PCOS and metformin

I was going to put this on the non-hair board, but I noticed people were discussing PCOS issues here.

Has anyone taken metformin for PCOS and felt WORSE? I took the pill for a few months following my PCOS diagnosis, but I felt like it made me more anxious. I started on metformin in Decemeber. I was doing really well, got a period in early January, but later that month I got a second period. There was only a week in between the two periods. I felt like I was going insane in the days prior to the 2nd one, just really intense moodswings and extreme fatigue. I've struggled with depression for a few years now, but never have felt that bad. My doctor took me back down to 500mg. I've been doing that for a couple of weeks and have felt fine until yesterday I began having the emotional ups and downs again. I didn't have a period early this month when I usually have them. I'm not sure whether it's my body trying to re-adjust itself or what but this is terrible. He gave me a script for 750mg because he said long-term 500mg would likely not be enough. I'm keeping with the 500mg for the rest of this month.

Is this one of those cases where it gets worse before it gets better? I'm just so over this. I've always wanted kids and have been told I likely can have them, but I'm now thinking about a hystorectomy. I feel like I will eventually commit suicide if I can't get some relief from this condition which has basically ran my life for the past several years. I've known something was off for the longest time, but doctors insisted I was normal. It was only recently that I felt pains and went for an ultrasound. I don't think I have a bad case if that makes sense since the doctor only noted several follicles on my left ovary which apparently is inconclusive. He said he didn't like diagnosing PCOS from an ultrasound alone but judging by my other symptoms, he was 100% sure I had it. I'm not overweight, not diabetic. Regardless, I have the depression and anxiety as a result and those are my main issues. My doctor does think that these symptoms are a direct result of PCOS. I was wondering because I've always been sort of anxious. I had normal cycles through most of my teens so I'm guessing I didn't develop PCOS until my early adulthood.

I want to know if others here have had similar results with metformin. Did it take time to level things out? I didn't think it would start ovulation that quickly, let alone give me 2 periods in 1 month! I want to feel normal again so I can have some chance at a normal life. I've heard such good things about metformin and PCOS, but I don't know if I'm willing to tough it out with the crazy side effects.
There is an adjustment period. It took me 9-12 months to start having periods after I got on metformin. Like you I had cycles every month from age 10-20 and then it all fell apart. I understand what you are going through and I think the mood swings are do more to hormonal imbalances your body is jumping around from being unmedicated to medicated. It takes a toll. Hang in there. There are some other drugs my friends have had better results with. They are like metformin. I will ask round about there names and post them here just incase metformin doesn't work out (it doesn't work at all for some people). There are also many other symptoms and I'm surprised your doctor didn't ask you

Polycystic ovary syndrome (PCOS) symptoms tend to start gradually. Often, hormone changes that lead to PCOS start in the early teens, after the first menstrual period. Symptoms may be especially noticeable after a weight gain.
With PCOS, you may have only a few symptoms or many symptoms. It is common for PCOS symptoms to be mistaken for other medical problems.
Early symptoms

Early symptoms of PCOS include:
  • <LI sizset="128" sizcache="7">Few or no menstrual periods . This can range from less than nine menstrual cycles in a year (more than 35 days between cycles) to no menstrual periods.3 Some women with PCOS have regular periods but are not ovulating every month. This means that their ovaries are not releasing an egg each month. <LI sizset="133" sizcache="7">Heavy, irregular vaginal bleeding. About 30% of women with PCOS have this symptom.4 <LI sizset="135" sizcache="7">Hair loss from the scalp and hair growth (hirsutism) on the face, chest, back, stomach, thumbs, or toes. About 70% of women in the United States with PCOS complain of these hair problems caused by high androgen levels.5 <LI sizset="138" sizcache="7">Acne and oily skin, caused by high androgen levels.
  • Depression or mood swings. Hormonal changes are a known cause of emotional symptoms.
Living with PCOS symptoms can affect your sense of well-being, sexual satisfaction, and overall quality of life. This too can lead to depression.6 For more information, see the topic Depression or Depression in Children and Teens.
Gradual symptoms

PCOS symptoms that may develop gradually include:
  • <LI sizset="145" sizcache="7">Weight gain or upper body obesity (more around the abdomen than the hips). This is linked to high androgen levels.5 <LI sizset="149" sizcache="7">Male-pattern baldness or thinning hair ( alopecia). This is linked to high androgen levels. <LI sizset="150" sizcache="7">Repeat miscarriages. The cause for this is not known. These miscarriages may be linked to high insulin levels, delayed ovulation, or other problems such as the quality of the egg or how the egg attaches to the uterus. <LI sizset="153" sizcache="7">Inability to become pregnant ( infertility). This is because the ovaries are not releasing an egg (not ovulating). <LI sizset="156" sizcache="7">Symptoms of too much insulin ( hyperinsulinemia) and insulin resistance, which can include upper body weight gain and skin changes, such as skin tags or dark, velvety skin patches under the arm, on the neck, or in the groin and genital area. <LI sizset="159" sizcache="7">Breathing problems while sleeping ( obstructive sleep apnea). This is linked to both obesity and insulin resistance.3
  • Pain in the lower abdomen and pelvis ( chronic pelvic pain).
High blood pressure may be more common in women with PCOS, especially if they are very overweight. Your doctor will check your blood pressure.
The most common reasons that first bring women with PCOS to a doctor include:
  • Menstrual problems.
  • Male-type hair growth (hirsutism) on the face and body.<LI sizset="166" sizcache="7">Infertility.
  • Weight gain or upper body obesity.
I'm sorry this is so long but it's a good place to start. Another good place to go is soulcycster.com
Thanks, curlygirlyme. I would be interested in hearing what your friends are taking. If you could find out, I'd really appreciate it.
I wanted to ask you too, curlygirly, if you are taking metformin long-term. This is what I meant to ask at my last appt., how long I'm to be on this since he gave me 11 refills. I know I've heard that it usually takes 6 months to regulate cycles, and then I assumed you go off it once that happens. I really hope he doesn't expect me to be on this forever. I've had a loss of appetite all along with it and I was underweight to begin with.
It depends for everyone. Sometimes (esp. with people who gained a lot of weight like me) when the weight comes off and your body can regulate horomones better and become more stable you can see how it goes when you stop taking the metformin. For others it's a lifetime thing. I can tell you that my husbands aunt was dx with PCOS at 16 (she is 35-40 now) and is and always has been underweight. She didn't find out that she had a glucose problem until about a year ago. They just put her birth control and told her she'd never have kids. Once she got on the metformin she got pregnant. I will ask around about the names of the other meds and let you know.

Edit
Here are some of the meds my friends take and have had better luck with Avandia, Acots, Low or non estrogen Birth Control, Flutamide (I'm not sure if this is on the market in the U.S.), and I know a lot of people who take cinnamon suppliments because they help with the sugar/glucose problem. Hit the soulcycters website they have info on doctors for every state in the U.S. and other countries, medication threads, and lots of other helpful tools.

Last edited by curlygirlyme; 02-17-2010 at 10:56 PM. Reason: added med names
Hi ElasG,

I don't have much to add (I'm not even taking my meds right now so I'm the wrong person to ask for advice!) but I just want to say that I sympathize and empathize with you. I'm not diabetic but my insulin is high and I have several ugly symptoms as a result of PCOS. I have also suffered with depression and severe anxiety for most of my life. I'm trying to take a more natural approach to my issues/health conditions now but it will be a long process.

As for how long you have to be on meds, I've always been told its until you go into Menopause. But I think if you take meds or exercise or do whatever it is that helps your symptoms, you may very well be able to go off meds long before that. I don't remember feeling worse when I started taking the Met, but I was never able to go up on it. The stomach pains were terrible. I was literally crying in agony! BUT, I have a very low tolerance for pain. It is not that bad for most people. Most people get used to it and it helps them.

And anything to get your heart rate up and your blood sugar down, is beneficial. When they did the ultrasound, did they say your ovaries looked polycistic? Or was it just inconclusive? I'm just curious b/c it doesn't sound like you have a lot of symptoms besides the anxiety/dep. But maybe you just haven't mentioned them...
MixedUpCurlyChick, lack of menstrual periods was the main symptom I had (beginning in my teens), then as the years went on, I got fewer and fewer. I still typically got one every 1 or 2 months, but I would usually skip at least one at a time. This past year it's been more like 2 skipped months, then 2 periods. This past year, I began to get skin breakouts and bloating in the months I'd skip my periods. I also began gaining weight in my belly and had some unusual pelvic pain.

I'm not overweight and the gyno doesn't fear diabetes in me at all. Reading the sections on thin women with PCOS in this slideshow really helped me to finally understand as my Dr. did a poor job explaining it to me: http://www.jarrettfertility.com/PCOS...%20handout.pdf

I still feel like I could have insulin resistance. Some thin PCOS women do esp. if they have diabetes in their family. I'm going to get some tests ran next week to see if the blood sugar side of PCOS exists in me.I get that metformin will help me even w/o diabetes issues since it works on hormone levels but it definitely won't be worth it to me if I don't have insulin/blood sugar issues. MUCC, do you feel that exercise and diet are enough for your insulin control? It's strange, I didn't have stomach issues with met other than when I went up to 1000mg in the first month, but lately I've had tons of constipation and gas pains. That's a picnic compared to the emotional ups and downs.
Metformin can cause some intestinal issues when you first start it. I had horrible gas, cramping, and diarrhea (sorry, probably TMI!). It was one of the meds I was on while trying to conceive both of my children. It's hard to say if it caused any emotional side effects, though, because I was also on Clomid and Menopur and they are both known to cause hormone swings.

I hope you're feeling better soon. PCOS is definitely no picnic. Good luck!
"Maybe Lucy's right. Of all the Charlie Browns in the world, you're the Charlie Browniest."--Linus, A Charlie Brown Christmas
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MixedUpCurlyChick, lack of menstrual periods was the main symptom I had (beginning in my teens), then as the years went on, I got fewer and fewer. I still typically got one every 1 or 2 months, but I would usually skip at least one at a time. This past year it's been more like 2 skipped months, then 2 periods. This past year, I began to get skin breakouts and bloating in the months I'd skip my periods. I also began gaining weight in my belly and had some unusual pelvic pain.

I'm not overweight and the gyno doesn't fear diabetes in me at all. Reading the sections on thin women with PCOS in this slideshow really helped me to finally understand as my Dr. did a poor job explaining it to me: http://www.jarrettfertility.com/PCOS...%20handout.pdf

I still feel like I could have insulin resistance. Some thin PCOS women do esp. if they have diabetes in their family. I'm going to get some tests ran next week to see if the blood sugar side of PCOS exists in me.I get that metformin will help me even w/o diabetes issues since it works on hormone levels but it definitely won't be worth it to me if I don't have insulin/blood sugar issues. MUCC, do you feel that exercise and diet are enough for your insulin control? It's strange, I didn't have stomach issues with met other than when I went up to 1000mg in the first month, but lately I've had tons of constipation and gas pains. That's a picnic compared to the emotional ups and downs.
Originally Posted by ElsaG
Well, its hard to say...I'm not currently working out. My insulin and testosterone were lower when I was working out but I was also taking the medicine regularly, which I'm not now. So I can't say 100% that it helped but it seems like it does. The metformin definitely helps with the testosterone. My anxiety is much worse since I've been off the med, and I'm pretty sure there's a connection. If you don't have any stomach upset, I'd say it would be worth it to at least try it for awhile. I had some worse issues than those mentioned on here but I don't think anyone needs me to be that specific lol. The bottom line is that some people are more sensitive than others. I may go back on it, but I'm not positive I will.
I have nontraditional PCOS. I still have lady time, but I don't ovulate. Anywho. I've been on Metaformin since I was 16 when I was diagnosed. It must be doing its job, because I have no acne, I regulate normally, etc etc. In fact, apart from not ovulating the only thing I battle is my weight, but part of that is hereditary. I've heard that if you take it with a, and I quote "water pill" it helps to regulate you out even more. Now I have no idea what a water pill is, so if you've heard please let me know!
If I understand what you are talking about a water pill is something you take when you actually have too much water in your body. I've taken it with too much swelling after pregnancy and it sucked. I agree about metformin. It did a number on my stomach when I first started taking it but it went away after awhile. I think you really have to talk to your doctor and find out what right for you everyone reacts different to meds. Good Luck.
I take my metformin with Sprionolactone(the blood pressure/diuretic-water pill) to help with my high andgrogen issues. The metformin deals with the high insulin and the Spiro deals with the other.

One thing that is common with Met use is you could become B12 deficient. You could be feeling pretty fatigued all the time which could be a sign you don't have all the B12 you need. Met can block or increases excretion of B12 in your urine so you might have to supplement with a high dose methylcobalamin(bioavailable B12) supplement. I have this at home but I keep forgetting to take it.

here's an article:
http://www.diabetesselfmanagement.co...12_deficiency/
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I went off the metformin two weeks ago, and I feel sooo much better! My doctor wants to do an insulin resistance test on me, but I have to wait a month until taking it (to make sure the met is out of my system, I guess). I'm taking evening primrose oil and cinnamon supplements to help regulate my cycles though I may want to nix the cinnamon since in addition to helping with menstrual cycles, it can lower blood sugar. I doubt one capsule a day is enough to affect IR test results... I kinda doubt it's enough to do anything as the doses I'm taking of both supplements are shown to only give slight effects, but just knowing that I'm doing something helps me feel better.

I probably should go on the pill, but I got a period this month so I want to see how it goes being on nothing (but the supplements). Maybe taking met as long as I did will be enough to get my periods in order. I normally do ovulate and have cycles, but I want to do it every month instead of every other month or every 2 months. So we'll see what all my blood work says (he's giving me A LOT, but it takes a few different tests to guage IR). If I have IR then I'll take something for that. I got a rash (not sure if I mentioned it before) that I thought could be acanthosis negroids which is very symtomatic of insulin resistance/pre-diabetes. It turned out to be ringworm of all things, totally unrelated to PCOS. Though it's funny when I was treating the areas on my neck, I noticed that I do have a wide line of slightly tanner skin on both sides of my neck. I kinda had noticed before but thought it was just mild discoloration. Now I think it could be AN.

Believe it or not, I'd rather have IR than "thin woman" PCOS. It's easier to have a tangible cause IMO. Neither of my doctors believe I do just based on my weight and previous blood sugar tests, though my dad isn't overweight and is close to diabetes.
Formerly ElsaG
I take my metformin with Sprionolactone(the blood pressure/diuretic-water pill) to help with my high andgrogen issues. The metformin deals with the high insulin and the Spiro deals with the other.

One thing that is common with Met use is you could become B12 deficient. You could be feeling pretty fatigued all the time which could be a sign you don't have all the B12 you need. Met can block or increases excretion of B12 in your urine so you might have to supplement with a high dose methylcobalamin(bioavailable B12) supplement. I have this at home but I keep forgetting to take it.

here's an article:
http://www.diabetesselfmanagement.co...12_deficiency/
Originally Posted by Ondulee



Ondulee, what were your results with Met and Spiron.? My problem is that I can't remember to take the pills period. And also, do you take these pills with Birth control or without? taking up to 5 pills a day is draining. And those Met pills are huge!
Ondulee, what were your results with Met and Spiron.? My problem is that I can't remember to take the pills period. And also, do you take these pills with Birth control or without?
my results are mainly visible-reduction/slowing of bristly black facial hairs. I still have excess facial hair but it's more managable for removal. Also, I used to get severe cystic acne in my chin area and that has completely disappeared. I haven't had a zit for I don't know how long now.

I'm guessing that the lower insulin(from the Met) and the lower androgens(from Spiro) are working together to give me my results. I don;t think I would have half my results if I went off of one of them.

Also, I don't use birth controlpills. I used to a long time ago and it just masked the hormone imbalance, it didn't fix it. I find I can control my most visible symptoms with the Met/Spiro combo and don't notice any need for the BC. I would use a physical BC instead of a chemical one if called for. One specialist wanted to put me on Yasmine or Yaz or whatever it's called and now I hear there's some kind of recall or something because of very severe side effects and even class action lawsuits over it....so I think all BC pills have dangers that maybe we don't know about....
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That combo of meds sounds good; too bad I have super-low blood pressure. After I have my baby, I'm trying to find a good combo to help keep the PCOS under control. Weirdly, my symptoms are so much better when I'm pregnant. I guess my body HAS to produce more estrogen and progesterone to support the pregnancy.
"Maybe Lucy's right. Of all the Charlie Browns in the world, you're the Charlie Browniest."--Linus, A Charlie Brown Christmas
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My fotki: http://public.fotki.com/nynaeve77/
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I take my metformin with Sprionolactone(the blood pressure/diuretic-water pill) to help with my high andgrogen issues. The metformin deals with the high insulin and the Spiro deals with the other.

One thing that is common with Met use is you could become B12 deficient. You could be feeling pretty fatigued all the time which could be a sign you don't have all the B12 you need. Met can block or increases excretion of B12 in your urine so you might have to supplement with a high dose methylcobalamin(bioavailable B12) supplement. I have this at home but I keep forgetting to take it.

here's an article:
http://www.diabetesselfmanagement.co...12_deficiency/
Originally Posted by Ondulee
Ondulee, does the Spiro make your cycles more regular? I thought that was the point of it, but someone on the soulcysters site said that Spiro has a side effect of irregular periods.

I just know that the metformin was awful and I'm not anxious to re-try that especially since I found out I have no sugar/IR issues! Yay! My thyroid was low which could be responsible for the fatigue I've been feeling. Even though thyroid is a main cause of PCOS, I'm not confident that it caused my PCOS because I was just recently dxed with low thyroid when I've had wonky periods for years. I've been stressed with my new job which can cause thyroid to get low. It's also often associated with PCOS but not always the cause of it. Though I guess hypothyroidism can be hard to dx esp. with a TSH test so I spose it could've been low all along and just not caught. IDK, I never even got a follow-up appt., just a script for a thyroid med. I hope at any rate the medicine he gave me will help with PCOS, though it actually can have the side effect of making periods irregular!

It's all so discouraging. Sometimes, I just want to get a hystorectomy. I hate the guessing games with my period, and on the months it doesn't come, the bad side effects. My doctor actually brought it up which was a shock to me with my PCOS being a pretty mild case. I complain to him about my anxiety/moodswings a lot, and I spose I come across as more anxious as usual when I'm in there. It's something to think about. I've always wanted kids, but at 29, I'm getting a little old. I want this crap gone more than I want kids, honestly. I really believe if it wasn't for the recovery time, I'd probably just go ahead and do it. That's how frustrated I am. Anyone else here considering it? Does it really reduce your lifespan?
Formerly ElsaG
I don't know if the Spiro has any effect on my cycle. I've always taken the two together and not seperately. I've never had any bad side effects from the combination so I have to assume that I wouldn't have side effects from them seperately either....

my "cycle" is not a real cycle either. It's only a bleed from estrogen dominance since I don't ovulate. I never get any of the signs of ovulation but I get a four day bleed every 24-26 days which my doctor says will happen because of the estrogen overload.
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Spiro will mask Testosterone, but Metformin is what really helps. That's what will help regulate the menstrual cycle.
I am new to naturally curly. I originally was seeking advice for hair loss associated with PCOS. I was interested in all of the postings related to PCOS here and I would just like to share my experience. For years I've struggled with PCOS symptoms such as hair loss, acne, weight gain and menstrual irregularities. I also tried metformin but had to discontinue it because of some unpleasant side effects. A little over a month ago I was doing some research, wondering what I could do next and found an article that I thought was very interesting on managing pcos symptoms with a natural approach. I have only been following the recommendations for approx 6 weeks but I feel better than I have in a long time. Changes I made to my diet included cutting out as many simple carbs as I could and choosing complex carbs like brown rice and whole-grain bread. Complex carbs take longer to digest and release a lesser amount of sugar at a more consistent rate, therefore, it was very helpful in terms of insulin resistance. I incorporated only lean proteins and healthy fats along with an exercise plan. I chose yoga and it's not as easy as it looks!! A PCOS friendly diet, exercise and the appropriate natural supplements I feel have improved my overall feeling of wellness. I take zinc, omega 3 and B vitamins as well as maca which is an herb that aids in hormonal regularity. I feel I am off to a good start to regulate my hormones naturally therefore, decreasing my PCOS symptoms. I wish you ladies battling PCOS all the best in whatever treatment you choose. I hope some find this helpful. The article that encouraged me to take a natural approach was by detoxscientific and can be found by searching PCOS diet.

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