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Polycystic Ovary Syndrome (PCOS) is one of the most prevalent hormonal disorders impacting women of reproductive age. Its complex presentation varies from irregular periods, anovulation,...
Polycystic Ovary Syndrome (PCOS) is one of the most prevalent hormonal disorders impacting women of reproductive age. Its complex presentation varies from irregular periods, anovulation, acne and weight gain. A key underlying factor of PCOS symptoms is insulin resistance. This can be targeted by Metformin, a traditional type 2 diabetes treatment.
Before you ask “if its a diabetes drug, what does metformin do for pcos ?”. Metformin has proven to effectively regulate menstrual cycles, induce ovulation and promote weight loss for women experiencing PCOS. Although it is generally safe to use, there are some precautions to be aware of. This article explores the relationship between metformin and pcos, its benefits in managing PCOS, when to use it and any potential risks you should be aware of.
Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder which affects between 4 and up to 12% of women worldwide. PCOS has various effects presenting with hormonal, dermatological, reproductive and psychological symptoms.
It is characterised by:
Despite its prevalence, PCOS is unfortunately under-recognised, and many women still go undiagnosed. If you are concerned about PCOS and would like to consider treatment for it, you can do so through Meds for Less.
Common presentations of PCOS are: infertility, irregular menstrual cycles, abdominal weight gain, acne and type 2 diabetes mellitus symptoms. As well as the physical manifestations, this also has psychological impacts on women concerning their self-esteem, body image and social standards.
One of the key features of PCOS is insulin resistance. Insulin is a hormone which regulates your blood glucose levels, helping your body’s cells take up sugars and glucose.
When your body’s cells have a poor response to insulin, i.e become resistant to insulin, more insulin is secreted to compensate. High insulin in your blood, or ‘hyperinsulinaemia’, has various effects on your body and it is what contributes to anovulation and high androgen levels seen in PCOS.
Metformin, on the other hand, reduces insulin resistance and can even induce ovulation in non-obese women experiencing infertility because of PCOS.
High androgen levels brought about by hyperinsulinaemia are responsible for many of the common presentations of PCOS. These features are listed in the table below and include hirsutism (increased body hair), acne, weight gain and anovulation.
Symptoms of PCOS
| Reproductive effects | Visible or dermatological effects | Metabolic effects | Psychological outcomes |
| Irregular menstrual cycles | Hirsutism (increased body hair) | Type 2 diabetes mellitus symptoms (IR, hyperinsulinaemia, weight gain) | Eating disorders |
| Anovulatory infertility | Acne | Abdominal weight gain | Low self-esteem |
| Hair thinning |
Metformin has proven its ability to induce ovulation, improve fertility, re-establish regular menstrual cycles, promote weight loss and relieve symptoms in women with PCOS. It is therefore a commonly recommended treatment for PCOS, especially given the positive metformin fertility associations.
Action of Metformin:
Metformin is a drug regularly prescribed to treat type 2 diabetes mellitus and works by increasing your body’s sensitivity to insulin and reducing the production of glucose by the liver. This lowers your body’s levels of insulin, which has positive effects for fertility, healthy weight loss and decreases the levels of androgen hormones.
Since Metformin targets one of the key factors contributing to PCOS- insulin resistance, and also hyperandrogenism, it is able to relieve many of the symptoms women with PCOS face. Using metformin for fertility improvements is one other benefit it provides as an ovulation-inducing drug.
The consequent effects of Metformin on PCOS symptoms are in the table below and highlights how does metformin help pcos.
Metformin’s effects on PCOS
| Reproductive outcomes | Visible or dermatological outcomes (due to lowered androgens) | Metabolic outcomes | Psychological outcomes |
| Induces ovulation to promote fertility | Reduces hirsutism (body hair) | Lowers risk of type 2 diabetes mellitus | Empowering for self-confidence |
| Helps regulate cycles | Relieves acne caused by PCOS | Promotes healthy weight loss | |
| Lowers androgens | |||
| Lowers risk of IVF-associated ovarian hyperstimulation syndrome |
Although considered mostly safe, the side effects of using Metformin include:
Since PCOS is one of the most common causes of anovulatory infertility, one of the key benefits of metformin for pcos is inducing ovulation to improve fertility outcomes in non-obese women and alleviating PCOS symptoms.
Metformin is also relatively safe and can simply be taken orally. It helps manage PCOS symptoms such as:
It does this by increasing your body’s insulin sensitivity, which reduces the insulin and androgen hormones responsible for PCOS symptoms.
Effects of excess body fat on PCOS and Metformin:
The insulin resistance observed in PCOS can make it more difficult to lose excess weight, but it has been proven that losing just up to 5% of your total weight can profoundly improve PCOS and its symptoms, especially if taken alongside Metformin.
Excess weight loss helps lower the levels of insulin and androgens responsible for PCOS symptoms. This helps re-establish menstrual regularity, ovulation, relieve PCOS symptoms and allows your body to respond better to treatments like Metformin.
Studies have found that women who took Metformin on low-calorie diets were more successful in losing weight than those on low-calorie diets alone.
Starting metformin for pcos weight loss is therefore a viable option. It helps alleviate your symptoms, and you can gradually alter your treatment according to the advice of your doctor.
If you would like to consider implementing lifestyle changes or have any metformin weight loss pcos queries, then consult your doctor for more advice to help you.
While Metformin relieves many PCOS symptoms and is considered mostly safe, it can also have side effects which typically relate to abdominal symptoms. The table found below summarises the side effects.
There are also contraindications if you have pre-existing conditions such as:
If you are concerned about the side effects or interactions Metformin may have, then contact your doctor to seek medical advice. They may be able to start you on a progressive dose to balance the relief of PCOS symptoms and any side effects you’re experiencing.
Side effects of Metformin
| Common side effects | Rare, more severe side effects and/or interferences |
| Nausea | Lactic acidosis |
| Diarrhoea | Poor absorption of vitamin B12 |
| Bloating | |
| Abdominal pain | |
| Excess weight loss or anorexia | |
| Metallic taste |
Metformin can be taken by most women who experience PCOS symptoms. Metformin is typically prescribed to women with a higher BMI to help achieve less excess body fat and treat PCOS symptoms. This is because excess body fat contributes to insulin resistance and, therefore, the symptoms of PCOS.
Although Metformin has proven to be even more effective at treating PCOS in women with lower BMI as well.
Metformin is also considered a first-line treatment for inducing ovulation in non-obese women since PCOS commonly causes anovulatory infertility.
To recap, as long as you have obtained the medical advice of a medical professional, it is worth considering taking Metformin for PCOS:
If you are concerned about PCOS or would like to discuss metformin dosage for pcos weight loss, and to minimise any side effects, consult your doctor who can explore the options which are best for you.