I'm almost certain my doctor thinks i'm an idiot- I ask this every time I visit and never get an answer I understand fully or believe!

Please can you tell me this in simple terms; How will taking 1500mg of met each day help with my PCOS? What symptoms does it effect? More importantly will it help me lose weight?
I also have other symptoms of polycystic ovaries including a lot of unwanted hair and bad skin, my doc tells me that it will make it less noticeable but i've never noticed a difference. I would rather not be taking so much medication for no reason! How does met relate to me and my PCOS?

Thanks guys, sorry about all the (probably) silly questions

Hey, I just started on metformin and basically quizzed my doctor on why I was taking it, plus did a ton of research.

So Met basically has three effects that are relevant to PCOS.

1. It reduces absorption of carbohydrates in the intestine, which may help with weight loss and blood sugar/insulin control.

2. It reduces production of glucose by the liver. Again, this helps stabilize blood sugar and insulin.

3. It increases the sensitivity of your muscle cells to insulin. People with insulin resistance, as is commonly associated with PCOS, don't transport glucose into their cells efficiently. As such, their blood glucose levels remain high, and the body produces more insulin to try to lower the glucose. This can be problematic and lead to the muscles being even LESS sensitive to insulin, since they're being flooded with it...and that continued flood of insulin can lead to diabetes. Making the cells more sensitive to insulin means your body needs to produce less, so the levels in your blood are lower.

So, in terms of how this helps with PCOS:
1. PCOS is strongly correlated to insulin resistance, which is a precursor to diabetes. Putting patients with PCOS on metformin helps to prevent the insulin flooding and delay or prevent those patients developing type 2 diabetes.

2. There is some good research to show that lowering insulin slows the activity of an enzyme in the ovaries that controls testosterone production. A lot of the more annoying PCOS symptoms (hair growth, acne, etc) are due to excess testosterone, so if lowering insulin levels helps lower testosterone levels, that'll help a LOT of your symptoms.

The decrease in testosterone also helps improve ovulation and fertility in women who are trying to get pregnant, and can reduce the risk for gestational diabetes and for miscarriage (both of which are extremely common in women with PCOS).

So the decrease in insulin caused by metformin not only reduces your chances of developing diabetes, but also reduces your abnormal testosterone levels, which can improve hair growth, acne, and fertility problems. In addition, the metformin can, in some women, aid in weight loss (not EVERYONE, and not by much, but it can have some effect), which can also help with symptoms.

Hope that helps!

oh god mandalinn82, that more than helped! I read it three times and have printed it out!

So i'll stick with the met. I had read it affects your weight but had no idea it can bay off type 2 diabetes. I carry ALL my excess weight around my middle so know I am at risk and perhaps the met can help, along with diet and exercise of course!
I have to take the pills 3 times a day (500mg at a time) and sometimes find this overwhelming as I take a lot of meds.
Is it ESSENTIAL that all 1500mg must be taken at separate intervals? Could I perhaps take two at one time and one at another?
I know you are not my doctor but any advice or experience would be very greatly appreciated

I'm on the extended release, and therefore only take mine once a day. My dad is type 2 diabetic, and he isn't on the extended release and therefore has to take it twice a day. You might ask your doc if you can switch to the extended release, so you can take all the pills at once (mine are with breakfast). The non-extended version only sticks in your bloodstream for a short amount of time, so you have to take it more often to keep the appropriate amount of met in your system - the extended release is digested slowly, so you can take it in the morning and maintain more consistently levels all day without taking additional pills.

wasn't even aware that was an option! Thanks again for the advice mandalinn82, I think I need to have a serious chat with my doc!xx

For me, the effects of metformin were so subtle, that I thought there weren't any. It was only when I had to go without it for a few days (insurance snafu), that I was able to notice any difference at all (and it was still subtle).

I did lose a little extra weight when I first started taking it, but it wasn't a huge amount of weight, and it wasn't dramatic enough to point to the metformin and not my own efforts. I think it did help, but how much is hard to say.

When I had to do without it for a while, I did notice a significant increase in appetite and hunger (probably blood sugar issues). But if I weren't paying close attention, I'm not sure I would have noticed the difference. Like a lot of medications, I think that the effects aren't always perceivable (sort of like I can't feel my cholesterol levels changing).

My blood sugar numbers have been WAY better since I've been on the metformin, but since I don't have to test at home, I only see those results every 4 months.

I have also found the same results with the South Beach Diet, and limiting refined carbs/sugars. Really Insulin Resistance is how type 2 diabetes starts. When its left untreated its develops into Diabetes over time. My Dad who is almost 70 is in the Insulin Resistance phase. And with proper care he will stay in the insulin resistance phase.
I like to look at insulin with the key and lock idea. There are locks on the cell walls that can only be opened with Insulin. When insulin unlocks it, glucose goes in. When someone has insulin resistance, the key doesn't fit the lock very well, so your body produces more and more insulin to try to hopefully get glucose in. So you have way to much insulin. Because of increased insulin levels your body signals your ovaries to produce andorgens (testosterone) and that is where all the "lovely" PCOS symptoms come in. So Metformin essentially helps the key fit the lock, and everything from there should technically be restored.
Like I said though, I have seen my own body respond to diet and exercise. My LH used to be SO crazy, I would get + OPK's all month long. But now they have leveled out, and it seems like I am getting regular AF. Anyways, so there are options out there. I just couldn't stand the side effects of the Met, and I couldn't stand being on pills the rest of my life. So I looked for alternatives.

Diet and exercise definitely can work for some PCOS cases (I'd venture to guess even MOST PCOS cases). Unfortunately, it doesn't work for everyone. I didn't start the met until I'd been at goal for 3 years, tried everything, and already had regular intense exercise and a whole grains/produce/lean protein approach to eating in my toolbox...while I was losing weight and for about 1 year afterward, I had almost total symptom improvement, regular cycles, all of that good stuff. But at 1 year maintenance, despite keeping the same diet and exercise going, all of my symptoms came back, even though my diet keeps my blood sugar steady and my insulin on the high end of normal. I'm pretty sure there's at least one other PCOS maintainer who had the same experience...temporary relief of symptoms until after goal, then a return to them.

I hate the idea of taking pills, too, and most likely will stop them once I've gotten pregnant, but most research shows much better conception and pregnancy success rates (even in non-obese, non-insulin-resistant PCOS women), so I'm resigned to taking them to prep my body for that. After that, we'll see how my blood sugar and insulin are and make a decision on whether to proceed.

I agree Mandalin...we all have to do what we need to. That's one of the things I really don't like about PCOS is there really are no hard fast answers. Every case is so different. Like for me besides obese and cysts and no ovulation, I have no other symptoms of PCOS. No excess hair, no acne...I was on Met for about 2 months and the symptoms (from the Met) never stopped for me. I have considered at times restarting and I might someday. But for now, I'm just trying to more focus on losing weight. There is totally nothing wrong with being on Met. Just wanted to add in my 2 cents.

I've been on 2000mg of Met XR a day for a couple years, and honestly I never noticed a difference. The only reasons that I'm still on it is just in *case* it happens to start working or if maybe it's prevented my symptoms from worsening over the years I've been taking it.

I was told that I have PCOS, but I'm not insulin resistant. I've honestly never understood that concept - how can PCOS occur without IR??

I was just diagnosed with PCOS today, and my doc has prescribed met... What are the side effects? He said it may cause diarrhea but that it would only last a couple days?

I lost 30 pounds in 7 months while i was on metformin 2 years ago. Sadly i gained it all back
I had the most horrible side effects, but the weight loss was worth it in the end

Yes, you might as well move into the bathroom. But it doesn't affect everyone the same way, so you might not get such bad side effects. Also, eating carby foods will make the side effects worse. Definitely stay away from bread and pasta. And anything overly sugary. Good luck

I'm curious about this as well. I've been told I have PCOS but not IR...what is the point of being on Met for those of us without IR?

I am totally in the same boat. I've been on Met since...2007 I think? I feel like it's been longer than that, but I can't remember. 1500/day for most of that, and in the last few months, a new doc upped me to 2000. My blood levels have never shown IR, but for some reason I am on Met for preventative measures, or so I gather. I'm kind of not questioning it, but I would like to know WHY. When I initially started Met, I was also extremely good about sticking to a SBD-like diet and lost about 20lbs. So I'm not convinced that I can give all, or any, of the credit to the Met. (I haven't gained back to my original weight, though, while on Met, so that's good.)

I was a lucky one and never had any side effects with Met. But I also can't tell any difference in the way I feel when I forget to take pills or take them too close together or anything.

I was nervous about this too, for YEARS, and would try to be as consistent as possible in taking Met with meals and at regular intervals. But I talked to my most recent doc who is a specialist and she said it's a really easy drug, you can take it all at once (if your body can handle that), or do the XR, or take them spread out throughout the day. THis is great because I'm a grad student and my days are not the same schedule day-to-day. So I usually have one in the morning, one around lunch if I remember and around 5 or 6 if I don't remember at lunch, one after dinner and one before bed (I also take birth control and a blood pressure med 2x a day). If it's hard to remember, the obvious solution for this is to just get the XR, but I'm a creature of habit and I don't mind the multiple pills. Get yourself a little pill carrier with days of the week if you don't already.

It might be for preventive measures, so that you don't develop IR.

I've heard of people who take Met (even though they don't have anything wrong with them) so it can extend your life. It seems that IR is a measure of how long you can live and they take it because they believe it will make them live longer, better.