Calling metformin users.........over here please!

[GiraffeAHolic]

Bit of background, diagnosed with PCOS about three years ago. Quite bad; hirutism, weight instability, no ovulation, 100+ day cycles.

Concieved dd by some soft of fluke

anyway, fast forward to now. TTC again with no success, PCOS symptoms worse than ever

saw gp and he has prescribed metformin (well I asked for it to be more precise!) 500mg a day for a week then up to 1000mg a day.

I've read that it is best to follow a low carb diet while taking metformin is this true in anyone experience?

If so any clues on what to put on shopping list (I'm a pasta and toast person, which are obviously not appropriate)??

Are the side effects bad? I have only one last night and suffered with nausea most of the night

I know the official line is to completely avoid alcohol while on it. I have my hen night in three weeks and obviously my wedding after that. I would like to be able to have a drink on my hen night (first night out in 2.5 years), would it be ok if I just missed the previous days tablets?

And finally....does it work? has anyone successfully used it to control PCOS symptoms/resume ovulation?

Nobody?

Hi Giraffe

I have PCOS too, though my symptoms are not always as severe as you describe. I had a miscarriage in Jan 2009, but I am now 17wks after conceiving on Metformin and staying on it for the first 12 wks. Will try to answer some of your questions from my experience.

Firstly, your dose sounds a bit low - I was put on 1500mg a day by an Endocrinologist who I saw privately. I think the more you weigh, the more you need to take - and I'm a thin PCOS, had a BMI of about 21 when I started it (- which rapidly dropped almost into the underweight range while on the Met - so if you are looking to control your weight the Met may help with that)

It's good that you are building up the dose gradually as that helps with the side effects. I had quite bad side effects - nausea, upset tummy, fatigue and lack of appetite, esp after going up to the higher dose, but they did gradually ease over a period of about 4 weeks, so I would recommend sticking with it even if it's rough going at first. It's supposed to help if you take the pill bang in the middle of your meal, rather than after or before food.

Re: alcohol - officially avoid, but in practice you can follow this quite loosely. I did have a glass of wine at least once a week. Any more than that and I really felt it. If you want to enjoy a big night out I'd miss your evening dose of the Met.

Now, diet. Metformin is thought to be more effective if you follow a low GI diet, low carb probably even better (but not those silly no carb, Atkins style diets), and do regular moderate exercise. Some women say if they eat too much sugar / refined carbs it makes the Met's side effects worse, but I didn't really notice this to be honest.

For your shopping list - I have found 2 books on low GI diet useful, one by Jenny Brand Miller and one by Rick Gallop (search on Amazon) - they go over the basic principles and have recipes. So, eg. pasta is actually ok, but a) cook it al dente, b) only eat about a quarter of a plate and fill the rest of your plate with fresh veggies/salad and c) have some protein with it. Same with toast - you can have it, but stick to wholemeal, don't eat too much at once and if possible have with protein, eg. peanut butter.

I stuck to this quite strictly at first and a bit more loosely later on. My cycle had gone totally awol and it came back quickly on the Met, BUT I can never be sure if it was the Met that caused this, as I used to have semi-regular cycles (before my miscarriage) anyway. I decided it was worth it to improve my chances of conceiving a sticky one, which I seem to have done now...

If you want to chat to more ladies taking Metformin for PCOS you will meet lots of them on the Verity discussion board.

Sorry that was a long one but no-one else had responded so I hope that helps some...

I echo what 2ndDestiny says. I've been on 3x500mg per day for a while now and lower doses didn't work for me (though they do for some women, so don't write off a lower dose until you've given it a while).

Initially I had a few "loose motions" while starting on it, and when I go to a hot climate I sometimes get tummy aches too, but these go away and I find I can tolerate it well. Build up your dose gradually to minimise the tummy problems. IMHO it does suppress your appetite quite a bit - I certainly lost weight on it. I am practically repelled by salad on it too, for some reason but don't find starchy or sweet things an issue at all.

Where possible I try to severely limit my alcohol intake because of the packet instructions, but you will be fine to have a glass or two every so often. If you want a big night, probably as well to skip the tablets for that day but I have actually never had a particular problem with drinking and taking met.

Good luck with it and your wedding - hope you get lucky on honeymoon!

Thank you both for your responses.

My BMI is now at 24 so within the ideal range, I am hoping the metformin along with a diet will help me lose some more weight.

I did look at low GI but I also suffer from IBS and some of the menu ideas were full of stuff that sets it off so I thought a low carb diet might work with both conditiions.

I've taken the advice to take the tablet half way thru a meal and fingers crossed no sinister side effects yet

congratulations and good luck with your sticky bean 2ndDestiny it's nice to hear that the medication has worked for someone, also interesting that you took it for the first 12 weeks. Official advice seems to be to stop taking if you concieve but there seems to be a higher miscarriage rate if you do stop.

Hi again Giraffe

The 'official' advice is actually highly contested. I was advised by my Endocrinologist to keep on taking it, there's no evidence of it harming the unborn baby in any way but as you say, there IS evidence that it reduces the mc risk, so it seemed worth it to me, although many doctors disagree because they worry that no large scale control studies have been done on metformin use in pregnancy. It is more widely used in pregnancy in the US than here.

Anyway I hope the metformin helps to sort out your cycle and that the side effects are all gone in time for your wedding!