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Wednesday, July 26, 2006

Metformin (Glucophage) for PCOS

Metformin (or Glucophage) for polycystic ovararian symdrome (PCOS)
by Kelly

Why would you be taking metformin or glucophage (metformin is the generic for glucophage)

Metformin is a diabetes medicine used for lowering insulin and blood sugar levels in women with polycystic ovary syndrome (PCOS). This helps regulate menstrual cycles, start ovulation, and lower the risk of miscarriage in women with PCOS. It is generally used in conjuction with clomid.
The most common side effects of metformin

Nausea.
Loss of appetite.
Diarrhea.
Increased abdominal gas.
A metallic taste.
Tiredness.

Problems that might arise and ways to troubleshoot

I have always had pretty strong side effects (lots of nausea and always very tired) while taking metformin. It does get better as time goes on but working myself up to the maximum dosage has always been hard.

I've been to a number of different doctors who have all suggested different ways to work up to my maximum dosage (1500 mg). It is generally suggested that you start with the lowest dose and keep increasing it as you get used to it (or as the side effects start to go away). The first time I took it, I took 500 mg for about three weeks (1 pill in the morning). Then added a second pill at lunch time (so I took 1000 mg for 3 weeks). And, then I added a third pill at dinner time.

The second time that I took metformin, I increased the dosage from 500 mg to 1500 mg over the course of three weeks. I was sick a lot but I feel like I got the worst part over with faster.

My personal experience has been that it usually takes me about 1 month for the side effects to start to lessen. I will still have bouts of nausea, but after about 2 months that starts to happen less often.

My personal tips

Always take with food or a glass of milk - I always take my metformin when I am eating either breakfast, lunch or dinner.
I have heard from others that following a low carb diet helps with the side effects (I personally haven't found this to be true - or maybe I just couldn't follow the low carb life).
When increasing your dosage, just increase it as you feel ready.

19 comments:

Anonymous Infertile said...

I just have an update ..... my dosage has been increased to 2000 mg by a new endocrinologist and he kinda gave me an easier dosage schedule so I thought I would share. I am now taking 2 pills in the morning with breakfast and 2 pills at night with dinner. It is a lot easier because I only have to take medication twice during the day. And, I haven't noticed it being any harder on my stomach.

Hope this helps someone!!

Kelly

Ren said...

I was on this for about 5 months and was only able to get my dosage up to 1500mg. Something they don't tell you, is that when you start taking it, an each time you increase your dosage, you can experience extremely bad back pain. In your kidney area. Mine was awful. It would last 4-5 days each time I increased the dosage. The nurses and doctor all looked at me like I was crazy, they'd never heard of this side effect. It wasn't until I read on other infertility sites that I could see other people had the same problem.

Anonymous said...

Thanks for the info. Did it work for anyone??

Tina said...

I took metformin -- I cannot recall the exact dosage, but I think I worked up to around 1500-2000 mg. My diagnosis was PCOS. I cannot say for sure whether metformin was the magic bullet, as I was also taking Clomid. I was also doing acupuncture. My REI was agnostic on metformin -- he had me take it on the theory that it couldn't hurt, given that we were motoring ahead with other things. And I did eventually get my baby!

Anonymous said...

I have been on metformin for about a year. I started at 1000 mg a day, but my new REI doctor told me that I should be above 1500 in order to help. I actually take 850 twice a day. I didn't notice any ill effects, but I started following a low glycemic index diet right away. Eliminating blood sugar spikes helps with tolerating the drug because the drug limits how much insulin you can release at a time. My theory is that if you overload your body with sugar and refined carbs, they don't have anywhere to go but straight through your GI system because you can't release the insulin fast enough. I wavered from the low glycemic diet once and had a milkshake. BIG mistake. I was on the bathroom floor all night with cramping, bloating and severe you know what. That was all I needed to be committed to it! Anyway, I later changed to a naturpathic diet that cuts almost all grains out and requires that I eat only whole, naturally occuring foods. It also seems very compatible w/ metformin. Another tip - if you are a big fitness person, I recommend that you bring propel or diluted juice to the gym with you until you figure out how the metformin affects your energy level. I had several bloodsugar crashes during workouts because I didn't have the same liver glycogen storage as before. Drinking something w/ carbs in it during workouts really helped until I could figure out what I needed to eat before to make it through the hour.

Lisa said...

Has anyone experienced weight loss while on metformin? My doctor says it's common, and of course, I'm on Metformin, eating less, pretty active, breastfeeding, and gaining weight...

I was diagnosed with insulin resistance in conjunction with PCOS. Took metformin 2x daily. That and progesterone suppositories are the reason I have my 8-month-old daughter today. Didn't have those problems when I got pregnant with my son, but after 2 m/cs, they found the problem.

Heather said...

It is good to know that I am not the only one out there who feels like her butt explodes every time the docs mess with the dosages. I started on Metformin a year ago for PCOS/Insulin Resistance and have been on 1000mg that whole time. Granted I didn't take it faithfully, so my side effects were worse than if I had taken it every day like I should have. I am now seeing an REI who increased my dosage to 2000mg daily. I take 1000mgs twice daily - breakfast and dinner. I am also on a low carb, diabetic diet which really helps with my appetite and sugar control. I am also losing weight fast! I find that the higher carb and fat content in my meals, the worse my side effects are.

butterflz said...

i have just been diagnosed with pcos even thogh ive known for about a 2 years.
I have been on metformin for 3 weeks now and i am on my third tablet.
I have felt great on these tablets and they have built my confidence as i have now started to lose weight since being on them.
I take mine after meals but it probably works well for me because i changed my diet early on in the year and love eating healthy as it amkes me feel good but i dont feel guilty if i treat my self.
it is also a good idea if you manage to reduce your stress levels and if you read you leaflets carefully your doctor should be given you blood tests to check on your kidneys and should be given you vitamin B12 as metformin can starve your body from it.
PCOS is linked to auto immunes disease have a look on the web and you will be surprized how many things link to it.
anyone can ask me any questions im quite good as i have alot of time to research about pcos, metaformin, insulin resistance and auto immunes disease.

Anonymous said...

First I wanted to say thanks for all of the great information!

I also wanted to comment on this really quick: "Metformin is a diabetes medicine used for lowering insulin and blood sugar levels in women with polycystic ovary syndrome (PCOS)"

Just about everything that I've read, heard from my doc, and verified with my pharmacist, is this: Regarding the use of Metformin to treat PCOS: Although Metformin lowers elevated blood sugar levels in diabetics, when given to nondiabetic patients, they only lower insulin levels. In fact, episodes of "hypoglycemic attacks" appear to be reduced.

I'm not trying to make corrections - I only wanted to mention it b/c if anyone reading this is experiencing hypoglycemic attacks while taking Met for PCOS, they may want to have their dr do some b/w to verify that they haven't developed diabetes.

Amanda said...

I was diagnosed with PCOS over 10 years ago, but was just put on Metformin a few months ago in an attempt to get pregnant. I started with one 500MG dose once daily and was immediately met with a metallic taste in my mouth, nausea and diarhea. Over the course of a month, I worked up to 1500MG daily, but the diarhea never really left me. I took it with milk. I took it with food. I took it with low carbs. I took it with high carbs. Nothing really mattered - I was still having at least one loose bowel movement EVERY DAY. Luckily, three months into treatement, I began to see some signs that I was ovulating and voila! I'm happy to report that I'm pregnant.

I came off the Metformin at 8 weeks of pregnancy because it seemed to be aggravating morning sickness.

Even though I felt that I had a difficult experience with Metformin, I will definitely take it again to pursue my next pregnancy. But this time, I'll ask for the extended release version - there's some discussion that it's a little easier on the tummy.

Pamela said...

What a great post. Metformin is wicked, despite drinking water, eating right, etc. I took it for years. Supposedly the extended release is easier on your system, although that is what I took and it was HARD on me. There is a new version of Metformin that many PCOS'ers are taking, forgive me I cannot recall the name.
I'm taking the herbal "form" of Metformin, Gymnema, and its working a lot better -- plus NO side affects, thank goodness.
Pamela
http://www.pcosinfo.com

adviceseeker said...

I was recently diagnosed by a Nurse Practitioner with PCOS. She said she thinks I may have this but there is no test to be sure. I had blood work done and she said everything was ok. She also said there was no problem with my glucose levels. When I went back about a week ago she said she thinks I should take Metformin. I am not sure why I should take this. I am 20 years old and not currently trying to get pregnant. If anyone has any advice or explanation I would love to hear anything you have to say. I know I should really take to the doctor but I dont have health insurance and I cant afford to make anymore appointments right now. I just want to know what the advantages of taking this drug is and what it does for the PCOS.

emily said...

dear adviceseeker,

there is a test for PCOS, first you have hormonal blood tests to check your testosterone, prolactin, progesterone, and your ration of LH to FSH. then, if necessary, you have a vaginal ultrasound to view your ovaries.

there is no need to take metformin unless you want to conceive. the birth control pill will regulate your hormones and decrease testosterone production to help with symptoms.

i don't know how it works where you are, but here in the UK there is quite a process you have to go through for diagnosis and referal to a fertility specialist before you get metformin!! a nurse practitioner, as far as i know, is not trained enough to give a diagnosis or any opinion on medication like that.

Jellibells said...

I went on metformin one year before conceiving my daughter, and really we were only actively trying for about six months before getting pregnant. Prior to going on met, I had been diagnosed with PCOS and had irregular periods - sometimes only a few a year. Metformin regulated my period and helped me to ovulate more regularly after only about six weeks of regular use (I stayed on a dosage of 1000/day - 500 two times a day - the entire time I was on it. They did not see a need to increase the dose). I did stay on the met through my 20th week of gestation as I was concerned about miscarriage and much of the international research now seems to indicate that staying on met past the first trimester can be beneficial in preventing miscarriage. I did end up developing gestational diabetes (common with PCOS) around the 28th week of gestation and had to go on insulin which was a mess...my sugars never were well regulated until I delivered a week early. I have been off met for a year while breastfeeding and look forward to going back on - despite stomach problems (which did get much better after the first few months of regular use) I felt better, had more energy, and lost weight on the met...in addition to it helping me to get and stay pregnant with my amazing now one year old daughter. She is extremely healthy, btw, surpassing all milestones, 95% height and weight, and the picture of health in general. Maybe it does not work this way for everyone, and yes there may be things we don't know about met...but that can be said of much of the food and drink and other chemicals we put into our bodies on a daily basis...to me, the benefits seem to outweigh the detriments. Good luck to everyone!

Anonymous said...

I saw that someone said that there is no need to take the glucophage if you aren't trying to conceive. I have had a hysterectomy and am on the glucophage for PCOS. Glucophage reduces insulin, testosterone and glucose levels -- which reduces acne, hirsutism, abdominal obesity, amenorrhea and other symptoms. This is a great site to get some information, but make sure you aren't taking medical advice from people on here. Listen to your doctor.

Anonymous said...

Hi -- was wondering if anyone could offer my some advice. I am in my mid 20s....was a high school athlete and now working as a personal trainer. I have been a very active my whole life and have always been very health conscious.

Over the last 6 months I have gained about 10 lbs, in addition to serve cold intolerance, fatigue and irritability.

Last month I went to my OBGYN for amenorrhea (I have not had a cycle in +2 years). Previously, she attribute my condition to the female athlete triad.

However, after testing she diagnosed me with hypothyroidism (although my levels were normal?) and put me on 25 mg synthyroid. She also did an ultrasound and started me on 1500 mg glucophage for ovarian cysts.

This is only my 2nd week taking the meds. But I feel horrible. I am training for a marathon and after I run I am physically exhausted the rest of the day. I know training is taxing, but I usually have a lot of energy.


Has anyone experience similar symptoms? How did you deal with it? How long does it take to get back to normal?

Thanks for any advice or feedback.

Kelsey said...

I, too, have been exhausted after taking the Glucophage. I usually am going from 5:30 am till 10:00 pm, but not today! I took the medicine this morning around 7:00 and ended up leaving work early as well as missing three of four of my classes. I haven't had any trouble with the nausea as others have mentioned, only fatigue. I am also 20 years old and taking this medicine for PCOS. I took BC only for a while but it made my blood pressure way too high so I now take the Glucophage as well as the birth control. I guess they level each other out or something? I think my doc. plans on taking me off the BC next month. I don't know how long it takes to get used to it but I sure hope it's soon!!!

WiseGuy said...
This comment has been removed by the author.
WiseGuy said...

I have recently been put on Metformin...I take two 500 mg pills a day...

and I have not experienced much of the side effects that were mentioned here...but yes, I believe it is making me pee more often, and I am not complaining because finally my bloating is reined in.

As mentioned in the post above, I have been given the Metformin in conjuction with Clomid to help me ovulate and I do NOT have PCOS.