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PCOS & METFORMIN

Metformin may be used for treatment of symptoms associated with Polycystic ovarian syndrome (PCOS). Metformin may help correct your hormone imbalance and lead to regular periods and improved fertility. It may also help women with increased facial hair, acne and scalp hair thining/loss. Metformin is used widely for the treatment of PCOS, however, it is currently only licensed for the treatment of diabetes mellitus.

Metformin and Fertility problems:

Metformin can help women with PCOS who have problems with ovulation, ovulate regularly. It can also help women with PCOS increase the chances of getting pregnant with IVF or ICSI treatment as well as reduce the risk on ovarian hyperstimulation syndrome (OHSS).

How does Metformin work?

Metformin works by by helping your body respond better to its own insulin, a hormone which regulates sugar levels. Women with PCOS often have high levels of insulin, therefore treatment with Metformin may help improve the symptoms of the syndrome. It is also used in the treatment of diabetes. However, Metformin will not make you low in blood sugar if you are not diabetic.

What kind of side effects can Metformin cause?

One in six women will experience side effects, nausea (feeling sick) and diarrhoea are commonest. These usually settle with 3-4 weeks. Women may also experience a metallic taste in their mouth. Taking your Metformin with meals can help reduce these side effects.

How should Metformin be taken?

Your doctor will tell you how many tablets to take and how often. Treatment is usually started at a low dose and increased slowly. In the first week of treatment start with 500mg Metformin after the main meal. If you are not having side effects, increase to 500mg twice a day. In the third week increased to 500mg three times a day or 850mg twice daily. If you have side effects, continue on the dose you can tolerate until they settle. This can take up to six weeks.

Can I take Metformin if I am pregnant?

There is no evidence that Metformin harms an unborn baby. However, it is often no longer required once a pregnancy test is positive. We therefore recommend metformin is discontinued once your pregnancy test is positive, however in certain cases we would recommend continuing treatment until 12 weeks of pregnancy, this should be discussed with your fertility specialist particularly if you are overweight or have had miscarriages.

What should I avoid while taking Metformin?

Metformin should be used with caution in women with high alcohol intake or those on a high protein, minimal carbohydrate diet, such as the “Atkin’s diet”.

When should I stop taking Metformin?

WARNING: A small number of people who have taken Metformin, have developed a serious condition called lactic acidosis. Lactic acidosis is caused by a build-up of lactic acid in the blood. Lactic acidosis happens most often in people with kidney problems but can happen in other conditions too.

You should stop taking Metformin if you:

  • have kidney or liver problems.
  • drink heavily or are planning to drink a lot of alcohol (6 units) in the next 24 hours
  • are dehydrated (as when your body has lost a lot of water from diarrhea or vomiting).
  • are going to have an x-ray procedure with an injection of dye in your veins.
  • are scheduled to have surgery or an operation.
  • develop a serious condition such as a heart attack, severe infection, or a stroke.
  • have had an allergic reaction to Metformin.

Does Metformin help me if am overweight?

If you are overweight Metformin alone will not reduce your weight, unless combined with healthy eating (diet) and exercise programme. We recommend three light meals a day, plenty of fruit and vegetables, as well as exercise for an hour three times a week.

 

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