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Metformin (Glucophage) and PCOS

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Metformin (Glucophage) is a pharmaceutical drug often prescribed for women with PCOS (Polycystic Ovarian Syndrome). It is an insulin-sensitizing biguanide commonly used to treat elevated blood glucose levels in people with Type 2 Diabetes and often employed as an off-label prescription for PCOS. This means that it was originally used only for individuals with Type 2 Diabetes but is now prescribed for PCOS patients because it has similar actions in both groups.

Many women with Polycystic Ovarian Syndrome are insulin resistant. With this condition, the ability of cells to respond to the action of insulin in transporting glucose (sugar) from the blood stream into muscle and tissue is greatly diminished. Metformin improves the cell’s response to insulin, and helps move glucose into the cell. As a result, your body will not be required to make as much insulin (1).
PCOS and Metformin Studies
PCOS and it’s symptoms of hyperandrogenism (acne, hirsutism, alopecia), reproductive disorders (irregular menses, anovulation, infertility, polycystic ovaries), and metabolic disturbances (weight gain) have been linked to hyperinsulinemia and Insulin Resistance (2). Therefore, it makes sense to address the hyperinsulinemia and Insulin Resistance caused by this condition.

Studies have reported the treatment of Metformin to improve hirsutism, induce ovulation and normalize menstrual cycles (1). For example, according to one study, which looked at 39 women with Polycystic Ovarian Syndrome and hyperinsulinemia (excess insulin in the blood), treatment with Metformin for women with PCOS resulted in a decline of insulin as well as total and free testosterone, leading to significant improvement of clinical manifestations of Hyperandrogenism (the excessive production of androgens in women) and an improvement in menstrual cycles (3). However, studies have also shown weight loss through exercise and changes in diet and lifestyle alone to be as effective in regulating menstrual cycles and showing improvement in hyperandrogenism (4, 5).
Metformin – Side Effects
Many women prescribed Metformin must discontinue its use due to the gastrointestinal side effects. The most commonly reported adverse effects include diarrhea, gas and bloating, abdominal discomfort, nausea, and vomiting (1, 6). Another consideration of Metformin therapy is its effect on B12 absorption. Ten - 30% of people receiving long term Metformin therapy develop B12 malabsorption, which could potentially lead to anemia.

It has also been shown that treatment with Metformin may increase homocysteine levels (amino acids found in the blood), which is a risk factor for atherosclerosis or fatty deposits in blood vessels (7).

The contraindications in using Metformin include liver failure, alcoholism, compromised renal function, hypoxic conditions and moderate to severe infections. These conditions predispose women to having lactic acidosis, which is a life-threatening complication and carries a mortality rate of 30% - 50% (1).
A Complete System for Reversing PCOS
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Insulite Laboratories’ view on the pharmaceutical treatment of Polycystic Ovarian Syndrome – including Metformin - is that there is no one drug on the market that will change your condition. The only way to reverse the disorder is to reduce elevations in insulin which directly affect testosterone and other hormonal changes that are responsible for causing PCOS. Metformin can impact weight loss, infertility, acne and other PCOS-related symptoms however, the results are variable. There are also many negative side effects with the treatment of Metformin that can impact your health.