Metformin is a commonly prescribed medication for women with polycystic ovary syndrome (PCOS). PCOS is a hormonal disorder that affects 5-10% of women of reproductive age. Women with PCOS typically have high levels of androgens (male hormones), insulin resistance, and irregular menstrual cycles. These hormonal imbalances can cause a range of symptoms, including acne, hair loss, weight gain, and infertility.
Metformin is a medication that is used to treat type 2 diabetes. It works by reducing the amount of glucose produced by the liver and improving the body’s sensitivity to insulin. This mechanism of action makes metformin an effective treatment for PCOS, as insulin resistance is a common feature of the disorder.
In this article, we will explore the benefits and side effects of metformin for PCOS in detail.
Benefits of Metformin for PCOS:
Improves Insulin Sensitivity
One of the primary benefits of metformin for women with PCOS is its ability to improve insulin sensitivity. Women with PCOS often have insulin resistance, which means that their bodies do not respond to insulin properly. Insulin resistance can cause the body to produce more insulin, leading to high levels of insulin in the bloodstream. These high insulin levels can cause a range of symptoms, including weight gain, acne, and irregular menstrual cycles.
Metformin helps to improve insulin sensitivity by reducing the amount of glucose produced by the liver and increasing the body’s ability to use insulin. This can help to lower insulin levels in the bloodstream and reduce the symptoms of insulin resistance.
Reduces Testosterone Levels
Women with PCOS often have high levels of androgens (male hormones) such as testosterone. These high levels of testosterone can cause a range of symptoms, including acne, hair loss, and excess hair growth. Metformin has been shown to reduce testosterone levels in women with PCOS, which can help to improve these symptoms.
A study published in the Journal of Clinical Endocrinology and Metabolism found that metformin reduced testosterone levels by 22% in women with PCOS. This reduction in testosterone levels was associated with improvements in acne, hair loss, and excess hair growth.
Improves Menstrual Regularity
Irregular menstrual cycles are a common symptom of PCOS. Women with PCOS may have infrequent periods, or their periods may be very heavy or very light. Metformin can help to improve menstrual regularity in women with PCOS.
A meta-analysis of 14 studies found that metformin improved menstrual regularity in women with PCOS. The studies included in the analysis found that metformin increased the frequency of menstrual cycles and reduced the time between periods. The improvements in menstrual regularity were seen in women who were overweight and women who were not overweight.
Helps with Weight Loss
Weight gain is a common symptom of PCOS. Women with PCOS often struggle to lose weight, even with diet and exercise. Metformin can help with weight loss in women with PCOS.
A meta-analysis of 14 studies found that metformin led to significant weight loss in women with PCOS. The studies included in the analysis found that metformin led to an average weight loss of 3-4 kg (6.6-8.8 lbs) over a period of 6-12 months. The weight loss was seen in women who were overweight and women who were not overweight.
Improves Fertility
Infertility is a common complication of PCOS. Women with PCOS may have difficulty ovulating, which can make it difficult to conceive. Metformin can help to improve fertility in women with PCOS.
A meta-analysis of 29 studies found that metformin improved ovulation rates and pregnancy rates in women with PCOS. The studies included in the analysis found that metformin increased ovulation rates by 48% and pregnancy rates by 32% in women with PCOS. The improvements in fertility were seen in women who were overweight and women who were not overweight.
Metformin is often prescribed in combination with clomiphene citrate, a medication used to stimulate ovulation, in women with PCOS who are trying to conceive. The combination of metformin and clomiphene citrate has been shown to be more effective at inducing ovulation and improving pregnancy rates than either medication alone.
Side Effects of Metformin for PCOS
Like all medications, metformin can cause side effects. The most common side effects of metformin include:
Gastrointestinal Symptoms
Gastrointestinal symptoms such as nausea, diarrhoea, and abdominal pain are the most common side effects of metformin. These symptoms usually occur at the beginning of treatment and can be reduced by taking metformin with food or by starting with a low dose and gradually increasing the dose over time.
Vitamin B12 Deficiency
Metformin can interfere with the absorption of vitamin B12, which can lead to a deficiency of this important vitamin. Vitamin B12 is important for nerve function, red blood cell production, and DNA synthesis. Women taking metformin for PCOS should have their vitamin B12 levels checked regularly and may need to take a vitamin B12 supplement.
Lactic Acidosis
Lactic acidosis is a rare but serious side effect of metformin. It occurs when there is a build-up of lactic acid in the bloodstream. Lactic acidosis can cause symptoms such as nausea, vomiting, abdominal pain, and difficulty breathing. Women taking metformin for PCOS should be aware of the symptoms of lactic acidosis and should seek medical attention immediately if they experience any of these symptoms.
Hypoglycaemia
Hypoglycaemia, or low blood sugar, can occur in women taking metformin for PCOS. This is more likely to occur in women who are also taking insulin or other medications that lower blood sugar. Women taking metformin for PCOS should be aware of the symptoms of hypoglycaemia, which include shakiness, dizziness, sweating, and confusion.
Conclusion
Metformin is a medication that can be very beneficial for women with PCOS. It can improve insulin sensitivity, reduce testosterone levels, improve menstrual regularity, help with weight loss, and improve fertility. However, like all medications, metformin can cause side effects. Women taking metformin for PCOS should be aware of the potential side effects and should discuss any concerns with their healthcare provider. With proper monitoring and management, metformin can be a safe and effective treatment for PCOS.