Metformin Questions

[syntheticklust.livejournal.com]

I was diagnosed with PCOS on Thursay and I started Metformin on Thursday night. Is it normal for the side-effects to come and go? For those of you who have been on it, how long was it before you got your first period on the medication? Did it help with the cycle length?

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Comments

[geminigirl]

When I first started it, I found that the side effects did come and go a bit depending on what I ate. It took some time to figure out what my body's limits on the medication were.

My first cycle on Met was 28 days. After that they settled into 34 day cycles until I got pregnant with my first daughter. I had her, nursed her, (stayed on Met while pregnant and nursing both my kids) my period came back, I had two cycles total (so they never regulated again.) and then got pregnant again. I just had my first period in about two years last week and so it'll take a while before they get regular again unless I decide to try for another baby before that happens.

Some things that I've learned in four-ish years on Metformin that were never told to me when I first started is that in addition to making diet changes (lower carb or lower GI depending on what works for you, along with higher fiber and higher protein) fiber supplements are very important-they help with a lot of the gastrointestinal side effects from the medication (I like FiberCon, but there are a lot of options.) Also, vitamin B and calcium supplements-for some people, Metformin can affect the absorption, so supplementing appropriately may be important.

Good luck with it.

[syntheticklust.livejournal.com]

Thanks. I have cut out almost all soda ( which is very hard ) and am only drinking water. Which I have noticed has helped. Though we went out to eat today so I am sure it will kick my butt tomorrow. My doctor made it seem that I was going to have to be by a bathroom a lot of the time. I am just worried that the dosage is not enough.

[paraxeni.livejournal.com]

Not everyone gets the GI side effects. I did, but my partner never did.

With regard to your other query, it depends on a lot of things. Met isn't a cycle-regulating drug, it just addresses insulin resistance. So when your period resumes/normal cycling starts, very much depends on how severe your IR is, and what your body considers to be ideal conditions (in terms of weight, insulin levels, hormone levels/function) for cycles to resume.

ETA - dosages start small and are increased on the basis of need. Starting met at the maximum dose can be very dangerous, so usually people start on 500-1600mg per day, and the dose can be adjusted up to the max at the prescriber's discretion.

[geminigirl]

Although with PCOS, there seems to be evidence that even without IR, it can help with cycle regulation by interrupting the estrogen-testosterone cycles. I've had no IR with PCOS, been on Met for four years and other than the typical disruptions for pregnancy/nursing, I've been cycling regularly once I started Met.

[paraxeni.livejournal.com]

No, I know that, I'm well aware of the uses of drugs like metformin in PCOS management, - but metformin wasn't ever designed to act on the menstrual cycle, so there's no set of definite outcomes or effects. Some people get nothing out of metformin at all, be it regular or XR, high dose or low dose. Whether someone has insulin resistance or not doesn't change the fact that it's what metformin is designed to do - address insulin resistance. The Pill was designed to prevent pregnancy, that was it's sole purpose. Yes it can help with PMDD, skin problems etc. but HBC wasn't designed for that purpose.

The pill - you know that's going to always automatically override cycling, prevent pregnancy etc. because that's what it was designed specifically for.
Met doesn't have that advantage because although it can affect menstrual cycles, that wasn't it's original function. Sure there's some available data now (as opposed to 13 years ago when I started it) but there's always going to be more data available (or even just anecdotal evidence) when talking about the purpose a drug was designed for, rather than an off-label usage.

All I'm trying to point out is that there is no set guide to what happens when, unlike there is with drugs designed for cycle regulation/hormonal imbalances, her endo/gyno should've explained all of that.

[paraxeni.livejournal.com]

Also, because I've edited the other one enough (sorry, morphine) although my partner got perfect 29 day cycles for a while, that stopped and couldn't be brought back despite altering her dose/formulation/timing.

I got anything from 3 days to 103 days between bleeding, then lost too much weight and developed lactic acidosis. It was only when I stopped the metformin that my periods started again, and then stopped! It was a merry-go-round, to say the least. I miss it, in a way, but death wasn't welcome in my schedule so I had to junk the met :D

[geminigirl]

You didn't start the full dose all at once, right? You started at a low dose and are stepping it up? I found the first week at the lowest dose wasn't bad, but the second week was very tough. I don't recall what happened after that.

Some people find the extended release doesn't cause the bathroom effects that the regular does. Others find the opposite. I'm on the regular tablet-the extended release made me more ill. Sadly, I'm one of those people for whom the gastro side effects never went away, though they've slowed down and become manageable.

[syntheticklust.livejournal.com]

I wasn't told to start at a low dose. They started me out on 500mg 2x a day.

[paraxeni.livejournal.com]

Yeah, that's a typical low starting dose.

[thesmallonerae.livejournal.com]

best of luck...I have been taking 1500 mg daily with no stabilizing effect to my cycle.......

Also in my case the GI side effect have not subsided....

[paraxeni.livejournal.com]

They can be pretty horrible, poor you!

I just added a comment above to say that my partner had scarily perfect cycles for a while on 1500mg, then they vanished. No amount of tweaking doses/schedule/formulation helped. It just made me bleed really erratically, and vomit constantly, until I lost 84 pounds in a few weeks and nearly expired!

Good luck, I hope your luck changes.

[tigana33.livejournal.com]

It took me maybe three months to start having periods. I tend to get around 10 a year now, after three years on it. Plus clear skin finally, which was the bigger cosmetic issue of mine from PCOS. My IR has hopefully stabilized, but I do have some lingering gastro issues. I take 1500 IR a day

[syntheticklust.livejournal.com]

I had some spotting this morning. So I am hoping that AF is on its way.

[washable.livejournal.com]

I've been on Metformin for a year and had my dosage upped in October.

My period came as scheduled, but I am also on NuvaRing which has made it very regular. It's a typical 28 day cycle.

As for the side-effects, it's normal for them to come and go. If you are nauseous, I highly recommend taking your pills if you can. It helps coat the stomach. Also, try to stay away from fatty foods, etc.

[slice254.livejournal.com]

The extended release version of metformin can help ease the side effects a lot. I'm doing much better on that than I did on the other version.

[beautymask.livejournal.com]

i was on the extended release metformin which helped with my diarrhea issues (sorry if that's tmi haha!). it helped to be on a low carb diet as everyone has said but after awhile, i was able to eat more carbs and not have a problem with it.

my cycle was REALLY long in the beginning at about 60 days and then got shorter and shorter. i ovulated every other month