Metformin tablets are most commonly used to regulate blood glucose levels in people that have been diagnosed with type 2 diabetes, but they’re also often prescribed “off-label” to women that struggle with symptoms of polycystic ovary syndrome (PCOS).
Although metformin tablets aren’t licenced to treat PCOS in the UK, many studies have found that women with the condition benefit from treatment with the medication, and many doctors across the country prescribe it to help with reducing some of the symptoms of polycystic ovary syndrome.
Unfortunately, metformin tablets might not be suitable for everyone, despite how well it can manage conditions such as type 2 diabetes and PCOS. This is because it is a prescription medication that can affect the body and worsen certain medical problems. If you have any of the conditions listed below, you should avoid metformin until you’ve spoken to your own GP about whether or not it is safe for you to take:
- Allergy to metformin
- Liver problems
- Severely reduced kidney function
- Uncontrolled diabetes with severe hyperglycaemia, nausea, vomiting, diarrhoea, rapid weight loss, lactic acidosis or ketoacidosis
- Severe infection (especially of the bronchial system or kidney)
- Receiving treatment for acute heart failure
- Recent heart attack
- Severe problems with circulation
- Breathing difficulties
- Heavy drinker
- Due to have an iodine based contrast dye injection for a scan
- Due to have surgery
Metformin for PCOS
Metformin can help to ease many of the symptoms of PCOS and improve a woman’s quality of life if she finds that the condition causes her mental or physical distress.
When taken for PCOS, metformin can help to reduce hirsutism (facial hair), reduce androgen levels, improve fertility, regulate menstrual cycles, lower insulin and blood glucose levels (especially in women that also experience insulin resistance with their PCOS), reduce the risk of miscarriage, heart disease and high cholesterol, and may even help some women to lose weight.
Whilst this sounds like a lot for one medication, it’s all down to the way metformin works in the body and how it affects each individual.
Whilst metformin may help some women with PCOS to lose weight, it’s important to know that it isn’t a weight loss medication, and may not yield results for everyone. However, if you’re obese and struggling to lose weight due to your polycystic ovary syndrome, there are various weight loss medications that may be suitable for you. Some of these may be used in conjunction with metformin, but you should always ask your own GP for advice if you aren’t sure if a treatment is right for you. Weight loss in obese women has been proven to reduce some of the symptoms of PCOS in many cases, but it can often become a “catch 22” situation, as the condition itself makes it more difficult to reach and maintain a healthy weight.
Metformin is often given to women with polycystic ovary syndrome that are hoping to conceive but are having difficulty, due to the fact that it can help with regulating menstrual cycles, stimulate ovulation and improve fertility. Irregular periods and infertility are common symptoms of PCOS, but metformin may help with these if taken correctly.
How does metformin work?
Metformin primarily works by lowering blood glucose levels and increasing the body’s sensitivity to insulin. Because PCOS and type 2 diabetes are closely linked conditions, metformin works in a similar way, but often has other side effects in women who take it to help with polycystic ovary syndrome.
Women with this condition often experience insulin resistance – something that many people with type 2 diabetes also experience. This happens when the body can’t use insulin properly, so blood sugar levels are allowed to rise. Metformin combats this by reducing how much glucose is produced in the liver, and helps to make your body respond better to insulin, utilising it in a way that helps the cells in the body use glucose as energy. PCOS is a risk factor for type 2 diabetes, and taking metformin can help to control any pre-existing insulin resistance as well as delaying or preventing the development of diabetes.
Insulin also plays a part with other symptoms of PCOS. When insulin levels are high, it can affect the ovaries, causing higher than normal levels of androgens, or male sex hormones. When this happens, it can cause symptoms such as visible facial hair (hirsutism) and acne. As metformin improves the body’s response to insulin, it can also help to reduce facial hair and acne, which are also very common symptoms of polycystic ovary syndrome. A reduction in androgen levels can also explain how metformin can help with regulating menstrual cycles and encouraging ovulation – improving fertility in women that struggle to conceive without medical help.
Sometimes, metformin may not be enough to control your symptoms on its own, and your GP may suggest that you combine it with another medication depending on which symptoms are bothering you the most. For example, if you struggle with facial hair, metformin can take several months to make a difference, but when combined with other therapies for hirsutism such as Vaniqa (eflornithine cream) or spironolactone (if you aren’t trying to become pregnant), the problem can often improve within a shorter space of time.
Although weight loss isn’t guaranteed with metformin, a reduced appetite is listed as one of the most common side effects in the patient information leaflet, which may explain why some people that take the medication experience some reduction in weight.
Metformin’s only official use is to treat type 2 diabetes, but it is also commonly used to prevent this condition in people who are considered to be at risk of it. By using metformin as a preventative therapy, it can help people to regulate their blood glucose and insulin levels within a healthy level before they reach a point that would be considered a diabetic diagnosis.
In addition to this, metformin is also used off-label to treat a wide range of symptoms of PCOS, as we’ve already explored so far.
Currently, the use of metformin for other conditions is being investigated, but more research is needed before any decisions can be made on whether the treatment is safe for anything other than type 2 diabetes and PCOS.
Metformin side effects
Metformin is generally tolerated very well by most people that take it, but it’s still important to remember that it is a prescription medication that has the potential to cause side effects in some people. Some of the side effects of metformin are very common, and experienced by more than 1 in 10 people, but most of these are only temporary and subside within a few weeks once your body has adjusted to the medication.
Some of the most common side effects of metformin include:
Changes in taste
Abnormal liver function results
Redness of the skin
Low vitamin B12 levels
Most of the common side effects experienced with metformin are gastrointestinal, and may be solved with simple over-the-counter remedies if you find that they become a problem for you. However, most people find that these side effects are mild and subside within a few weeks of treatment.
If you notice that you’re still experiencing adverse effects to metformin after a month or so, you may be able to switch to slow-release metformin, which means that you only take the tablet once a day, but are less likely to experience any side effects from it.
If you do experience low vitamin B12 levels, your GP may suggest injections or supplements, but this is more common in people that use metformin for a long time and at high doses. It’s a good idea to be regularly monitored by your GP with annual blood tests to check that everything is alright.
You may be more likely to experience adverse effects of metformin if you’re also taking any treatments that have been known to interact with it. Because of this, if you’re taking any of the medications listed below, you should speak to your own GP first about whether or not you can take metformin, as some of your doses may need to be adjusted, or you might need extra monitoring:
Angiotensin II receptor antagonists
*unless also prescribed by your GP to use in conjunction with metformin.
Although there is a lack of licenced treatments for PCOS in the UK, there are various medications available that can help to relieve some of the symptoms of the condition. For example, if you struggle with hirsutism, you may benefit from using Vaniqa cream on your face to slow down hair growth over time. If you experience irregular periods, many women with PCOS find that the contraceptive pill can help to regulate them and even reduce some pain and bleeding associated with PCOS menstrual cycles. Obesity and weight gain are also common in this condition, and weight loss medications are available to those that struggle to lose weight through diet and exercise alone, though these shouldn’t be used as a substitute for a healthy lifestyle.
PCOS treatments generally tend to manage the symptoms rather than the condition, but if you find that your symptoms are still problematic whilst taking medication for them, you should make an appointment to speak to your GP about other options that might be available for you.
Buy metformin UK
You can now buy metformin within the UK from Doctor4U. Our online service provides consultations for metformin for both PCOS and type 2 diabetes. All you need to do is answer a few consultation questions about your symptoms and treatment so that our GMC doctors can review them to decide whether it’s safe for you or not. If they approve your request, they will generate a prescription which will be dispensed and shipped from our UK-based partner pharmacy.
It’s fast, safe and simple to buy metformin online in the UK, and as we’re online, you can complete your consultation and order your treatment at a time and place that’s best for you.
To buy metformin, please click the button at the top of the page to answer some questions about your condition. If you’re buying metformin to treat PCOS, you should be aware that it is used off-label. For more information about off-label prescribing, please click here