Metformin and PCOS: What You Need to Know Now To Help Improve Fertility
Metformin and PCOS, what's all the hype? Because metformin is one hot topic in PCOS groups, am I right?
And maybe you're also asking yourself if you should take metformin for your PCOS. Or do you wonder how metformin treats PCOS?
If that's you, then you are in the right place.
What is Metformin?
Metformin is a blood sugar balancing medication. It is mainly used for type II diabetes because of how well it gets blood sugar levels back in line. Metformin has been around a long time and is still used frequently today for both diabetes and PCOS.
Metformin and PCOS: the typical dose
A typical metformin PCOS dose is 1500mg a day, but can be between 1000-2000mg per day. Most doctors will start slowly at 500mg a day. That's a starter dose to make sure there are no side effects. As long as nothing comes up, then the dose is increased slowly until you get to that target dose.
Side Effects of Metformin
Metformin has some notable side effects. Have you ever been on it and did you feel nauseous, dizzy, or have diarrhea? That can happen. Up to 30% of people who take metformin experience digestive upset side effects.
Another important side effect to watch out for is lowered vitamin B12 in the body or a chance of developing an actual deficiency of B12. Metformin both lowers how well B12 is absorbed from food and lowers levels of vitamin B12 in the blood.
Here's why that matters.
One research study found that vitamin B12 deficiency can cause miscarriages and/or ovulation issues.
It's recommended to get vitamin B12 levels checked yearly to be sure those levels are staying where they need to be. Keep that in mind if metformin is apart of your fertility journey.
How long to be on Metformin before seeing results
When starting metformin, you may see some results. It takes between 2-3 months before blood sugar levels are fully normalized.
Curious to learn more about what PCOS is?
Like how it's diagnosed, what the different types of PCOS are and treatments available?
Click here to check out the
Ultimate Guide to PCOS Fertility: What You Need to Know article
Metformin and PCOS: The Connection
Metformin and PCOS: How it Works
So how do metformin and PCOS come together? Because metformin was excellent at balancing blood sugar and because so many women with PCOS had blood sugar issues, doctors started using them together.
In fact metformin quickly became the go-to PCOS fertility medication.
The medical community was excited about how metformin would help most all the aspects of PCOS. It was thought that not only would metformin help with blood sugar, but also symptoms like unwanted hair growth, ovulation issues, weight gain, acne and infertility.
So you can see why it began to be used so widely for PCOS.
Well, the metformin and PCOS heyday soon came to an end.
After years of being used and more research being done, it has been decided that metformin does not work for improving unwanted hair growth, balancing periods, or infertility.
Does that surprise you? It still surprises me! Particularly because I hear of so many women who are on or being offered metformin for fertility support.
Metformin and PCOS: What's Next
The first line medication for PCOS fertility is now Letrozole which is one of the ovulation induction medications.
The benefits of letrozole for PCOS fertility is that it has higher rates of live births over metformin. So while metformin was still helping women ovulate, there was a greater risk of miscarriage than those who used letrozole.
Before you write off metformin forever, it still may have benefits. Even though metformin isn't used first-line for PCOS, it's still commonly used for type II diabetes. If diabetes, or insulin resistance is apart of your PCOS journey, metformin may be useful.
Trying IVF? Metformin is also used before treatment as a preventative for ovarian hyperstimulation syndrome. Don't be surprised if your doc has you start it!
So now you know what metformin does and why it's used for PCOS. But is it right for your fertility journey? Here's the thing, talking with your doctor or PCOS specialist is the most important step in determining whether or not it's necessary for you.
FAQ's About Metformin and PCOS
Why is metformin prescribed for PCOS?
Metformin was once the first-line medication for PCOS because it helps balance blood sugar. It was also thought to help regulate periods, reduce testosterone (and those symptoms like unwanted hair growth and acne), and to improve ovulation.
Over time, it was discovered that it wasn't performing like expected for PCOS. But, metformin may still be used for fertility because it has other benefits.
Does metformin treat PCOS?
Metformin does not treat PCOS, although it can be helpful to treat insulin resistance or diabetes which may still be apart of PCOS.
Does metformin help with PCOS weight loss?
Metformin has been found to help with some weight loss although it is not a weight loss medication. It is used to help control insulin and blood sugar levels. Once blood sugar is more balanced, that promotes weight loss.
Researchers found in one study that people on metformin lost between 6 and 7 kilograms while the control group who weren't on metformin gained weight. At this time, metformin should not be used exclusively for weight loss. Have a conversation with your doctor about what weight loss plan is right for you and if metformin is helpful.
Should I take metformin for PCOS?
Whether or not to take metformin is a decision between you and your doctor. Metformin may still be beneficial for your fertility needs even though it's not a first-line fertility medication.
Why shouldn't you take metformin for PCOS?
The side effects are the biggest reason people don't like metformin. Up to 30% of people experience the digestive upset like nausea and diarrhea. Metformin can also cause vitamin B12 deficiency so it's important to talk with your doctor about how to prevent that.
Metformin and PCOS: Summary
Metformin balances blood sugar and was once the first-line medication for PCOS fertility. It has now fallen out of favor because it hasn't been found to improve the PCOS symptoms like it was first thought. But it still helps balance blood sugar really well. It is still helpful if insulin resistance or diabetes need to be taken care of.
If you just get a 15-minute appointment with your doctor and you only walk out the door with a prescription and a pamphlet for PCOS, you are missing out on important fertility answers.
Sign up here for a complimentary PCOS Fertility Session today to get the answers you need to boost your chances of getting pregnant.
Here's what you will discover at your free session:
How to turn around your PCOS frustrations to be closer to reaching your fertility goals.
Why what you’ve been doing is leading you away from optimal fertility and what actually works.
What’s been missing from your care that’s keeping you from seeing results.
Clear step-by-step guidance to have your best chance at becoming pregnant.
References used in this article:
Barbieri, Robert. Metformin for treatment of the polycystic ovarian syndrome. In: UpToDate, Wolters Kluwer (Accessed on September 7, 2023).
