Metformin for PCOS: All You Need To Know

If you have been diagnosed with PCOS, you've probably heard about the use of metformin for PCOS. But does everyone need to take metformin and how can it help improve your PCOS symptoms? Learn more in this article.

Posted on September 17, 2022 ·

BY Team Veera

Medically Reviewed

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Being prescribed metformin might sound overwhelming to begin with but benefits often outweigh the side effects. It may help you manage the symptoms of PCOS by reducing insulin resistance and can also help avoid complications associated with type 2 diabetes. ⁣

Metformin for PCOS

Metformin is the most commonly prescribed medication for type 2 diabetes. But the benefits of metformin are not limited to only type 2 diabetes — it is also prescribed for other conditions such as prediabetes, gestational diabetes and PCOS. 

The primary reason for taking metformin in women with PCOS is to reduce insulin resistance and testosterone (male hormone) production. This can help regularise ovulation and periods, assist with weight loss and reduce the risk of developing diabetes. Not all women with PCOS will benefit from metformin, but you should discuss with your doctor whether it is appropriate to start this medication.

Usually metformin is prescribed to women with PCOS under these scenarios:

1. There is definitive sign of prediabetes or type 2 diabetes with altered sugar profile
For cases of definitive type 2 diabetes or prediabetes, the metformin course may be longer. Sometimes you might need to take metformin for life if your body is not able to produce sufficient insulin or the insulin is not functioning properly. However, you might even be able to stop taking it if your diabetes has moved to remission.

2. There is excessive weight gain with signs of insulin resistance 
For weight gain and signs of insulin resistance, your doctor can gradually reduce the dosage of metformin based on your sugar levels. Losing weight and making changes to your diet can help maintain your blood sugar levels without needing any medication. 

3. In order to boost fertility and chances of conception 
If started for fertility purposes, metformin helps improve the function of the ovary and re-establish regular periods and ovulation by reducing insulin resistance and androgen levels. It is usually stopped once you stop trying to conceive.

Are there side effects of taking metformin?

Metformin’s side effects are well understood and are often not a cause of concern. Usually when you are prescribed metformin, your doctor will start off with a low dosage and build the dosage over time to avoid stomach issues. ⁣

Some of the common side effects include

  1. nausea,
  2. diarrhoea,
  3. bloating,
  4. stomach ache and
  5. loss of appetite.

However, these symptoms are usually mild and will vary depending on how your body reacts to it.

It is best to take metformin with food to avoid feeling sick. Also if you see signs of diarrhoea, keep hydrating yourself and speak to your doctor who can either adjust your dose or give you tablets to manage the side effects.⁣

The risk of developing serious side effects is low — lactic acidosis, which is the buildup of lactic acid in the bloodstream can happen in those who have kidney problems. For such exceptions, doctors tend to avoid prescribing metformin. ⁣

Regardless of its side effects, metformin is considered to be one of the safest and effective drugs in treating insulin resistance. If you do experience side effects, speak to your doctor first who can either adjust the dose or guide you on how to take metformin.

Do I need to take metformin for life?

Some people are able to stop taking metformin, by putting their diabetes into remission or by decreasing their insulin resistance. Remission means that your blood sugar levels are within the healthy range without the need of taking any medication. There are many ways you can manage your blood glucose levels and they mostly involve making changes to your diet and losing weight. However, this may not be an option for everyone depending on your condition. ⁣

Also don’t stop taking metformin suddenly. Depending on your blood sugar levels and other symptoms your doctor might gradually decrease the dosage. Only if your kidneys are not working properly, your doctor will tell you to stop taking metformin.⁣

Starting metformin isn’t a sign of failing to manage PCOS. In fact, it will help you get on top of your PCOS and manage it with greater confidence.⁣

Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice, or as a substitute for medical advice given by a physician

Verified by Dr. Iris Lee

Fellow in Reproductive Endocrinology and Infertility, University of Pennsylvania

Dr. Lee is a fellow in reproductive endocrinology and infertility at the University of Pennsylvania. She completed medical school and residency training at the University of Pennsylvania as well. Her work focuses primarily on PCOS, particularly the metabolic and mental health implications. Outside of work, she enjoys baking, reading, and spending time with her husband and two puppies.

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