Metformin and PCOS?

I have PCOS and my doctor prescribed Metformin (Glucophage) to regulate my blood sugar because I always feel tired after meals. I know it is a common drug for women with PCOS but when I went to pick it up, the pharmacist was confused because he didn't know anything about PCOS. He was really concerned that the doctor prescribed it without first checking my blood sugar levels. Now I'm nervous about taking it. Has anyone else been put on metformin without any tests first?

Answers:
Using metformin for PCOS is still an "off label" use, meaning it hasn't been approved by the FDA for treating PCOS. But research, as well as thousands of patients, have shown that it works, so doctors prescribe it.

Some doctors believe that all women with PCOS should be treated with metformin, even if they don't test positive for insulin resistance. This is because it is thought that PCOS is caused by having excessive insulin in the bloodstream, which causes the ovaries to produce too many male hormones. Metformin can help control those insulin levels. There is a link between insulin resistance and PCOS because women who are insulin resistant do not use glucose at quickly as normal people do, and so their bodies produce excess insulin because they "think" more is needed.

Having your blood sugar checked will not tell you if you are insulin resistant or if your insulin levels are too high. People who are insulin resistant have normal fasting blood sugar levels because their bodies can control these levels--it just takes a bit longer. Insulin resistance is detected through a glucose tolerance test and/or an insulin test.

My advice is that since you have PCOS and symptoms of insulin problems, you most likely can benefit from metformin. But if you are concerned, you should ask your doctor for testing. Having those levels checked before beginning metformin isn't a bad idea anyway, since it will give your doctor something to compare later tests with to see if you've improved.

Hmm. I can see why your pharmacist was concerned, because he might be worried about you having hypoglycemia (where your blood sugars get too low) and passing out. According to my sources, though, hypoglycemia is not an adverse effect.and the effect of metformin is to sensitize your body to insulin and prevent your liver from producing excessive glucose. It probably will help you plenty, especially if you're a bit overweight or if your blood sugars have been borderline. PCOS definitely has been proven to have a metabolic syndrome link, and many women who loose weight and improve their glycemic control begin to ovulate more regularly, thus having more regular menstrual cycles. Hope this helps a bit. I wouldn't worry too much about taking the drug, if I were you..
My OBGYN did the same thing. I didn't have any tests done before she put me on the Metformin. I haven't had any bad side effects though. I did go to my primary dr. thought to get a liver function test done just to be safe because I read on the medicine insert that it could affect the liver.
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