Instructions for use of Metformin for polycystic ovary syndrome

What should I do if I have been diagnosed with polycystic ovary syndrome, but I want to get pregnant?

Not every woman is required to undergo treatment. If you get your periods regularly, you'll likely be able to get pregnant naturally. As a rule, in such a situation, the doctor gives one year to conceive. During this period, you need to understand exactly when the probability of conceiving a child is highest. If after a year the patient has not become pregnant, it is necessary to undergo a course of treatment.

The doctor draws up an individual course of treatment if a woman does not observe the constant appearance of menstruation, or she was unable to become pregnant within the allotted period. You must be prepared for the fact that pregnancy will not occur from the very beginning of treatment, but after 6-12 months.

About the reasons for the development of PCOS

Many microbiological and chemical studies have helped doctors identify and describe several of the most common causes of the formation and progression of polycystic ovary syndrome:

1. The first and most dangerous reason why cysts on the ovaries can begin to form in a woman’s body is considered to be an increase in the level of insulin in the blood. Such failures may be associated with sudden weight gain or sudden changes in diet, stress, or physical activity. Miscarriages and interrupted pregnancies can also provoke the development of polycystic disease. Metformin for polycystic ovary syndrome, according to reviews, helps when the level of insulin in the blood rises above the normal level. All the glands that are responsible for producing hormones and restoring hormonal balance immediately begin to react to this. Insulin in abnormal amounts provokes increased production of male hormones, which in turn suppresses the functioning of the female reproductive system and stops fertility.
2. The second common reason why polycystic ovary syndrome develops is considered to be genetic disorders in the pituitary gland. The exact cause and features of this genetic pathology have not yet been established. However, it is known that during intrauterine development, a pathologically altered gene can be embedded in the fetal brain. Subsequently, this gene leads to dysfunction of hormonal regulation and the appearance of a disease such as polycystic ovary syndrome.
3. A common reason why polycystic ovary syndrome is registered in young girls is multiple adolescent disorders and failures. At the age of puberty, a large number of abnormal inflammatory processes, disruptions, and hormonal dysfunctions can develop in the body of a teenager. To these changes can be added psychological stress, sudden weight loss, possible premature pregnancies and miscarriages, abortions and unplanned sexual relationships. Together, these problems can provoke hormonal imbalance and the appearance of cystic bodies on the ovarian tissue.

Why does the doctor prescribe me birth control pills if I have completely different goals?

By themselves, birth control pills are a “first aid” drug. Naturally, while completing the course you will not have a chance of getting pregnant. But after some time from the end of the prescribed course, the chances of pregnancy will increase significantly. The paradox is explained by the fact that the use of hormonal contraceptive pills can regulate the menstrual cycle.

Practice shows that doctors most often prescribe pills that have an antiandrogenic effect. But do not forget that only a qualified specialist can make the right choice of drug. Under no circumstances should you self-medicate.

Polycystic ovary syndrome and its danger to women's health

PCOS or polycystic ovary syndrome is a fairly common gynecological disorder of the reproductive organs today, which in particularly advanced forms can cause infertility and diabetes. Every year, approximately 8-15% of women in the world are diagnosed with cystic bodies and foreign changes in the hormonal cycle.

Polycystic ovary syndrome is dangerous because it leads to deformation of the paired organs responsible for the production of follicles and monthly menstrual processes. With hormonal imbalances and endocrine system disorders due to polycystic disease, the ovaries stop producing healthy follicles and produce abnormal amounts of male-type hormones. An excess of “foreign” hormones negatively affects the functioning of not only the female reproductive system, but also the entire body as a whole.

Polycystic ovary syndrome appears due to deformations and disturbances in hormonal regulation, which is carried out by the pituitary gland and hypothalamus. For this reason, many modern medical communities are beginning to abandon hormonal drugs in the treatment of polycystic ovary syndrome and other methods of aggressive therapy and prescribe Metformin.

Hormonal treatment methods do not eliminate the cause of the onset and development of the disease, but remove the symptoms, creating the illusion of temporary health and smooth fertility. Many hormonal invasions of an artificial nature into the body, and not the treatment of PCOS with Metformin, according to reviews, do not lead to recovery. On the contrary, hormones often contribute to the worsening of the disease, the development of other side ailments, inflammatory processes and oncological problems.

In addition to hormonal disruptions and disturbances in ovulation and menstrual processes, significant hormonal changes occur in a woman’s body with polycystic ovary syndrome, which entails the abnormal functioning of many other internal organs and systems. For example, with PCOS, a woman may become overweight, the functioning of the pancreas may be disrupted, and the body’s tolerance to glucose may develop and primary diabetes mellitus will develop. Thus, the question of whether Metformin can be taken with PCOS does not face modern gynecology.

IT IS IMPORTANT TO KNOW!

Improving ovulation - what is it?

If you notice that with polycystic ovary syndrome, menstruation does not occur regularly, and there is no ovulation (checked using special tests or targeted ultrasound of the ovaries), the gynecologist may advise you to undergo ovulation stimulation.

Stimulation (improvement) of ovulation is a course of treatment during which a woman takes certain hormones that come in different forms (injections or tablets). The dosage schedule depends on the days of the menstrual cycle. When hormones enter the body, a follicle begins to mature inside the ovaries. In the middle of the menstrual cycle it will burst, causing the egg to be released. All this is called ovulation. It is during this period that a woman has the greatest chance of becoming pregnant.

What is metformin

The drug based on metformin is produced in tablets for oral administration. A substance from the group of biguanides - compounds that can suppress gluconeogenesis - a metabolic process that results in the formation of glucose from non-carbohydrate substances. Metformin also blocks the formation of free fatty acids and fat oxidation.

In addition, it increases the sensitivity of receptors to insulin and activates the utilization of glucose in cells. The substance does not affect the blood level of insulin, but changes its action by reducing the amount of bound hormone to free and increasing the level of insulin in relation to inactive protein cells proinsulin. At the same time, metformin activates glycogen synthesis and improves glucose transport.

The advantage of metformin is that it does not affect the patient’s weight, which is very important for women with PCOS. Body weight after using medications with metformin remains the same, in some cases even decreases.

After oral administration, the active substance is absorbed from the gastrointestinal tract. Peak plasma concentrations occur after 2-2.5 hours. The substance is distributed at high speed throughout all tissues. Almost does not interact with plasma proteins. Can accumulate in the salivary glands, liver, kidneys.

The drug was developed to improve glucose control in the body in those diabetics who do not respond to diet therapy and physical activity. In this case, it is prescribed as a mono- or additional agent in a combination therapy regimen.

The hypoglycemic agent is available in tablet form in a dosage of 500, 850 or 1000 mg of metformin in one pill. The medicine is produced in the form of tablets coated with a special coating, with a regular or prolonged release of the substance.

Tests before improving ovulation: who should be tested?

In order for the stimulation process to be as effective as possible and still lead to the conception of a child, the husband must have high-quality sperm, and you yourself must have good patency of the fallopian tubes. Otherwise, the treatment will be in vain.

The husband undergoes a spermogram (the composition of the sperm is analyzed), the woman undergoes hysterosalpingography (the patency of the fallopian tubes is checked). If the test results are in perfect order, you can immediately begin stimulating ovulation with the help of COCs - combined oral contraceptives.

Every woman planning a pregnancy must additionally take a blood test.

Something about the side effects of metformin

In general, most people tolerate metformin well. The most common side effects that occur when you first take the drug may be:

• nausea,
• flatulence,
• bloating,
• discomfort in the abdominal area,
• diarrhea.

Metformin should be taken with food to minimize side effects. For best results, it is recommended to slowly increase the dose over several weeks. Consumption of sugary and processed foods may worsen digestive side effects and such foods should be avoided.

Metformin may affect the absorption of vitamin B12. Long-term use and high doses of the drug increase the likelihood of its deficiency. Lack of this vitamin can cause mood changes, memory loss, and cause permanent damage to the brain and nervous system. You should supplement your diet with vitamin B12 and have your blood levels checked annually. The optimal dose of the vitamin should be >450 pg/ml. Elevated serum levels of homocysteine ​​and uric methylmalonic acid (MMA) also indicate B12 deficiency.

Lactic acidosis is a rare side effect of metformin. Drinking alcohol during treatment is not recommended.

Metformin use and vitamin B12 deficiency

Long-term use of metformin increases the risk of developing vitamin B12 deficiency. After 5 years, 5.2% of users had low serum levels of this vitamin. It is believed that metformin may affect small intestinal ileal absorption. Not only is B12 levels affected, metfomin also negatively affects homocysteine ​​levels and a marker of cardiovascular risk.

Other studies have shown that metformin can affect vitamin B12 levels after just three months of use. A systematic meta-analysis looked at people with type 2 diabetes and women with PCOS who took metformin. Their results showed that the higher the dose of the drug, the greater the vitamin deficiency.

The average dose of metformin for women with PCOS is 1500 to 2000 mg per day. Most women with PCOS take high doses long-term, increasing the risk of vitamin B12 deficiency.

Importance of Vitamin B12 for the Body

Water-soluble vitamin B12 is essential for nerve function, mental functioning, DNA synthesis, and red blood cell formation. It is mainly found in animal products. The recommended daily amount of the vitamin for most adults is 2.4 mcg.

Symptoms of B12 deficiency include certain types of anemia, neuropathy (nerve damage), chronic fatigue, memory loss, confusion, mood changes, and even dementia.

Deficiency is very serious, affects mood and energy, and can lead to permanent and irreversible neuropathy. Individuals taking metformin should be screened annually and supplement their diet with vitamins.

Can there be side effects after stimulation?

Medicines are created for a wide range of consumers, so any exposure to medicines is associated with some risks to one degree or another. It is for this reason that ovulation stimulation should be carried out exclusively under the supervision of a gynecologist who is able to notice deviations in time.

According to experts, the most dangerous side effect of the procedure is ovarian hyperstimulation syndrome. The bottom line is that a large number of follicles mature inside the ovaries at the same time, as a result of which the ovaries increase in size, and the woman feels discomfort and pain in the lower abdomen. If the ovaries enlarge too much, they will rupture. Fluid accumulates in the abdominal cavity. For timely detection of hyperstimulation syndrome and prevention of negative effects on the body, it is necessary to constantly undergo ultrasound examinations according to the calendar established by the gynecologist.

Side effects of metformin

Like any medication, Metformin can cause negative reactions in the body. Most often, at the beginning of therapy, disorders of the functioning of the gastrointestinal tract occur. Typically, patients complain of nausea, vomiting, abdominal discomfort, and diarrhea. There are also functional liver failures and hepatitis. Basically, unpleasant symptoms are not pathological in nature, so special measures to eliminate them are not required. As therapy continues, side effects disappear on their own.

In addition, women taking metformin for the treatment of PCOS may experience impaired absorption of cyanocobalamin (vit. B12), which can cause anemia. Other side effects of taking pills:

• Increased content of amino acids: is a factor in the occurrence of atherosclerosis.
• With a long course, the drug can increase the concentration of homocysteine, a toxic substance formed during detoxification processes in the body. A high level of a toxic compound contributes to inflammatory reactions, heart pathologies, oncology and any diseases of non-infectious origin (including polycystic ovary syndrome).
• Causes an imbalance of thyroid hormones (although the mechanism is not yet fully understood).
• Uncontrolled decrease in androgen levels can contribute to further hormonal imbalance with subsequent development of complications.
• Development of a depressive state or worsening of an existing one
• Decreased libido.
• Insomnia.

In particularly difficult cases, lactic acidosis may develop. If this dangerous condition occurs, you should immediately stop taking the pills and contact your doctor. Relief of lactic acidosis is possible only in a hospital hospital setting.

A high level of insulin and resistance of tissue cells to it leads to the development of PCOS - a condition in which infertility develops, the threat of cancer increases, etc. Over several years of using metformin for PCOS, the effectiveness of the drug has been proven. But, as with any method of therapy, the success of treating gynecological pathology with an antidiabetic agent depends on the correct diagnosis and strict adherence to prescriptions.

What is Metformin (Siofor)?

When drawing up an individual course of treatment, your doctor may recommend purchasing a drug called Metformin. By itself, this drug is not a means for complex treatment of infertility. However, reviews from doctors have shown that the use of Metformin for polycystic ovary syndrome promotes the regular appearance of menstruation. Accordingly, ovulation is felt, and the likelihood of getting pregnant increases. Metformin justifies itself as a tablet for the treatment of PCOS with elevated insulin levels.

Metformin is mainly used in the complex treatment of type 2 diabetes mellitus. Even if you do not have diabetes, the drug will have a positive effect on the condition of the ovaries with polycystic disease.

Experts have confirmed information that taking Siofor before the procedure for stimulating ovulation minimizes the risk of resistance to the drug Clomiphene, another medicine without which complex treatment is indispensable.

The effect of Metformin on the likelihood of conceiving a child with polycystic disease has not yet been fully studied. Some experts advise using this drug only in situations where doctors have discovered insulin resistance (this is when fasting glucose levels increase). Other doctors decide to prescribe Metformin regardless of blood glucose levels. We hope that medicine will soon provide detailed and accurate answers to all questions, but in the meantime, independent examinations are increasingly proving the positive effect of using Metformin in the treatment of infertility due to polycystic ovary syndrome.

There are a number of studies that have proven the advisability of prescribing Metformin both when planning to conceive a child and in the first trimester of an ongoing pregnancy. Experts note that Metformin significantly reduces the likelihood of miscarriage if there are problems with the ovaries. However, the final effect of Metformin on a child has not been fully studied, so it is important to have an individual consultation with your doctor.

Who did metformin help get pregnant with PCOS: reviews

According to reviews from patients who helped Metformin get pregnant with PCOS, the drug is more effective if there is decreased sensitivity to insulin. But when taking the drug, strict adherence to the diet is very important.

Results

So, Metformin is a drug used to treat insulin resistance. It gradually normalizes the concentration of glucose in the blood and, as a result, eliminates chronic hyperinsulinemia.

If the cause of the development of polycystic ovary syndrome is a violation of insulin tolerance (with a BMI over 30, the probability increases significantly), then Metformin (Glucophage, Siofor) will certainly help you. This is confirmed by statistics - two thirds of women successfully become pregnant while taking the drug.

Happy planning!

How to take metformin for PCOS?

The drug treatment regimen is determined individually and depends on the level of insulin in the blood. The dosage of Metformin for PCOS is 850-1000 mg twice a day. The maximum safe dosage is 850 mg three times a day. To minimize gastrointestinal upset, it is recommended to start with a low dose and gradually increase it to the recommended dosage. The tablet must be swallowed whole, without chewing, without dissolving in water or breaking beforehand. The course of treatment is about 6 months.

Treatment of PCOS with Metformin is contraindicated in minor girls and elderly patients over 60 years of age.

In some cases, taking Metformin for PCOS can be replaced by lifestyle changes. To do this you need to eat right and exercise regularly.

Diabetes and polycystic disease: what do they have in common?

The cause of diabetes mellitus is functional disorders in the endocrine system. As a result, glucose uptake into tissues is impaired due to insulin resistance. Since cell receptors stop responding to hormone commands, the concentration of glucose in the body increases. In turn, an excess of the substance triggers subsequent disturbances in biochemical processes.

Research into the causes of PO syndrome conducted in recent decades has revealed the role of insulin in the occurrence of gynecological pathology. As a result of examinations, it turned out that every second woman suffering from PCOS also has an insusceptibility of body tissues to the effects of insulin, i.e. we are talking about insulin resistance. Moreover, the lack of response to the effects of the pancreatic hormone does not depend on the degree of obesity or the presence of extra pounds.

During the research, it was proven that insulin directly affects the production of androgens by the ovaries, activating their “production”. Therefore, the higher the level of insulin in the body, the more actively the ovaries produce male reproductive cells. With a decrease in insulin concentration, the rate of androgen formation also decreases.

The coincidence of the causes of diabetes and PCOS has prompted experts to think about the possibility of treating gynecological disease with metformin, a drug for glycemic control in type 2 diabetes by eliminating insulin resistance.

Is there a risk of miscarriage with polycystic disease?

Women with polycystic ovary syndrome are more likely to suffer from missed abortion than women without polycystic ovary syndrome. A potential cause is the lack of normal hormonal balance maintained throughout pregnancy.

It is also worth noting that pregnant women with polycystic disease may experience gestational diabetes mellitus (when diabetes mellitus develops during pregnancy) and premature birth.

Women who become pregnant with PCOS should see their doctor regularly. In no case do we recommend purchasing stimulants and other medications on your own, as they can cause complications. A timely visit to the gynecological office, following all the recommendations of a specialized specialist, patience and the desire to conceive a child - all this will make it possible to give birth to a healthy baby in the future. Therefore, it is best not to even try to engage in independent treatment, much less pay attention to alternative medicine. It can cause serious harm not only to the child, but also to the mother.

Reasons for the ineffectiveness of Metformin in PU syndrome

In some cases, medications containing metformin are ineffective in treating PU syndrome. There may be several reasons:

• Wrong assignment. When selecting a treatment regimen, it is important to determine the most effective drug for a particular patient. In some cases, with PCOS, it is better to prescribe Clomiphene or stick to diet therapy and physical activity.
• Long-term metformin is less effective than diet and physical activity. Despite the good results of metformin therapy, after the end of treatment its interference with internal processes will also cease. And it is possible that pathological processes will appear again. Therefore, in some cases, patients are advised to change their diet and physical activity.

• Metformin is not suitable for treatment for individual reasons, as PCOS can be caused by other factors. According to statistics, insulin resistance is observed in 60-70% of patients. Therefore, in other cases, the drug may not work or have a minor effect on the outcome of treatment.

In addition to excessive androgen content, factors in the development of PCOS include stressful situations, the use of contraceptives, reduced levels of hormones (sex and thyroid hormones), regular physical overload, gastrointestinal pathologies, etc. That is, if the cause of the pathology is initially incorrectly determined and the woman does not have an excess of male hormones Due to the high insulin content, the prescription of metformin will be pointless.

Dosage and overdose

Treatment of polycystic ovary syndrome (PCOS) with Metformin should be carried out as prescribed and under the close supervision of a physician. Initially, the specialist must conduct various tests and determine the cause of the disease.

The drug is sold in pharmacies strictly according to prescription. Self-medication can be harmful and lead to serious complications.

The dosage of the medicine is determined by the doctor, based on individual circumstances, indications, medical history and glucose levels. The following regimen is considered optimal - 500 mg 3 times a day. The maximum daily dose should not exceed 1700 mg. The tablets should be taken before meals or during meals. Take the medicine with a glass of clean still water. Tablets should not be chewed or bitten.

The course of treatment with Metformin or its analogues is 6 months. During this time, the woman should resume her menstrual and ovulatory cycles. After six months, you need to take a break from therapy. The doctor will then conduct an examination and determine whether the course of treatment needs to be repeated.

Having taken pills in excess, a woman will feel the main symptoms of an overdose:

• nausea;
• stool disorder;
• vomiting;
• acute spasmodic pain in the lower abdomen;
• dizziness;
• loss of strength and drop in body temperature.

The most serious consequence, involving a risk to life, is lactic acidosis. This is a pathological process in which lactic acid accumulates in excess in the body. This condition requires immediate medical attention. The doctor stops taking the drug and prescribes hemodialysis, treatment is carried out in a hospital setting. If you do not see a doctor in time, death is possible.

Undesirable effects

Among the negative consequences of taking Metformin, it is worth mentioning anemia, a decrease in the concentration of sugar in the blood, and lactic acidosis. Some felt sick and vomited.

Possible abdominal pain. Some were concerned about increased gas formation, an unpleasant aftertaste, loss of appetite and stool disorders. Such manifestations are characteristic of the initial period of the drug program and do not require specialized correction and do not force one to stop taking the drug.

It is known that tablets can provoke allergies. Reactions are most often skin - rashes, areas of itching, redness. There is a danger of liver disorders.

What is polycystic disease

A hollow, pedunculated neoplasm filled with fluid is diagnosed on the ovaries in 3/4 of women of reproductive age.
The cyst can grow, squeezing surrounding tissue and causing pain. But, despite the pain and other unpleasant sensations, single cystic formations do not disrupt the functioning of the ovary and women have almost no deviations in the reproductive sphere. But if several cysts appear on the organ, then doctors diagnose PCOS or polycystic ovary syndrome.

Multiple formations impair organ function and patients experience:

• decreased libido;
• disruption of the menstrual cycle;
• rapid weight gain with normal diet;
• hair loss on the head and other parts of the body;
• emotional lability (outbursts of anger can be followed by attacks of apathy and depression);
• insomnia or problems falling asleep.

One of the common causes of polycystic disease is a violation of the hormonal ratio of estrogen and progesterone, caused by increased insulin synthesis. The pancreatic hormone responsible for glucose metabolism suppresses the maturation of the follicle, causing cycle failure, and increases the production of testosterone, and this leads to the development of polycystic disease.