Metformin and PCOS

 Metformin and PCOS

      If you have polycystic ovary syndrome (PCOS), you're not alone. According to the National Center for Biotechnology Information, this hormonal disorder affects between 5 percent and 15 percent of women of reproductive age in this country.

In polycystic ovary syndrome, cysts develop on the ovaries, and the body produces excess hormones called androgens, which cause an irregular menstrual cycle. As a result, ovulation can be unpredictable, and getting pregnant can be challenging.

"Since puberty, I've averaged one menstrual cycle per year," says Carrie, a mother from the Midwest who has PCOS. "I always wondered if I could have children."

Carrie tried getting pregnant for several months, but wasn't able to because she wasn't ovulating. After evaluating her bloodwork, her OB/GYN suggested she go on either Clomid or Metformin to help balance her hormones to promote ovulation.

"Because I had a very slight imbalance in my hormones, my doctor suggested trying Metformin before going straight to Clomid. Since I heard horror stories about Clomid causing multiples, I was happy to try Metformin first," Carrie says.

Metformin is a diabetes medication that is sometimes used to regulate hormones in women with PCOS by balancing their insulin level. This effect leads to more regular menstruation and ovulation cycles, according to WebMD.

Carrie got pregnant the first month she took Metformin.

But not all women with polycystic ovary syndrome have such good results. In fact, experts say more evidence is needed to prove that Metformin helps conception in PCOS patients.

"When putting all the data together, it appears Clomid is better at achieving a live birth rate than Metformin, and that adding Metformin is not beneficial," says Dr. Joanne Stone, director of maternal fetal medicine at The Mount Sinai Hospital in New York.

Even if Metformin helps some women get pregnant, Stone says it does not increase actual live birth rates. Women with polycystic ovary syndrome have an increased risk of miscarriage, according to the American Pregnancy Association.

Some studies have looked at whether Metformin can decrease the rate of miscarriage in these women. Dr. Suzanne M. Kavic, director of reproductive endocrinology and infertility at the Loyola University Health System and associate professor of OB/GYN and medicine at the Loyola University Chicago Stritch School of Medicine, cautions against using the drug solely for the purpose of reducing miscarriage risk.

"Routine Metformin treatment during pregnancy is not recommended for women with PCOS. In large randomized trials, no differences in miscarriage rates have been shown between women with polycystic ovarian syndrome who did and did not receive Metformin," Kavic says.

According to the Australian Breastfeeding Association, the hormone imbalance caused by PCOS has also been linked to low milk supply. It has been suggested that Metformin can increase lactation in women who have the disorder and are struggling to breastfeed. But Dr. Christine Mullin, reproductive endocrinologist and infertility specialist at North Shore LIJ Health System in New York, disputes this notion, saying "Metformin has not been shown to aid in breastfeeding."