More Metformin questions...

[aspelua]

I have a few questions about Metformin. I was recently diagnosed with PCOS and I am trying to get pregnant. The only symptoms I have are irregular periods (about once a year) and polycystic ovaries (as seen by ultrasound). I have tried Clomid 3 times and I ovulated once, but not again and I was perscribed Metformin. The docs didn't have answers for all my questions and this has all been very confusing. It is extremely difficult to find someone to talk to.

Here are some of my questions:

1. I am not overweight and not insulin resistant so will and/or why will Metformin induce ovulation in me?

2. I have been on the drug for about 6 weeks and I started spotting a week ago. Does this mean I ovulated? Will I get my period? Or is this some strange side effect of the drug no one told me about?

3. I was told that it will take a long time for my body to adjust to the drug before I ovulate. Is this true? How long has it taken all of you?

4. Does having PCOS mean that I will become diabetic at some point?

5. Does diet make that big of a difference? I understand that a low carb diet will help with the gastrointestinal symptoms, but will it also help with ovulation?

6. Will exercise help with either the symptoms or the ovulation?

7. If I ever do ovulate on Metformin, will home ovulation kits work in predicting when I ovulate?

I'm sorry to dump all these questions on all of you, but I am so excited to find a place that has useful information. The docs have been pretty disappointing.

Thanks,
Amy

[Lauren2005]

Amy,

I'm brand new to PCOS, too (dx this week!) so I will be totally useless in answering your questions. Instead, I'd like to add one! I hope you don't mind. Thanks to anyone on the board who can help us newbies.

8. I ovulate every month and have generally regular periods (28-32 day cycles), yet I still have to take 1000mg Metformin XR. What will this do for me, if its purpose is to help women to ovulate? Could it actually mess up my ovulation?

Thank you, thank you. This is confusing.

Lauren

[KnittingMarie]

You have many very big questions and I will try to answer them, but your doctor shoul be willing and able to answer them all. So, first and foremost you need to find a Reproductive Endocrinologist and take all of these questions to them. Go! Run!

1. Doctor's don't really understand PCOS all that well, despite what they may tell you. The more the doctor claims to know, the more you should fear them and run. Insulin resistance is difficult to diagnose. There are several ways to test for it, but not everyone agrees on the accuracy of each test so most doctors just use the standard glucose to insulin ratio, which isn't particularly sensitive. Your doctor may recognize the limitations of this test and has decided that Metformin is worth trying.

2. Who know's...PCOS'ers have messed up hormones. Its hard to tell how your body will react to the Met, or why you might be bleeding at a given time. You probably are not experiencing any strange side-effects of the met, but keep your doctor posted on how your cycle is going and let them know if you have any specific concerns.

3. Correct. Metformin can take up to a year to reach full efficacy. However, for most it doesn't take that long. Each person is different. Some respond quickly, some take several months.

4 and 6. People with PCOS are at a higher risk of developing type 2 Diabetes (non-insulin dependent). However, it is not a sure thing. Your risk of becoming diabetic is greatly reduced if you maintain a healthy BMI and exercise regularly. For those that are overweight, weight loss and exercise can help with PCOS symptoms.

5. Most doctors will tell you that a healthy diet and exercise will help you with PCOS and that there is not currently strong clinical evidence that demonstrates that a low-carb diet, specifically, helps with PCOS. That said, there are many, many women on this site that will tell you that they feel a low-carb diet has helped them immensely.

7. Yes, the home ovulation tests (the pee on the stick kind) do work when you are on metformin and they work when you are on clomid too.

8. Lauren - ask your doctor why you are on the Met. Are you a type II Diabetic? It should not interfere with your ability to ovulate, and I'm sure your doctor has a good reason for putting you on it.


The real moral to this story is that YOU SHOULD NEVER BE AFRAID TO ASK YOUR DOCTOR QUESTIONS. Doctors are people just like me and you, they put their pants on one leg at a time. If your doctor seems to think otherwise, then fire them and move on.

If you have any questions write/type them out before your visit. Then take TWO copies of the questions AND A PEN to your doctor's appointment. When the nurse puts you in the room give him/her the list of questions and tell them that you want to discuss these questions with your doctor. Keep one copy of the questions so that you can refer to them and take notes. DON'T LET THE NURSE ANSWER THE QUESTIONS! TELL THEM YOU WANT TO DISCUSS THEM WITH THE DOCTOR. If your doctor doesn't have time to answer the questions, fire them and move on. REMEMBER, YOU ARE PAYING THE DOCTOR TO WORK FOR YOU! Not the other way around.

[Lauren2005]

Hi Iowafriend,

Thanks for your comments! To answer your question, I'm not diabetic, my cholesterol level is normal, and I'm quite thin. I ovulate on my own, and my cycles vary only 28-32 days apart. However, my doctor saw 18 antral follies and dx PCOS.

I've seen several world-famous drs and am privileged to live in a great area for medical research, breakthroughs, and treatment. I realize that where I am now (at 1.4 yrs ttc) is where many women are at 8+ yrs ttc, because my drs have been very assertive/aggressive in their dx and tx.

Me:
dx endo 1986
lap #1 7/94: removed endo from my ovary, uterus, intestines, abdominal wall, ureter, rectum, bladdar, appendix (which itself was removed.) dx stage III
lap #2 5/05: removed endo from my ovaries and uterus, and released ovaries from scar tissue that had adhered them to the abdomial wall. dx stage I

dx LPD 2/05
progesterone pills 3/05 (didn't work)
progesterone suppositories starting 4/05 (did work)

good FSH, good HSG, good PCT, good SA, good CBC

2 Clomid/IUI cycles 3/05, 4/05 BFN

Clomid 7/05 but thinned my lining to 5.0, IUI cancelled. BFP (but gone in 2 days)

Full immune testing 7/05

dx severe antiphospholipid syndrome, moderately elevated NK cells, inherited thrombophelia, 50% DQ Alpha match 8/05

dx PCOS 8/05

So it really isn't a question, for me personally, of not being able to ask questions of my doctor(s), it's that there's so darn much going on, I'd be there for hours if I questioned every little thing. I've been working hard to understand my immune issues and am pursuing tx for them. I'm lucky to have been dx with them, because as it turns out, my particular issues can:

* cause implantation problems
* cause early m/c
* cause late m/c
* cause stillbirth
* cause fetal death
* give me serious, life-threatening problems throughout life if untreated

Just to give you some idea, I will be taking baby aspirin and Folgard everyday for the rest of my life, and whenever I fly (forever) I'll need to have a Lovenox (heparin) injection the day before, the day of, and the day after the flights. These immune issues have gotten worse with our efforts ttc, because my body is fighting the pg so hard each time. As it turns out, I've been pg many times but lost it prior to the HPT (which they can tell via leukocyte antibody tests.)

I could go on and on here. But I did just want to say thank you for your comments and to reassure you that I'm very active in talking to the drs about everything going on. It's just that PCOS sort of came out of left field and I haven't had time to deal with it yet. I was hoping the PCOS experts here could tell me what Metformin could do for me when I'm already ovulating...

Anyway, thanks again and baby dust all around.
Lauren

[Paula_in_DE]

I just wanted to let you know that being normal weight or even slightly below normal weight doesn't make your PCOS any less than if someone has a weight problem. I've been fighting this stereotype for years that how could I have PCOS and not be overweight!?! Dr. do not know a lot about PCOS unless it's a speciality and still it's a big grey area. Most dr. now do assume your Insulin resistant because testing is too difficult and most times inconclusive. I was mis-diagnoised for over 10 years because no one thought to test my androgens/testerone levels. I had amenorehha (sp?) and if I was lucky one period a year. Since being on Metformin and altering my diet some I've become semi-regular with periods between 30-37 days.

Welcome to the group!