Question of the Month
Q:
I have been reading about PCOS all night. I
was diagnosed several years ago. What I am trying to find out is: Does Metformin
shrinks cysts? I have read everywhere that women have a normal menstrual cycle
after using it, get pregnant, and reduced chance of miscarriage, helps weight
loss.
I just can’t find the answer I am seeking. Any help is appreciated.
A:
Metformin (Glucophage(R)) does improve PCOS in
many, but not all, women who take it. Because it can lower insulin levels,
restore regular periods and probably reduce the incidence of miscarriage, it is
a great advance in treatment of PCOS. I have not seen a study of its effect on
the tiny cysts in the ovary. However the appearance of the ovary on ultrasound
is not as important as how the ovary functions. And metformin often does restore
ovulation which is the important thing.
Some who take metformin have gastrointestinal side effects such as upset stomach
and diarrhea, but most feel fine on it.
Who should take metformin is not yet entirely clear. My own view is that it is
for women with evidence of insulin resistance or who need help in getting
pregnant. By itself, metformin has only a slight effect on the skin and hair
changes associated with PCOS. However, the decision of whether or not to use
metformin needs to be decided as part of an overall treatment plan on an
individual basis and in consultation with a knowledgeable physician.
Hope this is helpful.
Sincerely,
Geoffrey Redmond, MD
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