Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women in their reproductive years. 

Irregular periods, elevated testosterone hormone levels, and small cysts on the ovaries often characterize it. 

To help manage the symptoms of PCOS, doctors often prescribe Metformin as a first line of treatment.

This medication plays a significant role in hormone regulation and overall treatment.

To know more about Metformin for PCOS, continue reading the article. 

Overview

An overview of Metformin for PCOS treatment includes

AspectsMetformin for PCOS
PurposeReducing insulin levels, luteinizing hormones, and androgen levels in women with PCOS.
BenefitsRegulates menstrual cycles and promotes normal periods
Promotes ovulation and improves fertility
Aids in weight loss by improving insulin response
Lowers the risk of developing type 2 diabetes, a common PCOS complication
Dosage guidelines
Metformin dosage for PCOS gradually increases from 500mg once daily to 1g twice daily or 850mg three times daily. Start with 250mg for side effects and reach 1g twice daily over six weeks.
Missed DoseTake the missed doses as soon as possible. Skip if it’s close to the next scheduled dose. Avoid double dosing
Duration of UseNo specific time limit. Discuss with the doctor if no benefits are seen after six months.
Common side effectsCough or hoarseness, abdominal or stomach discomfort, fever or chills, general feeling of discomfort, and decreased appetite.
Rare Side EffectsBehavior changes like being drunk, drowsiness, difficulty concentrating, unusual sleepiness, lack or loss of strength, and lactic acidosis.

Metformin treatment for PCOS

In women with PCOS, high insulin levels can make the condition worse.

Metformin helps by reducing insulin levels and decreasing luteinizing hormones and androgen levels. 

Good to know:
Luteinizing hormone (LH) is a naturally occurring chemical that plays an essential role in the reproductive system by stimulating essential processes such as ovulation.

This helps regulate the menstrual cycle and promote regular periods.

It can also help lower the chances of developing type 2 diabetes, a common PCOS complication. 

Metformin is prescribed for women with PCOS who experience:

  • Irregular menstrual cycles: Metformin helps restore regular ovulation and regulate the menstrual cycles
  • Infertility: This medicine promotes ovulation and improves fertility
  • Obesity: Metformin can improve the body’s insulin response, helping to lose weight

How to take Metformin for PCOS

Consult a doctor before taking medcine
Consult a doctor before taking medcine

Metformin is a prescription medication; therefore, it is essential to consult your doctor before taking it.

Your doctor will provide specific instructions on taking Metformin, including the dosage and frequency that suits your needs.

Metformin should be taken with food to lower the chances of any side effects.

It should be started with a low dose and gradually increased over time to minimize potential side effects with the doctor’s consultation.

It is essential to take Metformin at the same time every day to maintain consistent levels of the medication in your bloodstream.

Also, check your blood sugar levels continuously while taking Metformin.

Metformin dosage for PCOS

According to Royal Berkshire – NHS Foundation Trust, the dosage of Metformin for PCOS includes the following:

Quick Route:

  • Weeks 1-2: Begin with 500mg of Metformin once a day.
  • Weeks 3-4: Increase to 500mg of Metformin twice a day.
  • Weeks 5-6: Further increase to 500mg of Metformin thrice or 850mg twice daily.
  • After Week 6: Take 1g (1000mg) of Metformin twice daily or 850mg thrice daily.

If Side Effects Develop:

Slow Route (for women experiencing side effects):

  • Week 1: Start with 250mg of Metformin once a day.
  • Week 2: Increase to 250mg of Metformin twice a day.
  • Week 3: Further increase to 250mg of Metformin thrice daily.
  • Week 4: Increase to 500mg of Metformin twice a day.
  • Week 5: Further increase to 500mg of Metformin thrice daily.
  • Week 6: Take 1g (1000mg) of Metformin twice a day.

If you miss a dose of Metformin, take it as soon as possible.

However, skip the missed dose if it’s almost time for your next scheduled dose. Avoid taking two doses at the same time.

But it is recommended that you consult a doctor if you ever miss a dose.

Duration of Use:

There is no specific time limit for taking Metformin. 

However, you haven’t noticed any benefits after six months. 

In that case, you can discuss with your doctor whether to stop using the medication.

It’s important to talk to your doctor about the right dosage for you and any changes that might be needed based on your needs and medical background.

Metformin for PCOS side effects

abdominal pain
Abdominal pain

Metformin is generally well tolerated, but it can cause many side effects.

Some of the common side effects include:

  • Cough or hoarseness
  • Abdominal or stomach discomfort
  • Fever or chills
  • A general feeling of discomfort
  • Decreased appetite
  • Diarrhea
  • Fast or shallow breathing
  • Muscle pain or cramping
  • Painful or difficult urination
  • Lower back or side pain
  • Sleepiness

Some of the less common side effects of Metformin include:

  • Anxiety
  • Blurred vision
  • Confusion
  • Depression
  • Headache
  • Nausea
  • Seizures
  • Unusual tiredness or weakness

Some of the rare side effects of Metformin include:

  • Behavior change similar to being drunk
  • Drowsiness
  • Difficulty with concentrating
  • Unusual sleepiness
  • Lack or loss of strength
  • Lactic acidosis
Caution:
Consult a healthcare expert immediately if you notice any of the side effects.

Takeaway

Metformin is an effective treatment for PCOS that helps regulate menstrual cycles, improve fertility, and manage obesity-related insulin resistance. 

When taking Metformin, you must consult your doctor for proper guidance on dosage and timing. 

Start with a low dose and gradually increase the dosage to minimize side effects. 

Common side effects may include stomach discomfort, decreased appetite, and diarrhea.

In contrast, rare side effects may involve behavior changes or lactic acidosis.

Metformin offers valuable benefits for women with PCOS, but individualized treatment plans and close medical supervision are essential.

It is essential to seek guidance from a healthcare expert for an accurate diagnosis and appropriate treatment of PCOS.

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Frequently Asked Questions

How does Metformin help PCOS?

Metformin helps PCOS by reducing insulin levels, regulating menstrual cycles, promoting ovulation, improving fertility, and addressing insulin resistance. It can also help with weight loss and help in decreasing the risk of developing type 2 diabetes, which is commonly associated with PCOS.

How quickly does Metformin work for PCOS?

Metformin’s effectiveness in treating PCOS varies for each person. Some may notice improvements in their menstrual cycles and ovulation within a few weeks, while it can take months to see the full benefits in fertility.

What are the alternatives to Metformin for PCOS?

Some alternatives for Metformin include Inositol, Clomiphene, Chromium, Berberine, or other insulin-sensitizing agents such as thiazolidinediones (TZDs). Lifestyle changes such as diet, exercise, and hormonal contraceptives for menstrual regulation can also help.

What are the benefits of Metformin for PCOS?

Metformin offers several benefits for PCOS, including reducing insulin levels, regulating menstrual cycles, promoting ovulation, improving fertility, and aiding in weight loss. It can also help lower the risk of developing type 2 diabetes, a common issue of PCOS. Individual responses to Metformin may vary.

Can you drink alcohol while taking Metformin for PCOS?

When taking Metformin for PCOS, it is usually best to avoid or reduce drinking alcohol. Lactic acidosis is a rare but dangerous side effect of Metformin that can be made worse by drinking alcohol. 

Citations:
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