PCOS and Metformin
Polycystic Ovarian Syndrome (PCOS) is a common hormonal imbalance in young women that can cause irregular menstrual periods, weight gain, acne and excess hair growth on the face and body. It occurs because of an imbalance in the hormones in the brain and the ovaries. Women with PCOS can also have higher levels of insulin made by the pancreas. PCOS can occur when hormone levels or insulin levels are too high causing the ovaries make too much "male" hormone (testosterone). Women with PCOS are also at increased risk of developing diabetes, high blood pressure, high cholesterol and heart disease.
Treatment
Your health care provider has likely done tests to check your hormone levels, blood sugar, insulin and cholesterol. While PCOS cannot be cured, it can be treated. Treatment for PCOS may include medications including hormone treatment and insulin-sensitizing medications. While the most common form of treatment for PCOS is the birth control pill, there is also a newer medicine (Metformin) which helps lower insulin levels in young women with high insulin levels. Healthy habits including diet and exercise are also important pieces in the treatment of PCOS and insulin resistance.
Metformin:
Metformin is a medication that has been shown to improve the body's use of insulin and can help treat the symptoms of PCOS. The goal of using medication (Metformin) is to decrease insulin resistance and "male" hormone levels in the body. These decreases help treat excess hair growth, acne and obesity as well as help menstrual periods to become regular.
Side Effects
In general, most young people do not have many side effects when taking Metformin. The most common complaints are stomach upset, nausea (feeling like you are going to vomit) and diarrhea. To decrease side effects, Metformin is usually started at a low dose then slowly increased until the individual can take the medication without complaints.
Your health care provider will likely do tests to make sure you do not have kidney or liver problems before starting Metformin. If you have kidney or liver problems, you should not take Metformin.
How to Take Metformin
If your provider prescribes Metformin, you should take it before your main meals of the day (usually breakfast and dinner). You will be told to begin taking a low dose of the medicine and slowly increase the amount. While you are on Metformin, it is recommended that you take a multivitamin every day because the medicine can decrease your digestion of certain vitamins (B12 and folate).
During Treatment
- It is very important that Metformin be stopped at least 48 hours before surgery or radiologic studies involving contrast materials.
- To be safe, avoid drinking alcohol while taking Metformin. Alcohol increases your risk of serious side effects.
- If you are sick and cannot eat, do not take Metformin. Once you are able to eat and drink normally, Metformin should be restarted.
- If you have stopped taking Metformin for a few days, it is important to restart the medication at a low dose and slowly build up to your regular dose so you don't have side effects. If you are unsure how to restart your medication, please call the clinic, 513-636-4681, option 2 (nurse line).
- Metformin is to be stopped if you become pregnant.
- It is very important to maintain a healthy diet and exercise on a regular basis while taking Metformin. Weight loss (if recommended) has been shown to decrease hormone levels as well as make the body more sensitive to insulin. If you need help regarding proper diet and healthy eating, please let your provider know so that you can be referred to a nutritionist.
Follow-Up
If you have PCOS and are on medication, your provider will ask you to come back for regular appointments to make sure that the medication is working well. Sometimes it is necessary to change a medication or the dose of a medication.
Call the clinic if you have any questions or are experiencing any serious or persistent side effects.
Resources:
www.youngwomenshealth.org
Rev. 9/08
