Just started Metformin and have questions

MollyM · 03-13-2008, 05:55 PM

Hi All,

I’m brand new to this website and happy there is a place where those of us with PCOS can connect. I was just diagnosed on Tuesday and have a few questions if anyone out there can help. A little background about me, sorry about the length:

I’m 34 I have suspected that I have PCOS for about 10 years now. When I was 18 I went to my first OBGYN doctor and he did a thorough exam including ultrasound. I don’t remember the specifics but I was told that I had cysts on my ovaries and that my male hormones (testosterone I think?) were high. I wasn’t too surprised because by this age I was getting more and more hairs in places that women shouldn’t get them. The unwanted hair was my primary concern at this point. He put me on the BCP for the cysts and told me that it would help the unwanted hair too – no mention of PCOS. I can’t remember exactly what I took but I was SO SICK! I could barely drink the water to take them with! After trying three different kinds and a few months of hell I finally said forget this! A few years go by and in the meantime the hairs are getting worse and my weight finally yo-yo’d to 200 pounds.

I first heard about PCOS after reading about it in Glamour magazine. My heart beat a million miles a minute as I read the article. I related to so many of the symptoms – unwanted hair, trouble losing and maintaining my weight, long cycles, and cysts on my ovaries. I bought this to the attention of several doctors throughout my 20’s and was assured that nothing was wrong – the unwanted hair was hereditary, I needed to exercise more and cysts on my ovaries don’t necessarily mean I have PCOS.

At about age 28, after hearing about low dose pills, I decide to try the BCP again (for birth control reasons). I was totally fearful of gaining weight but didn’t and seemed to tolerate the low dose BCP well. About this time I also got clean, as I had been abusing narcotic painkillers for several years. After I got clean I went on the Atkins diet and lost the bulk of my weight and actually maintained it within 10 or so pounds! After getting bored with Atkins, my husband and I went on Weight Watchers and I hit my goal weight and had been within 5 pounds ever since (about 1 ½ years). Also, before the wedding I got laser hair removal for all the extra hairs on my face which worked well. Life was good, I felt stable, and I thought that I had gotten control of the problems of my past.

So to the present time…my husband and I decide we are going to TTC at the beginning of the year. I took my last pill pack in December and in January all hell broke loose! The first thing I notice is that I gain about 4 pounds my first month off the pill. …Okay, 4 pounds isn’t so bad, I just need to watch what I eat a little closer. I keep gaining…half the clothes I own are no longer fit. I’m crying almost morning as I stuff myself into my fat clothes and despite my best efforts the most I’ve been able to do is keep from gaining more (on 20 points a day strict).

I feel my past coming back and the battle is starting all over again. My skin is oily again and I’m getting pimples like a teenager. On top of this, three cycles and no ovulation! I start researching online and keep coming back to PCOS. I can’t take anymore and make an appointment with my current GP. She’s great - thorough and takes her time with you. I explain to her my current situation and my medical past and she didn’t dismiss me! She said my suspicions of PCOS are very well founded and it was unfortunate that I was dismissed in the past. She wrote me a prescription for metformin 500mg 1X day for a week then 2X day.

Question: She didn’t do any bloodwork. When I asked why she said that it wouldn’t matter what the test results are, her course of treatment for me would be the same. I think maybe her primary focus right now may be getting me ovulating because we’re TTC. I’m okay with this, but does it seem odd?

Also, how long does it take for the met to work? I’ve taken two doses so far (Tues night and last night) and I’ve had no gastrointestinal distress and feel well. I weighed myself this morning and I am down a pound – the first drop in my weight since coming off BCP. Could it be working this fast???

Last, I’m on CD 20, should I expect to ovulate before I get my period?

If you’ve gotten this far, thank you for reading. I appreciate any input you may have.

ruth5356 · 05-10-2008, 02:10 PM

Hi Molly,
I'm also brand new to this site and have just recently started metformin yesterday. I just want to see how it is going for you

RoaryKennedy · 05-10-2008, 03:25 PM

Hi Molly! When I saw my OBGYN for an infertility consultation, he prescribed Met without ordering any bloodwork. However, I'd had bloodwork done with my PCP shortly before that (which she said was "normal", haha!). The primary focus of the Met was getting me to ovulate. After two months when the Met didn't take care of that, he prescribed Clomid, and I did ovulate and get pregnant off that combo.

My very first Met pill, I did have the side effect of the dreaded diarrhea. But that was really the only time I had a noticeable side effect. But I know the Met did work, as my cycles were regulated within two months. I also took 1000 mg per day (and I do right now, too, even though we are not TTC), spread out over two 500 mg doses.

Are you having normal cycle lengths right now, before Met? I hadn't had a period for like, six months when I started the Met, and it took two months to regulate that. But like I said, even though I was having regular cycles timing-wise, I wasn't ovulating. So, my *guess* would be that since you are so far along in your current cycle, the Met probably won't make you ovulate this cycle. It took two months for me to see a real impact.

Are you having any tests to check for progress? I had a progesterone test on cycle day 21 of each cycle, to check for ovulation. That's how we knew that the Met alone wasn't causing ovulation. Has she mentioned a plan for how to proceed if the Met alone isn't doing the trick?

Good luck! Let us know how you're doing!

MOJO33 · 05-10-2008, 04:01 PM

Jen - I had blood tests done with my OB/GYN who said they were all within normal range. I have since seen an RE who said those tests were not sensitive enough. He also said that my bloodwork was within normal tolerances for a regular OB/GYN, not for him. He also said a fasting glucose test was worthless. YAfter a fasting glucose test my RE put me on Met and also told me my LH level was slightly abnormal. You probably don't need metformin unless you are insulin resistant. I would ask to try Clomid (which did not work for me) If that doesn't help ask for a referral to an RE.

wpttrmom · 05-10-2008, 09:28 PM

I wish your doctor would have done bloodwork. If you aren't insulin resistant, the metformin isn't really going to do anything for you. I don't recall if you listed your dosage in your post. My RE told me that anything below 2000mg per day doesn't do much as far as helping with fertility issues. I don't know how accurate that is, it worked for me. Best of luck to you!

njeosys · 05-11-2008, 01:26 AM

You should get your levels checked. Metformin can help women who do not have IR (insulin resistance) because I have cysts and high testosterone (and that is it---there's nothing else, no insulin problems or anything like that).

And you have to work your way up to over 2000 mg slowly. So keep doing what you're doing!