Why use Metformin to treat PCOS?
Metformin is an insulin-sensitizing agent, first developed to treat type 2 diabetes. It works primarily on your liver to clear sugar after meals. Since 70% of women with PCOS have insulin resistance and high insulin levels, metformin is a favored treatment in the PCOS arsenal.
High insulin levels can lead to obesity and high androgen levels. By lowering insulin, your sex hormone binding globulin (SHBG) levels can go up. These are proteins which attach to free hormones and make them inactive. SHBG sops up your excess amounts of testosterone, the hormone that may lead to acne, scalp hair loss and body hairiness (hirsutism).
It definitely makes sense to try to lower insulin, to reduce symptoms as well as to address one of the underlying causes of PCOS. As opposed to other anti-diabetic drugs, this class of insulin sensitizers can lead to weight loss, definitely a desirable bonus if you are overweight. Also, metformin can help to restore ovulation by itself.
What are the downsides of Metformin?
Metformin may not be all it’s cracked up to be.
- For one, you may run the risk of developing lactic acidosis, an uncommon but dangerous condition of producing dangerously high levels of acid in your bloodstream. This is a medical emergency.
- Additionally, there have been a handful of reports of liver toxicity in some patients using metformin long-term.
- Metformin causes vitamin deficiencies, particularly folate and B12. These are important for many functions in the body, but particularly hormone balance, prevention of anemia and adequate detoxification.
Some studies suggest that the benefits of metformin PLUS lifestyle modification (exercise, healthy eating, adequate sleep) are NOT better than lifestyle modification alone. Additionally, metformin’s effectiveness goes down as you get older. It becomes less effective the longer you use it, and often cause gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal bloating, flatulence, and lack of appetite).
Does spironolactone work for abnormal hair growth (hirsutism) in women with PCOS?
Spironolactone is the go-to medication for PCOS women with heavy unwanted hair growth. It was originally used as a diuretic for blood pressure control, but turns out it also blocks androgen receptors – so it lowers androgen hormones. Downsides:
- It blocks the production of ovarian and adrenal hormones – which you don’t want.
- A full clinical effect may take 6 months or more.
- About 20% of women using spironolactone experience increased period frequency.
- It is contraindicated for women who are trying to conceive, as exposure has resulted in ambiguous genitalia in male infants!
A recent meta-analysis found anti-androgen agents like Spironolactone are only mildly effective. Although medications may improve hirsutism, they do not produce the dramatic results women desire, nor do they cure PCOS!
What to do beyond metformin and Spironolactone for PCOS?
The headline here is that although medications can partially reduce some of the overt symptoms of PCOS, they do not cure it. Address the underlying cause or causes of PCOS to reduce, and yes, even reverse the signs and symptoms of PCOS.
These underlying causes, or drivers of PCOS include:
- Adrenal stress hormone imbalance.
- Abnormal brain-adrenal-ovarian hormone communication.
- Gut infections and not enough beneficial gut bacteria.
- Inflammation in the body.
- Excessive chemical or toxin accumulation.
- Insulin resistance.
The PCOS SOLUTION program addresses all the underlying causes or drivers of PCOS, naturally, without medications. You can do the program in lieu of medications, or with them. First, check with your doctor, as you may lose the need for these medications during the program.
The American College of Obstetrics and Gynecology (ACOG) pegs diet and lifestyle therapies as the first-line therapy for PCOS. Therefore, wouldn’t you prefer to reverse your PCOS diagnosis and symptoms through these natural means? Diet and lifestyle changes sounds kind of vague, but we make it crystal clear and easy-peasy.
If you want to avoid medication, and learn how to reverse the drivers that cause PCOS in a guided diet and lifestyle program, then the PCOS SOLUTION program is for you. Join us! Wonder if you have PCOS? Take our quiz!