{"id":5730,"date":"2019-09-05T09:00:28","date_gmt":"2019-09-05T13:00:28","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=5730"},"modified":"2025-04-08T13:28:00","modified_gmt":"2025-04-08T17:28:00","slug":"metformin-for-pcos","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/metformin-for-pcos\/","title":{"rendered":"How the diabetic drug Metformin can be used to treat PCOS"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/pcos\/symptoms-causes\/syc-20353439\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">hormonal disorder<\/span><\/a><span style=\"font-weight: 400;\"> that affects <\/span><a href=\"https:\/\/www.endocrine.org\/patient-engagement\/endocrine-library\/pcos\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">an estimated 5-6 million <\/span><\/a><span style=\"font-weight: 400;\">women in the United States. The symptoms of PCOS vary person-to-person, which can make it challenging to identify. Many women suffer in silence, living undiagnosed for years.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Non-profit organizations throughout the U.S. work to spread awareness about symptoms and information about available treatment options\u2014from birth control to metformin. But it remains \u201cone of the most critical, underserved, under-diagnosed and under-funded conditions affecting women&#8217;s health,\u201d <\/span><a href=\"https:\/\/www.prnewswire.com\/news-releases\/pcos-challenge-brings-together-leading-experts-on-polycystic-ovary-syndrome-for-awareness-symposium-268264402.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">says<\/span><\/a><span style=\"font-weight: 400;\"> Sasha Ottey, executive director of the non-profit PCOS Challenge Inc.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Why do some women get PCOS, and how does it affect them?<\/span><\/h2>\n<p><a href=\"http:\/\/www.felicelgershmd.com\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Felice Gersh<\/span><\/a><span style=\"font-weight: 400;\">, MD, an award-winning OB-GYN, says PCOS is \u201cthe most common endocrine disorder of reproductive aged women\u2014but it involves every aspect of a woman\u2019s body. It affects all metabolic functions as well as all aspects of the menstrual cycle and fertility.\u201d <\/span><a href=\"https:\/\/www.girlshealth.gov\/body\/reproductive\/pcos.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Common symptoms<\/span><\/a><span style=\"font-weight: 400;\"> and diagnostic criteria may include: no period, an irregular period, or a heavy period; pelvic pain; extra hair growth on your face, known as \u201chirsutism\u201d; acne; excess weight gain or challenges with losing body weight; and patches of dark thick skin. <\/span><span style=\"font-weight: 400;\">According to <\/span><a href=\"https:\/\/www.endocrineweb.com\/conditions\/polycystic-ovary-syndrome-pcos\/what-causes-pcos-how-will-it-affect-body\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">EndrocrineWeb<\/span><\/a><span style=\"font-weight: 400;\">, women with PCOS may have 25 or more cysts, or fluid-filled follicles, on a single ovary. Follicles typically burst during ovulation when they release an egg. But with PCOS, this often does not happen\u2013each small follicle fills up with fluid, creating a cyst insead. People with PCOS may not have regular periods and may experience poor success rates at getting pregnant.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are a <\/span><a href=\"https:\/\/www.womenshealth.gov\/a-z-topics\/polycystic-ovary-syndrome\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">variety of reasons<\/span><\/a><span style=\"font-weight: 400;\"> why young women of reproductive age might develop PCOS, but research shows that genetics, insulin resistance, glucose intolerance, and androgen excess (also known as male hormones) all can put you at risk.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">PCOS impacts women from a diverse range of backgrounds. \u201cWomen of all races and ethnicities are at risk of PCOS,\u201d says <\/span><a href=\"http:\/\/drkatemd.com\/about-me\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Kate Killoran<\/span><\/a><span style=\"font-weight: 400;\">, MD, OB-GYN in Maine. But obese women and women with a family history are at increased risk of developing the disorder.\u201d\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.cancer.org\/cancer\/endometrial-cancer\/causes-risks-prevention\/risk-factors.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">According to the American Cancer Society<\/span><\/a><span style=\"font-weight: 400;\">, PCOS puts women at higher risk of endometrial cancer. A <\/span><a href=\"https:\/\/fertilityresearchandpractice.biomedcentral.com\/articles\/10.1186\/s40738-016-0029-2\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">2016 literature review<\/span><\/a><span style=\"font-weight: 400;\"> found that multiple studies reported a link between PCOS and endometrial cancer, but the authors did not take BMI into account, and a high BMI is an established risk factor for endometrial cancer. A <\/span><a href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.756137\/full\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">recent systematic review <\/span><\/a><span style=\"font-weight: 400;\">found no correlation between PCOS and endometrial cancer in women of European or Asian ancestry. The bottom line? Definitive evidence is lacking.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are PCOS treatments?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While there is no cure for PCOS, there are ways to manage symptoms and long-term health outcomes. Each patient\u2019s treatment plan will be a little different, based on their specific set of symptoms.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Killoran says that there are a few medications that may be prescribed for PCOS patients, depending on how the condition affects them. This is not a complete list, but it includes:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Birth control pills <\/b><span style=\"font-weight: 400;\">may help control menstrual abnormalities.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Oral contraceptives<\/b> <b>that contain estrogen<\/b><span style=\"font-weight: 400;\"> can help improve acne.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin-hcl\"><b>Metformin<\/b><\/a><span style=\"font-weight: 400;\"> or other medicines for insulin sensitivity might help with metabolic abnormalities and even improve fertility.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/letrozole\"><b>Letrozole<\/b><\/a><span style=\"font-weight: 400;\"> can induce ovulation when women with PCOS are trying to conceive.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/clomiphene-citrate\"><b>Clomiphene<\/b><\/a><span style=\"font-weight: 400;\"> can be used to induce ovulation and increase the odds of pregnancy in anovulatory women with PCOS.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u201cLifestyle modification, specifically exercise and calorie-restricted diet changes can improve or reverse PCOS,\u201d Dr. Killoran adds.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Should I take metformin for PCOS?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The insulin-reducing drug metformin is sometimes used off-label as a treatment of PCOS.<\/span> <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4200666\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Early clinical trials<\/span><\/a><span style=\"font-weight: 400;\"> of the drug showed evidence that metformin contributed to weight loss, reduced levels of androgens such as free testosterone, promoted regular menstrual cycles, and induced ovulation, so it may be prescribed by healthcare providers for these issues.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Though metformin is <\/span><a href=\"https:\/\/www.uptodate.com\/contents\/metformin-for-treatment-of-the-polycystic-ovary-syndrome\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">no longer recommended as a first-line treatment <\/span><\/a><span style=\"font-weight: 400;\">for PCOS, it may be used as an alternative treatment for hirsutism, a condition related to PCOS that results in excessive hair growth near the chin, upper lip, chest, back and stomach, when first-line treatments such as oral contraceptives, clomiphene and letrozole are contraindicated.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21466513\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">meta-analysis<\/span><\/a><span style=\"font-weight: 400;\"> of non-obese women with a body mass index (BMI) up to 32, the clinical pregnancy rate was similar among women taking metformin (36.7%) and women taking clomiphene (35.7%) as were live birth rates (30.3% and 30.3%) respectively. Metformin may be prescribed to women with anovulatory infertility and polycystic ovary syndrome to increase the odds of conception. Women with PCOS who conceive have a high prevalence of gestational diabetes.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">What does metformin do for PCOS?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Metformin is a common medication used to treat PCOS symptoms. It was originally developed and typically is prescribed to treat Type 2 diabetes, a metabolic syndrome similar to PCOS, says <\/span><a href=\"http:\/\/www.gerlis.com\/doctor\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Dr. Laurence Gerlis<\/span><\/a><span style=\"font-weight: 400;\">, a general practitioner in London, England.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to research, for patients with diabetes mellitus, a disorder characterized by high blood sugar levels, metformin helps to restore the body\u2019s response to insulin, increasing glucose tolerance and making you less insulin resistant. <\/span><span style=\"font-weight: 400;\">The role of metformin in the body is to control blood sugar by \u201chelping the body respond better to the insulin it makes naturally, decreasing the amount of sugar the liver makes [by increasing insulin receptor activation], and decreasing the amount of sugar the intestines absorb from food,\u201d according to the Food and Drug Administration (FDA).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Gerlis says metformin for PCOS, when taken regularly, will lower blood glucose levels by balancing insulin levels and decreasing other metabolic effects of the condition.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Are there side effects of taking metformin for PCOS?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are very few safety issues related to regular use of metformin, other than the loosening of bowels, Dr. Gerlis says. Gas, diarrhea, and stomach pain are some common side effects of metformin.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Gersh, on the other hand, does not prescribe metformin to her patients because it has been classified as an <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0045653515002830\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">endocrine disruptor<\/span><\/a><span style=\"font-weight: 400;\"> by some environmental scientists. Although there is much controversy surrounding them, endocrine disruptors <\/span><a href=\"https:\/\/www.who.int\/ceh\/risks\/cehemerging2\/en\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">have been suspected to be associated<\/span><\/a><span style=\"font-weight: 400;\"> with altered reproductive function, breast cancer, irregular growth patterns, and more.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">How much metformin should I take for PCOS? How long should metformin be taken for PCOS?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There is no consensus on a standard dose or duration of metformin for PCOS; the median dose is 1,500mg daily. Physicians often <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3475283\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">start patients on 500 mg<\/span><\/a><span style=\"font-weight: 400;\"> daily, and increase the dose gradually to reduce side effects of metformin.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Metformin is available through prescription only, and was approved by the Food and Drug Administration (FDA) in <\/span><a href=\"https:\/\/web.archive.org\/web\/20070929152824\/http:\/\/www.fda.gov\/bbs\/topics\/ANSWERS\/ANS00627.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">1994<\/span><\/a> <span style=\"font-weight: 400;\">in the United States. Metformin is taken orally, and is <\/span><a href=\"https:\/\/www.mayoclinic.org\/drugs-supplements\/metformin-oral-route\/description\/drg-20067074\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">available<\/span><\/a><span style=\"font-weight: 400;\"> under the brands <\/span><span style=\"font-weight: 400;\">Fortamet, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/glucophage\"><span style=\"font-weight: 400;\">Glucophage<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/glumetza\"><span style=\"font-weight: 400;\">Glumetza<\/span><\/a><span style=\"font-weight: 400;\">, and Riomet.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSince metformin is well-established with a good safety profile, it is highly recommended to start it early in the management of PCOS,\u201d Dr. Gerlis advises.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/dmsjournal.biomedcentral.com\/articles\/10.1186\/s13098-021-00660-5\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Long-term use<\/span><\/a><span style=\"font-weight: 400;\"> of metformin is considered relatively safe, but in rare cases, lactic acidosis (lactic acid buildup in the bloodstream) may occur. If you stop taking metformin for PCOS, you are likely to experience an <\/span><a href=\"https:\/\/dmsjournal.biomedcentral.com\/articles\/10.1186\/s13098-021-00660-5\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">increase in symptoms <\/span><\/a><span style=\"font-weight: 400;\">such as irregular menstrual cycles, increased androgen levels, and weight gain.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">How does metformin help PCOS and weight loss? How does metformin help with infertility?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For weight loss and infertility, the efficacy of metformin is not as clear cut.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Killoran says that patients with PCOS who may want to try metformin therapy to manage their symptoms are typically overweight or obese and trying to conceive, or are trying to prevent metabolic syndrome, cardiovascular disease, or worsening diabetes mellitus.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While metformin use is associated with weight loss, the results are inconsistent, she says. In one recent longitudinal <\/span><a href=\"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/9\/1\/EC-19-0449.xml#bib15\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">study<\/span><\/a><span style=\"font-weight: 400;\">, metformin users lost an average of 3.7% of their body weight within the first year, maintaining the weight loss after 4 years.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another <\/span><a href=\"https:\/\/www.fertstert.org\/article\/S0015-0282(04)00731-9\/fulltext\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">6-month <\/span><\/a><span style=\"font-weight: 400;\">randomized, placebo-controlled trial of overweight women<\/span><span style=\"font-weight: 400;\"> found that after 6 months, there was no significant difference in weight reduction among a group of individuals taking metformin and a control group who took a placebo and made lifestyle modifications\u2013eating a 500-1000 calorie deficit each day combined with 150 minutes of physical activity each week. People in the metformin group plus lifestyle intervention\u00a0 experienced the most significant reduction in weight.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Are there natural alternatives to metformin for PCOS?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most commonly recommended natural treatments for PCOS are finding ways to be more active, and eating more whole foods. Dr. Gersh believes that the number one way to address PCOS is through lifestyle changes, including:\u00a0\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eating a plant-based, balanced diet<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Reducing stress<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Focusing on sleep<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Incorporating physical exercise.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These new habits can have a positive effect on symptoms. For her patients, Dr. Gersh recommends a variety of vitamin supplements, in conjunction with dietary changes and exercise to treat symptoms of PCOS. For example, vitamin B12 may be recommended to be taken with or after metformin treatment, as malabsorption of vitamin B12 could be an effect of metformin if it\u2019s used long-term.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Meanwhile, Dr. Killoran says that PCOS impacts each person differently. She says it\u2019s important to treat PCOS even if the patient\u2019s symptoms aren\u2019t bothersome, yet. \u201cAll should be aware of their risk for later medical problems such as metabolic syndrome and cardiovascular disease,\u201d she advises. \u201cThe decision to treat PCOS and with what should be based on what a woman\u2019s symptoms are but also to reduce risk.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you are considering metformin, schedule a follow-up with your healthcare provider\u00a0 to see what is right for you.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a hormonal disorder that affects an estimated 5-6 million women in the United States. The symptoms of PCOS vary person-to-person, which can make it challenging to identify. Many women suffer in silence, living undiagnosed for years.\u00a0 Non-profit organizations throughout the U.S. work to spread [&hellip;]<\/p>\n","protected":false},"author":85,"featured_media":8471,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[4783,9461,8670],"coauthors":[8365],"class_list":["post-5730","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-birth-control","tag-pcos","tag-womens-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Metformin for PCOS: Benefits and potential side effects<\/title>\n<meta name=\"description\" content=\"In addition to treating insulin resistance, metformin is a medication that treats PCOS. 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