Many women of reproductive age are faced with a diagnosis of polycystic ovary syndrome.
The pathology belongs to the category of endocrine diseases and is accompanied by dysfunction of the ovaries.
Polycystic ovary syndrome always requires complex and serious treatment, as it can provoke significant complications - such as infertility, cancer pathologies and diabetes mellitus.
In this article we will talk about the drug Metformin - in particular, how effective it is for polycystic ovary syndrome.
The essence of pathology
Ovarian cyst is a fairly common gynecological pathology, which is diagnosed in almost 75% of cases in women of childbearing age. This formation is a capsule with a leg filled with liquid.
Depending on some provoking factors, such a tumor can grow and enlarge, which causes the appearance of quite unpleasant and painful symptoms.
When several of these capsules appear on a woman’s reproductive organ, doctors diagnose polycystic ovary syndrome or PCOS.
Pathology is often accompanied by some characteristic signs :
- a woman's acne increases;
- libido (sexual desire) decreases;
- uncontrolled weight gain occurs;
- baldness;
- violation of the psychological state (the woman becomes subject to frequent mood swings, irritable and prone to depression).
Polycystic disease is often caused by certain systemic diseases (hypothyroidism, diabetes and cardiovascular disorders).
NOTE!
To date, doctors have identified several causes of this disease - one of them is considered to be a hormone imbalance (fluctuations in estrogen and progesterone levels) and increased insulin production in a woman’s body.
It is insulin, or rather its excess, that provokes the appearance of cysts, as it disrupts the natural cycle of ovulation and follicle maturation, increasing the production of testosterone (“male” hormone) by a woman’s ovaries.
Therefore, gynecologists are increasingly prescribing a drug such as Metformin for the treatment of PCOS, a hypoglycemic drug whose action normalizes the balance of insulin and regulates its proper formation in a woman’s body.
Treatment with this drug leads to a significant decrease in the patient's blood sugar levels, interfering with the liver and the process of glucose formation.
A decrease in sugar (below the level it was after eating in a woman before taking the drug) provokes a decrease in the production of insulin, which “fights” excess sugar in a person’s blood, and, accordingly, a decrease in testosterone levels.
By lowering blood sugar levels, Meformin also lowers testosterone in women.
Diagnosis of insulin resistance
If you meet all the criteria for PCOS (irregular periods and elevated androgens), the next step is to evaluate for insulin resistance. How to determine this?
Obesity in the shape of an apple
Notice the apple-shaped physical sign of obesity (carrying excess weight around your waist). Using a tape measure, measure your waist at the level of your navel.
If your waist circumference is greater than 89 cm, you are at risk of insulin resistance. This can be calculated more accurately as a waist-to-height ratio: your waist should be less than half your height. Apple obesity is a defining symptom of insulin resistance. The larger your waist circumference, the more likely it is that your PCOS is the insulin-resistant type.
High insulin levels make it difficult to lose weight, and this can become a vicious cycle: obesity causes insulin resistance, which causes obesity, which makes insulin resistance even worse. The best weight loss strategy is to correct insulin resistance.
Blood test for insulin resistance
Ask your doctor for a referral for one of the following tests:
- Glucose tolerance test with insulin. With this test, you give several blood samples (before and after drinking a sugary drink). The test measures how quickly you clear glucose from your blood (which measures how well you respond to insulin). Leptin can also be tested, but most labs don't do this.
- Blood test under the HOMA-IR index. It represents the ratio between fasting insulin and fasting glucose. High insulin means insulin resistance.
If you have insulin resistance, you need treatments, which we will discuss next.
Description of the drug
Metformin is a medicine intended for the treatment of type 2 diabetes mellitus.
Type 2 diabetes causes insulin resistance, that is, the inability of blood cells to respond to insulin - glucose is not able to penetrate into the blood cells, which provokes a sharp rise in sugar levels.
The drug Metformin affects the functioning of insulin, “forcing” it to lower sugar levels and, accordingly, reduce the production of testosterone in the blood. In addition, the drug lowers cholesterol levels and helps normalize the weight of patients.
Although the instructions for the drug do not contain indications for its use in polycystic ovary syndrome, the effect of the drug is nevertheless capable of restoring ovulation and normalizing hormonal levels without causing hypoglycemic reactions. Therefore, Metformin is often prescribed to women for the treatment of polycystic ovary syndrome.
CAREFULLY!
Using the drug on your own, without a doctor’s prescription, can lead to quite serious consequences and dysfunction of many systems and organs!
Many or few?
Metformin prescribed for polycystic disease must be taken in strict accordance with the recommended dosages. Excessive intake may cause unwanted reactions in the body. An overdose can be suspected if a woman feels nauseous and vomits, if the stomach attracts attention with sharp, acute attacks of pain. Against the background of excessive intake, stool is disrupted and the temperature drops. Muscle spasms are possible. If a person does not receive treatment, he gradually gets worse. Breathing is suppressed, the head is dizzy, consciousness is confused and disturbed. There is a danger of coma.
Efficacy in polycystic ovary syndrome
The drug Metformin is used to treat type 2 diabetes, as its action helps control a person’s blood sugar levels and insulin production.
In addition, the substance contained in the drug reduces the level of LDL (“bad” cholesterol) and has a positive effect on the condition of the cardiovascular system.
To increase the effectiveness of the drug on the patient’s body, its use must be combined with a properly selected diet and a healthy lifestyle.
Taking Metformin for polycystic ovary syndrome in women helps reduce the manifestation of signs of the disease - reduces the appearance of acne on the face and stops excessive male-pattern hair growth.
Normalizing the cycle of menstruation and ovulation helps patients with PCOS syndrome to become pregnant.
Expert opinion
Dmitrieva Elena Yurievna
Gynecologist-endocrinologist, 40 years of experience
Usually, a doctor for PCOS syndrome prescribes correct and adequate treatment. This pathology is always accompanied by metabolic disorders; it is these symptoms that are treated with the drug Metformin (Glucophage), since the drug is able to normalize hormonal levels in a woman’s body. For a regular menstrual cycle, Duphaston is also prescribed.
Relevance of the issue
PCOS is diagnosed if a woman’s condition includes two signs of this disease from the full list of features determined by doctors. Among the signs are excess androgen content in the body, polycystic disease, an-, oligovulation in the form of a chronicle. Among all other pathological conditions, it is PCOS that is most often identified when trying to determine why a woman has anovulatory infertility. This is especially true in developed countries. Typical clinical manifestations of this condition include irregular menstrual cycles, hirsutism, acne, hair loss, indicating increased levels of androgens in the body.
A connection between PCOS and two types of metabolic disorders has been revealed. In America, studies were organized involving young women. It has been found that in the case of the second type of diabetic disease, PCOS occurs on average 10 times more often than in those who do not suffer from diabetes. Reduced glucose tolerance, the second type of diabetic disease, often develops closer to the age of thirty. In the case of PCOS and excess weight, such consequences were found in 30-50% of the people studied by the age of 30.
Advantages and disadvantages
Metformin is used to treat many abnormal or inflammatory conditions of the female reproductive system.
Under the influence of the substance included in the drug, patients’ optimal body weight is stabilized and hormonal levels are normalized.
In addition, the effectiveness of the drug in the treatment of endocrinological diseases has been proven.
IMPORTANT!
Like all medications that affect the human hormonal and endocrine systems, Metformin has a fairly large list of contraindications, which requires its sale strictly according to a doctor’s prescription.
Research by doctors has confirmed the effectiveness of the drug Metformin for the treatment of infertility. The effect of the drug improves ovulation and promotes the onset of a long-awaited pregnancy in a woman, especially in combination with other drugs, but, unfortunately, does not affect the number of live births.
What is it about?
PCOS is one of the widespread “female” diseases. On average, almost every fifth woman during her reproductive period suffers from this pathological condition. Polycystic disease is classified as an endocrine disease. When it occurs, the functioning of the ovaries is impaired, primarily affecting the reproductive and endocrine functions of the body. Metformin, used during polycystic disease, can somewhat smooth out hormonal imbalances, since the pathology leads to inadequate concentrations of estrogen and progesterone in the body. If you have been diagnosed with PCOS, self-medication is not allowed. This is a serious disease that can cause infertility and diabetes. It is known that against the background of such a disease, the risk of malignant processes is higher.
Indications and instructions for use
The drug is available in the form of round, white-coated tablets containing 500 mg of the active substance, metformin hydrochloride, in each unit.
Since the drug is sold in pharmacies only with a doctor’s prescription, this only confirms the danger of its uncontrolled use.
The use of Metformin is one of the stages of complex treatment for PCOS. The drug is prescribed to normalize a woman’s hormonal levels, restore the natural ovulation cycle and achieve the desired pregnancy.
Also, the drug Metformin is intended to reduce the manifestations of hyperandrogenism and hyperinsulinemia characteristic of PCOS.
For the treatment of polycystic ovary syndrome, a daily three-time dose of the drug (500 mg 3 times a day) is prescribed before or during meals.
The tablets must be swallowed whole, without chewing and with a sufficient amount of liquid (preferably water).
It is unacceptable to use more than 1700 mg of the drug per day. The dosage and conditions for taking the drug are prescribed by the doctor individually for each woman, after a thorough medical examination and laboratory tests.
It is recommended to take Metformin for a fairly long time - more than 6 months, regularly monitoring the menstrual cycle and ovulation phases.
As a rule, six months is a sufficient period to restore the ovulatory cycle; if necessary, the drug treatment cycle is repeated after a short break.
Side effects and contraindications
Although the drug Metformin often does not cause serious problems or threats to the health of patients, it still has some side effects:
- gastrointestinal problems - the use of metformin causes increased gas formation, nausea, diarrhea and a feeling of discomfort;
- the drug causes disturbances in the absorption of vitamin B12 in the body , which provokes the development of anemia;
- under the influence of the drug in the body the level of amino acids increases and, as a result, the development of atherosclerosis;
- psychological disorders are caused by changes in hormone levels and manifest themselves in the form of sleep disorders, decreased libido, decreased performance and memory impairment;
- in some cases, patients may complain of allergic reactions - redness of the skin, swelling and itching.
NOTE!
An overdose of the drug can cause the development of quite serious and life-threatening conditions for a woman. In such cases, the drug is immediately stopped, the patient is prescribed hemodialysis and symptomatic therapy and only in a hospital setting!
The main contraindication to the use of the drug Metformin is the presence of infectious diseases in a woman, impaired renal and liver function, alcoholism and hypoxia.
Metformin should also not be taken if:
- diabetic coma and gangrene;
- pregnancy and during breastfeeding;
- after major surgical operations and for patients over 60 years of age.
Drug analogues
Drugs containing metformin are divided into two groups - immediate and slow release of the substance.
Immediate or normal release occurs when taking Metformin analogues such as:
- Glucophage;
- Siofor;
- Metfogamma;
- Gliformin.
Read here what other medications are prescribed for polycystic disease.
Slow-release agents, such as Glucophage XP or Long, are aimed at reducing the side effects of the drug on the gastrointestinal tract.
Additional restrictions
Do not use the product if you have lactic acidosis. The drug is prohibited for women who are pregnant or breastfeeding. Do not use Metformin for polycystic disease and other diseases if the pathology is detected in a minor. For girls under fifteen years of age, it is necessary to select other means that are safe and approved for this age group.
It is strictly prohibited to take a pharmaceutical product if the patient’s body is sensitive or susceptible to the main ingredient or other components used by the manufacturer. An allergic reaction, sensitization as a response to the components of the drug are conditions that exclude the possibility of treatment with it.
