Why is metformin recommended for the treatment of PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women of reproductive age. It is one of the most common endocrine disorders among women, affecting around 5-10% of women of childbearing age. Early signs of PCOS can be seen even in the early months of puberty. The exact cause of PCOS is not known, but it is thought to be caused by a combination of genetic and environmental factors. Women with PCOS have higher levels of androgens (male hormones) than normal, which can lead to a range of symptoms, including irregular periods, infertility, weight gain, acne, and excessive hair growth.
PCOS is often associated with metabolic abnormalities, such as insulin resistance, dyslipidemia (abnormal lipid levels), and obesity. These metabolic abnormalities increase the risk of developing type 2 diabetes, hypertension, and cardiovascular disease in women with PCOS.
In addition to the metabolic abnormalities, PCOS can also have psychological effects, such as anxiety and depression, which can further affect the quality of life of affected women. Although there is no cure for PCOS, it can be managed through lifestyle changes such as regular exercise and a healthy diet, as well as medication to regulate menstrual cycles, reduce insulin resistance, and manage other symptoms.
Though metformin is predominantly used in the treatment of Type 2 diabetes, it is also used for the treatment of PCOS.
Does metformin actually help PCOS ?!, Let’s see, shall we
So what is metformin?
Metformin is the medicine / drug used to treat type 2 diabetes. It helps to reduce blood glucose level by different ways but the most reliant and efficient way is by increasing the effects of insulin. That’s why it is called the “insulin sensitizer”.
In insulin resistant conditions – the cells will not allow the glucose inside them, resulting in increased glucose in the blood. That’s where metformin comes to the rescue. The Insulin sensitizer – it makes the cells sensitise towards glucose, helps them use the glucose.
Does metformin help in pcos
The most prevalent hormonal imbalance, PCOS, affects women from the age of 14 (after their first period), up until their 40s. And it doesn’t stop there; the complications continue after menopause.
Let’s recall the most prominent symptoms of PCOS, shall we,
- Irregular periods
- Hirsutism
- Weight gain
PCOS is a metabolic disorder because it affects how the body processes insulin, leading to insulin resistance, which in turn affects the body’s ability to regulate blood sugar levels.
In most cases, PCOS comes along with insulin resistance. Women with PCOS and insulin resistance have a higher level of testosterone and higher levels of hirsutism, and they also have a lower ovulation rate compared to women with non-insulin-resistant PCOS. Having insulin resistance worsen the hormonal imbalance – thereby lead to unpredictable periods, increased hirsutism and more prone to gain weight.
PCOS women usually worry about dark pigmentation on their necks, armpits, knees, and even in their faces. Guess what the reason is: insulin resistance.
So to conclude, addressing insulin resistance is equally important in the treatment of PCOS. And having that in mind, metformin does help with PCOS.
Is metformin safe to take ?
Metformin is a relatively safe drug, but in rare scenarios there will be side effects.
Most of them are gastrointestinal side effects like
- nausea,
- vomiting,
- bloating,
- flatulence,
- heartburn,
- diarrhoea.
Metformin is the safe drug if you follow your prescribed dosage. Consult your doctor and get your medicines.
Other ways to address insulin resistance and PCOS
- Lifestyle modification, including weight management, adequate nutrition, exercise, stress free healthy mental state - improves insulin sensitivity, restoring ovulation in overweight, reduces the bothering symptoms of PCOS.
- Clomiphene citrate : a drug to address ovulation and helps with infertility treatment
- Letrozole : helps to induce ovulation by blocking certain hormones
The main PCOS treatment approach that doctors recommend is lifestyle changes.
End note : Metformin is basically the medicine used for insulin resistance, which is more common among PCOS women. That’s why you see doctors recommending metformin. If you have PCOS and insulin resistance, medicine and good nutrition can work wonders for you. Whichever treatment you choose, please seek appropriate guidance from doctors, nutritionists, and fitness trainers to find the best treatment options.
References
1.Shpakov A. O. (2021). Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms. Pharmaceuticals (Basel, Switzerland), 14(1), 42. https://doi.org/10.3390/ph14010042
2. Fraison, E., Kostova, E., Moran, L. J., Bilal, S., Ee, C. C., Venetis, C., & Costello, M. F. (2020). Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome. The Cochrane database of systematic reviews, 8(8), CD005552. https://doi.org/10.1002/14651858.CD005552.pub3
3. Sharpe, A., Morley, L. C., Tang, T., Norman, R. J., & Balen, A. H. (2019). Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. The Cochrane database of systematic reviews, 12(12), CD013505. https://doi.org/10.1002/14651858.CD013505
4. Nasri, H., & Rafieian-Kopaei, M. (2014). Metformin: Current knowledge. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 19(7), 658–664.
