Metformin and Polycystic Ovary Syndrome (PCOS)
What is Metformin?
Metformin is an oral diabetes drug that is primarily used to treat type 2 diabetes. This drug, which also goes by the brand name Glucophage, is used to help patients with type 2 diabetes control high levels of glucose in the blood. Metformin allows the body to respond properly to naturally produced insulin. However, it can also be used to treat polycystic ovary syndrome (PCOS). Polycystic ovary syndrome is an endocrinological disorder that affects 4-12% of women.
How Does Metformin Treat PCOS?
Most patients who have PCOS also have high insulin levels. High levels of insulin, also called hyperinsulinemia, can cause weight gain and cravings, which puts individuals at risk of developing type 2 diabetes. Hyperinsulinemia may also cause dark patches in the skin and the production of additional androgen hormones in the ovaries. High levels of androgen hormones such as testosterone can cause few or irregular periods, increased acne and body hair. Consistent exposure to high levels of insulin can cause insulin resistance, which also has a negative impact on the body.
Metformin treats PCOS by lowering insulin levels, which reduces the patient’s risk of diabetes and helps to regulate the level of androgens produced by the adrenal glands and ovaries. Though it is not labeled for use in the treatment of PCOS, metformin has been studied in girls as young as 8, and has become the most commonly prescribed medication for PCOS. It has even been recommended as treatment to help prevent its onset.
Metformin treats PCOS by suppressing the production of glucose in the liver, which lowers insulin and blood glucose levels, increasing the sensitivity of the liver, muscle, fat, and cells to the body’s natural production of insulin, and decreasing the absorption of carbohydrates.
Metformin provides additional benefits to those suffering from PCOS. It can improve ovulation and regulate unpredictable menstrual cycles, while lowering the risk of miscarriage. For this reason, this medication is sometimes used as a fertility treatment for women with PCOS who wish to become pregnant.
Metformin has also been shown to improve cholesterol and symptoms of hirsutism like excessive hair growth and acne. When combined with a healthy diet, the drug may even be able to help with weight loss, though it is not a weight-loss medication. This drug may also decrease the risk of gestational diabetes in people who are pregnant.
Though treatment of PCOS is not a labeled indication for metformin, there has been much research studying the safety and effective of its use. Despite its safe application for treatment of PCOS, individuals may experience some side effects. If patients experience any severe side effects, they should contact a doctor immediately.
Common Side Effects
- Temporary gastrointestinal symptoms such as nausea, diarrhea, bloating, and abdominal pain
- Loss of appetite
- Metallic taste in the mouth
Severe Side Effects
- Difficult and/or rapid breathing
- Swelling of the face, lips, tongue, or throat
- Excessive sweating
When to Take Metformin for PCOS
The dosage of metformin for PCOS is often increased gradually in order to reduce the risk of uncomfortable side effects. To start, this drug should be taken as a 500 mg dose once daily with a meal for 1 to 2 weeks. The dose can then be increased weekly or biweekly by 500 mg a day until a maximum dose of 2500 to 2550 mg per day is reached. The average dose is 1500 to 2000 mg daily.
Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.