Metformin is used to control blood sugar levels and increase insulin sensitivity. Metformin is frequently prescribed to treat polycystic ovary syndrome (PCOS) because these complications are common. We'll explore how Metformin works for PCOS and its side effects and alternatives. In addition, we'll talk about the precautions and risks associated with metformin use.
Type 2 diabetes mellitus can be treated with Metformin. Healthcare providers may also use it to treat PCOS and prediabetes. The drug metformin belongs to the class of drugs known as biguanides.
It normalises blood glucose levels by preventing the liver from producing too much sugar, decreasing how much glucose the intestines absorbs and increasing insulin sensitivity.
The drug is available as a generic and under brand names such as Glucophage, Fortamet, and others.
Metformin for PCOS
One in 10 women of reproductive age assigned as female at birth suffers from polycystic ovary syndrome. Symptoms vary, making it difficult to diagnose in some cases.
PCOS can cause the following symptoms:
- Cysts on ovaries
- Pelvic pain
- Insulin resistance and high glucose
- Menstrual cycle irregularity
- Hirsutism (excess hair growth on the face)
- Weight gain or problems losing weight
- Patches of thick, dark skin
Genetics, hormonal imbalances, obesity, and insulin resistance may contribute to PCOS.
In addition to treating insulin resistance and high blood sugar, metformin may also alleviate other symptoms.
Associated with PCOS. Treatments are usually combined with them.
How does Metformin treat PCOS?
The liver produces less glucose when metformin is taken, and the intestinal tract absorbs less glucose when metformin is taken. The body's response to insulin is improved when blood sugar levels are lowered. Thus, Metformin promotes hormone balance, weight loss, and metabolic health. It may also reduce the risk of preterm delivery and gestational diabetes in women with PCOS and who are pregnant.
Metformin Side Effects
As your body adjusts to Metformin, you may experience mild side effects that may resolve over time. You should contact your healthcare provider if side effects do not improve or worsen.
Metformin has the following side effects:
- Metformin causes diarrhoea because it changes the way the intestines absorb glucose. As a result, lactic acid is formed, which can irritate the intestinal lining. Healthcare providers usually start patients on low doses to allow the body to adjust. Diarrhoea may be less severe as a result.
- Vomiting occurs less often than nausea. Metformin should be taken with meals to reduce gastrointestinal upset.
- As Metformin changes the body's response to glucose, bloating, gas, and other intestinal discomforts may occur. Metformin's effects usually wear off with time, and taking it with food may reduce them.
- Metformin prevents the liver from making glucose, causing headaches. It is possible to experience mild headaches when taking medications that directly affect the liver.
- Metformin may cause a metallic taste in the mouth in about three out of 100 people.
- Metformin does not work as a weight-loss drug, but it may help balance insulin and glucose responses in the body.
- Metformin may help offset weight gain caused by insulin resistance and high glucose levels in type 2 diabetes.
Serious side effects of Metformin are less common:
- Hypoglycemia can occur when Metformin is combined with intense exercise, other diabetes medications, nutritional imbalances in the diet, or excessive alcohol consumption. It can cause lightheadedness, fatigue, feelings of weakness, nausea, vomiting, and a rapid or slow heart rate.
- Vitamin B12 absorption is impaired by metformin. B12 deficiency can cause anaemia. Symptoms include fatigue, dizziness, and feeling cold all the time. Symptoms of B12 deficiency include numbness and tingling, mood changes, fatigue, hair loss, and brain fog. Your healthcare provider can check the level of red blood cells and iron in your body if you are anaemic. This risk may increase with a vegetarian or vegan diet.
- A black box warning is given for Metformin's risk of lactic acidosis. Metformin builds up in the body too much, causing high levels of lactic acid. You might experience dizziness, lightheadedness, coldness, muscle pain, extreme tiredness, nausea, vomiting, trouble breathing, a fast or slow heart rate, sudden reddening of your skin, or feelings of warmth. This medical emergency can be fatal. Lactic acidosis should be treated immediately if you notice any symptoms.
Your healthcare provider can safely guide you on taking Metformin to decrease the risk of severe complications and side effects.
Other Treatment Options for PCOS
PCOS cannot be cured, but lifestyle and dietary changes and medication can manage it. Even though Metformin is not the only medication used to treat PCOS, it is the most commonly prescribed.
PCOS can be treated with alternative medications, including:
- Letrozole: A breast cancer drug that may stimulate the ovaries for regular ovulation in PCOS. Fertility treatments are usually combined with this procedure.
- Gonadotropins: PCOS can be treated with injectable medications that provide hormones to restore balance. Fertility treatments and in vitro fertilisation (IVF) often use them.
- Eflornithine: Treats excessive facial hair with this medication
The following drugs promote better insulin or glucose responses in the body:
- Sulfonylureas: As a result, blood sugar levels can be reduced due to improved insulin production. These include glyburide (DiaBeta, Micronase, others), glimepiride (Amaryl), and glipizide (Glucotrol). Metformin, on the other hand, is less commonly used because these drugs have a higher risk of causing low blood sugar.
- Meglitinides: In response to meals, these help the body produce more insulin. Repaglinide (Prandin) and nateglinide (Starlix) are examples.
- Thiazolidinediones: Pioglitazone (Actos) and rosiglitazone (Avandia) decrease insulin resistance. These medications should not be managed with high blood sugar since they may cause more severe side effects.
Precaution and Risks
It is typically taken a long time, possibly months or years. Anaemia is the most common side effect of long-term metformin use. Please make sure your healthcare provider knows all prescriptions, over-the-counter medications, and supplements you take. There is a possibility of drug interactions with Metformin, which can increase the risk of serious adverse events.
Metformin interacts with the following:
- Selective serotonin reuptake inhibitors (SSRIs)
- Alpha-lipoic acid
- Iodinated contrast agents
- Carbonic anhydrase inhibitors
- Ethanol (alcohol)
- Other diabetes medications
- Bupropion (Wellbutrin, Aplenzin)
In addition, Metformin should not be taken before radiology procedures involving iodine contrast or if you have any of the following medical conditions:
- Before surgical procedures
- Kidney problems or disorders
- Heart failure
- Metabolic acidosis
Frequently Asked Questions
1- For PCOS, how long do you take Metformin?
Long-term treatment of PCOS is possible with metformin. While some patients use it short-term to control their symptoms, others take it long-term to maintain their health.
2- Does Metformin help you lose weight if you have PCOS?
It may contribute to weight loss because Metformin normalises insulin and glucose responses in the body.
What is the speed at which Metformin works for PCOS?
Medical providers usually prescribe Metformin at lower doses to reduce the severity of side effects. Although everyone responds differently, it may take 1-2 weeks to reach an adequate amount.
4- What happens if I stop taking Metformin for PCOS?
Metformin should only be discontinued with the support of your healthcare provider. In addition to decreasing liver glucose production, Metformin changes how glucose is absorbed in the intestines. When Metformin is stopped without an alternative treatment plan, glucose levels and insulin resistance may increase.
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