Metformin is a common medication used in the treatment of type 2 diabetes and polycystic ovarian syndrome (PCOS). These are the primary uses of metformin because it increases your insulin sensitivity, and insulin resistance is a common problem for Cysters and those with this type of diabetes. Up to 80% of women with PCOS have insulin resistance, which can develop into type 2 diabetes and other long-term complications if left untreated.
So, if you’re a Cyster, is metformin the right medication for you? I plan to answer that question in this post today! I’ll break down exactly what metformin does, and I’ll give you my opinion on metformin for PCOS. Here’s what you need to know:
What Does Metformin Do For PCOS?
How Does Metformin Work?
Metformin works by triggering an enzyme called AMPK, which prevents gluconeogenesis. (The production of new glucose.) This helps your cells respond to insulin, prevents your liver from producing too much glucose, and reduces the amount of sugar absorbed by the intestines. When your body is better able to handle and break down glucose with the help of metformin, your blood sugar levels can lower, and your insulin sensitivity increases.
How Can Metformin Help A Woman With PCOS?
Metformin has been one of the main drugs prescribed to “treat PCOS,” because when there is a reduction in insulin levels, other hormones fall into balance as well. For example, high testosterone levels often stem from too much insulin in the body as well! (Ozempic is another similar drug you can learn about HERE.)
These extra male sex hormones (androgens) could be the catalyst for several PCOS symptoms including, excess body hair, acne, irregular periods, hair loss, mood swings, infertility, and weight gain. Needless to say, treating insulin resistance can make PCOS much more manageable!
Studies have shown metformin can indirectly balance your testosterone levels by lowering your body’s production and absorption of sugar. Which can relieve symptoms and potentially assist with weight loss.
What’s The Catch?
So, what’s the catch, right? Well, metformin does not “cure” PCOS or insulin resistance. While on metformin you’ll see results, but when you get off the medication, your insulin resistance problems will likely return unless you’re making other meaningful lifestyle changes. Plus, the side effects of metformin can make you feel as though you’re trading one set of symptoms for another.
People on metformin report upset stomach, nausea, abdominal discomfort, diarrhea, light-headedness on metformin, and worsening of other PCOS symptoms that don’t have to do with insulin resistance and testosterone levels. GI issues are one of those symptoms that sometimes worsen on metformin. If all that wasn’t enough, studies have shown that a natural supplement called inositol is over 35% more effective than metformin.
Pros And Cons Of Metformin For PCOS
- Helps cells respond to insulin
- Reduces sugar levels produced and absorbed
- Balances testosterone levels for symptom relief
- Does not cure insulin resistance
- Depletes the body of nutrients like B12
- Endocrine disruptor
- Alters your gut microbiome
- Side effects include upset stomach, nausea, abdominal discomfort, diarrhea, light-headedness, and lactic acidosis
- 5x more reactive side effects over Ovasitol
Should You Take Metformin For PCOS?
Get tested for insulin resistance.
Before you start treating your PCOS, you need to know what type of PCOS you have. First, you can take my quiz to get an idea of your PCOS type. After that, of course, you’ll need to see a doctor who can do insulin resistance testing.
Your doctor will probably start by doing an A1C Test, which tests your fasting blood sugar levels over 3 months. This test is helpful, but it only shows a body with extreme insulin resistance. (Think borderline diabetic or pre-diabetic.) If this test doesn’t show signs of insulin resistance, it doesn’t mean it’s not there! Make sure your doctor also does an insulin glucose tolerance test to catch your insulin resistance before it progresses to diabetes.
Consult with your doctor.
Once you’re certain you have insulin-resistant PCOS, talk to your doctor about symptom management and treatment options. Metformin is not the only way! Using inositol supplements in conjunction with lifestyle, diet, and exercise changes can be even more effective with none of the side effects.
Note: Taking inositol and metformin can be problematic, so definitely consult your doctor before you decide to take any amount of inositol when on metformin.
Review the side effects.
Metformin has several side effects I’ve discussed already. It’s been shown to disrupt your endocrine system and gut microbiome. This means metformin may throw off the balance of hormones in your body and bacteria in your gut, causing irritating side effects like stomach, nausea, vomiting, bloating, gas, diarrhea, constipation, heartburn, weight loss, headache, and loss of appetite.
Additionally, metformin depletes some of your body’s much-needed nutrients, like vitamin B12. A deficiency in vitamin B12 can cause extreme fatigue, muscle weakness, sore tongue, mouth ulcers, and vision problems. There’s also a risk of going hypoglycemic or getting lactic acidosis. Just make sure you have a good understanding of the risks before choosing to go on metformin.
Remember, metformin is not a long-term solution.
Metformin can work great for increasing insulin sensitivity while you’re taking it. However, it doesn’t fix the core problem. When you’re off metformin, your insulin resistance problems will probably continue if you don’t also change aspects of your lifestyle. Make a plan to improve your diet, exercise, and mindset before getting off if you do plan on taking metformin and be sure to consult your doctor.
You can do this by downloading The Cysterhood app to get PCOS-friendly recipes and workouts. Plus, you’ll be a part of a community of Cysters just like you on a journey to reverse their PCOS and reclaim their life. Join us!
Have an exit plan.
When possible, you should have an exit plan for your PCOS meds. Living with the side effects of prescriptions like metformin or ozempic forever shouldn’t be your plan! As I said, work on improving your insulin resistance using natural methods, so you can get off the medication and live free of the symptoms of insulin resistance and metformin. This win-win is totally possible with the right plan.
I don’t think metformin is the best medication for PCOS. There are circumstances when it’s necessary, but research shows Ovasitol is a more effective treatment option with little to no side effects. It can help with more than just symptoms of insulin resistance as well! This is why Ovasitol is my favorite supplement for PCOS.
To successfully use Ovasitol, talk to your doctor about a 40:1 ratio supplement that’s 4,000 mg like Ovafit. You’ll take 2,000 mg in the morning and evening. This is important because a lot of inositol supplements out there are Myo-inositol & d-chiro inositol and only 500 mg. You can learn more about the best supplement options and the pros of Ovasitol over metformin in this episode of A Cyster and Her Mister.
Metformin does not “cure”PCOS and it may come with a variety of irritating symptoms.
Every medication has a time and a place, but metformin is not a miracle pill. Consider an anti-inflammatory gluten- and dairy-free diet, the right workouts, a good supplement plan and self-care to support your insulin resistance. You can find out more about how to naturally heal your PCOS on the blog and my podcast. Let’s do this together, Cysters!