration and regain ovarian ovulatory cycles [7] and was assumed to have a linkage to the dramatic reduction in the incidence of EPL. [8] However, the use of metformin was strictly limited during pregnancy because of its potential teratogenic effects. In Australia, metformin has been classified by the Therapeutic Goods Administration as Category C. One study [9] suggested metformin had no adverse effects on children although it can pass though the placenta, particularly during delivery. Marques e Continue reading >>

Is It Safe To Take Metformin During Pregnancy?

Is It Safe To Take Metformin During Pregnancy?

Once you know that you are pregnant, all that you want is a healthy pregnancy and a normal baby. For this it is absolutely imperative that you take all the necessary precautions to avoid any complications and also to reduce the chances of any birth defects. Doctors usually ask you to stay away from certain medicines during pregnancy as they are known to cause birth defects in babies. But if you have been suffering from polycystic ovarian syndrome (PCOS) or type 2 diabetes, then there is a possibility that you have been prescribed Metformin as a treatment option. Once you conceive, you must be wondering whether you should continue taking this medication and if .there are any harmful effects of it on you or the life growing within you during pregnancy. Read ahead to find out more about this medication and how safe this is during pregnancy. What Is Metformin? This is actually one of the most commonly prescribed oral tablets that is found to be effective in controlling type 2 diabetes and PCOS. It works by reducing the production of hepatic glucose and also helps to lower absorption of glucose by the intestines. It also helps in hiking up glucose utilization and peripheral uptake levels. While PCOS is a type of endocrine issue that is normally found in women, type 2 diabetes is an issue of increased levels of blood sugar in your system. For women suffering from PCOS, this drug lowers the level of fasting insulin stimulated LH levels and basal and also free testosterone concentrations. The big question arises whether this drug is safe to use during pregnancy? This drug has been categorized in the B category by U.S. Food and Drug Administration (FDA) and is considered safe during pregnancy. Metformin Before Conception If you have been prescribed Metformin before you have conc Continue reading >>

Should I Continue My Metformin In Early Pregnancy?

Should I Continue My Metformin In Early Pregnancy?

Metformin is a drug that is often prescribed, off-label, for the treatment of PCOS and for regulating ovulation. It belongs to a class of drugs that improves the cells' response to insulin and regulates blood sugar. An off-label prescription means that the FDA has not approved the use of a drug specifically for that condition. In this case, metformin has been approved for the treatment of diabetes but not for PCOS specifically. How Metformin Works Because so many women with PCOS also have insulin resistance and diabetes, it is believed that treating the insulin dysfunction might have an effect on the other hormonal irregularities associated with the condition. While researchers aren’t sure of the exact mechanism, there is some evidence that backs up this theory: some studies have shown that women who take a combination of ​metformin and clomid (a drug that is used to induce ovulation in anovulatory women) have a better response to the medication regimen than those who take clomid alone. Some women with PCOS, especially those that are insulin resistant, may see more regular periods from taking metformin as well. Metformin Dosage Dosages of between 1,500 mg to 2,000 mg daily are typical, depending on a woman's insulin resistance and risks of side effects. Many women taking metformin report having stomach upset, nausea and diarrhea — especially with higher doses. The doctor may recommend slowly increasing your dosage until you reach the prescribed dosage to increase your tolerance to the drug. Other physicians will recommend the extended release form, meaning that a small amount of the medication is released throughout the day, instead of all at once like with a regular release pill. It is important to take your medication exactly as prescribed and let your doctor kn Continue reading >>

Metformin For Pcos And Getting Pregnant

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 Use During Pregnancy

Metformin Use During Pregnancy

A 31-year-old woman with polycystic ovarian syndrome and metabolic syndrome has been treated with metformin 500 mg twice daily until now; she is in the 8th week of her first pregnancy. Would it be recommended that she continue taking metformin throughout pregnancy or discontinue? What is the risk of the fetal damage caused by metformin? What is the risk of pregnancy loss caused by insulin resistance? Response from Peter S. Bernstein, MD, MPH, FACOG and Esther Schmuel, MD Polycystic ovarian syndrome (PCOS) occurs in 5% to 7% of reproductive-age women and is diagnosed if at least 2 of the following criteria are present: (1) oligo-ovulation or anovulation (often appearing as oligomenorrhea or amenorrhea), (2) elevated levels of androgens (total or free testosterone, androstendione), (3) clinical manifestations of hyperandrogenism (acne, hirsutism, male-pattern baldness), and (4) polycystic appearance of ovaries on ultrasound. Approximately 30% to 40% of women with PCOS have impaired glucose tolerance, and as many as 10% will develop diabetes by the fourth decade. Women with PCOS are also more insulin resistant than similar age- and weight-matched controls.[ 1 , 2 ] Metformin is an oral biguanide that is approved for the treatment of non-insulin-dependent diabetes. Metformin acts primarily by decreasing hepatic glucose production, as well as by decreasing intestinal absorption of glucose and increasing peripheral uptake and utilization of glucose. In patients with PCOS, it reduces fasting insulin, basal and stimulated luteinizing hormone (LH) levels, and free testosterone concentrations.[ 3 ] The role of metformin in ovulation induction is well established, and several studies have demonstrated that women with PCOS are more likely to ovulate with metformin than with placeb Continue reading >>

Pregnancy Outcomes Among Women With Polycystic Ovary Syndrome Treated With Metformin

Pregnancy Outcomes Among Women With Polycystic Ovary Syndrome Treated With Metformin

Pregnancy outcomes among women with polycystic ovary syndrome treated with metformin Human Reproduction, Volume 17, Issue 11, 1 November 2002, Pages 28582864, Charles J. Glueck, Ping Wang, Naila Goldenberg, Luann Sieve-Smith; Pregnancy outcomes among women with polycystic ovary syndrome treated with metformin, Human Reproduction, Volume 17, Issue 11, 1 November 2002, Pages 28582864, BACKGROUND: We sought to determine whether metformin, which had facilitated conception in 72 oligoamenorrhoeic women with polycystic ovary syndrome (PCOS), would safely reduce the rate of first trimester spontaneous abortion (SAB) and increase the number of live births without teratogenicity. METHODS: Seventy-two oligoamenorrheic women with PCOS conceived on metformin (2.55 g/day). They were prospectively assessed in an outpatient clinical research centre. Outcome measures included number of first trimester SAB, live births, normal ongoing pregnancies 13 weeks, gestational diabetes (GD), congenital defects (CD), birthweight and height, as well as weight, height, and motor and social development during the first 6 months of life. RESULTS: Of the 84 fetuses, to date there have been 63 normal live births without CD (75%), 14 first trimester SAB (17%), and seven ongoing pregnancies 13 weeks with normal sonograms without CD (8%). Previously, without metformin, 40 of the 72 women had 100 pregnancies (100 fetuses) with 34 (34%) live births and 62 (62%) first trimester SAB. In current pregnancies on metformin in these 40 women (46 pregnancies, 47 fetuses), there have been 33 live births (70%), two pregnancies ongoing 13 weeks (4%), and 12 SAB (26%) (P < 0.0001). There was no maternal lactic acidosis, and no maternal or neonatal hypoglycaemia. Fasting entry serum insulin was a significant explanator Continue reading >>

Metformin And Pregnancy

Metformin And Pregnancy

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure to metformin may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider. What is metformin? Metformin is an oral medication used to treat type 2 diabetes and insulin resistance in polycystic ovarian syndrome (PCOS). Other names for this medication include Glucophage®, Diformin®, Glumetza®, FORTAMET® and Glycon®. I use metformin for the treatment of type 2 diabetes. Should I stop metformin before I get pregnant? Before and during pregnancy, blood sugar levels should be under control to prevent a higher chance of birth defects and complications. Insulin is usually the medication of choice because it controls blood sugar more tightly than oral medications. However, metformin has also been used to treat type 2 diabetes in pregnant women when insulin alone provides only partial blood sugar control. Please consult your health care before pregnancy to determine which medication(s) is/are the most appropriate for you. For more information about diabetes during pregnancy, please see the MotherToBaby fact sheet Diabetes and Pregnancy at If you become pregnant while using metformin, you should not stop your medication without first talking to your health care provider. I am taking metformin to treat PCOS. Should I stop taking the medication before and/or after I get pregnant? You should not stop any medication without first talking with your health care provider. Studies have indicated that women with PCOS who are treated with metformin have a better chance of getting pregnant. Some studies Continue reading >>

Newly Pregnant With Pcos, Told To Stop Metformin?

Newly Pregnant With Pcos, Told To Stop Metformin?

Newly pregnant with PCOS, told to stop metformin? I am looking for a bit of advice/support. I have a son who is now who I conceived naturally (although it did take a while around 10 months but nothing alarming) and had a lovely pregnancy/birth with him. However since trying to conceive for almost a year I was diagnosed with PCOS. My doctor have me metformin as I had missed around 3 periods in the last year. After 3 normal cycles on metformin i fell pregnant, only finding out last week! After 15 months I was overjoyed and very excited but after doing research and reading up on PCOS (Polycystic Ovary Syndrome) and pregnancy I am really scaring myself... I am so worried about miscarriage, the anxiety is getting worse, I am constantly checking for blood. I have a few twinges/sharp pains and am convinced this is the start of one and am terrified to do anything. I know if it will happen it will whatever I do but I have waited a long time for this I can't bear to let it go. I know I am lucky to have my son and I am grateful beyond belief for him and this pregnancy but I just can't relax. My doctor has also told me stop taking metformin straight away. She has said there is no real evidence to support that it works and that we don't know what the effects of taking it during pregnancy could have on the children born in the future. I went to see another doctor who also spoke to a gynaecologist and both agreed however there is so much stuff on the net that states to take it! Please if anyone has any words of advice I would gladly appreciate it. I am booking in for a private scan at 9 weeks but am terrified there will be nothing there or not a healthy baby anyway... Continue reading >>

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