PCOS or polycystic ovarian syndrome is a complex condition that has a direct impact on the ovaries. This condition is considered complex due to the fact that there are some very particular appearances of the ovaries that give the condition its name, but these traits do not have to be present for a woman to be suffering from PCOS. Specifically, PCOS can impact the woman’s ability to become pregnant.
PCOS is a common cause for anovulation, a condition in which a woman’s body does not release eggs at all or on a regular basis causing irregular periods and difficulty conceiving. Polycystic ovarian syndrome is very common, affecting ten percent of all women between the ages of 15 and 50 making them infertile. For the population at large, PCOS affects twenty five percent of all women.
While PCOS makes getting pregnant difficult, there are a number of very good treatment options available. A rather newer treatment option that has been shown to be very effective is metformin. Metformin is a medication that typically has been used to treat and control diabetes. Metformin is effective in treating PCOS on its own, but not 100 percent of the time.
There are times when metformin is used in conjunction with other medications that treat PCOS such as clomid. This combination has been shown to be effective in helping those women that do not respond to metformin alone to ovulate. Should the combination of metformin and clomid not be effective, metformin can also be used in conjunction with letrozole, injectable FSH hormone, and in vitro fertilization.
There are side effects that are worth noting when using metformin to treat PCOS. Twenty five percent of women that use metformin experience some side effects such as: cramping, nausea, diarrhea and abdominal discomfort. While these side effects are not life threatening, they can become severe enough for a woman to stop using metformin.
If metformin is a treatment option for you, your doctor may order some lab work to make sure metformin is safe for you to use. These lab tests can include a fasting blood sugar and insulin levels, LH, FSH, DHEAS, testosterone, 17-OHP, TSH, kidney function and liver function as well as estradiol. These tests are important because some women may be insulin resistant and these tests can help determine that. Women that are insulin resistant should not take metformin.
There is also patient education that needs to be addressed before a woman takes metformin. For example, knowing when to have intercourse is important. Women will need to know the possibility of ovulating; this means regular intercourse is ideal to increase the chances of a woman becoming pregnant. Regular intercourse is defined as intercourse every two to three days. It is also important that the woman keep a menstrual calendar or journal. Keeping track of the days that there is bleeding and the days that she has intercourse.
Typically metformin will be prescribed at the dosage the woman can tolerate. For most women this is going to be a 500 mg tablet taken three times a day, this dose is built up to gradually. The starting dose is 500 mg once a day for the first week, the second week is 500 mg twice a day, and the third week is a 500 mg tablet three times a day. If taking metformin three times a day cannot be tolerated that woman will be kept on the twice daily regimen, noting that the most effective dose is 500 mg three times a day.