Metformin is indicated for the treatment of diabetes and acts as in insulin sensitizing agent. Between 40%-70% of women with PCOS are insulin resistant which means that their bodies try to compensate by “overproducing” insulin. Insulin resistance can be detected by fasting serum levels of glucose and insulin.
High insulin levels produce excess male hormones by increasing androgen production by the ovaries leading to increased PCOS symptoms. Androgens are male hormones such as testosterone. High insulin levels also increase the production of LH by the pituitary gland. The high LH in turn leads to an even higher level of male hormones. In several recent studies, Metformin has demonstrated effectiveness in inducing ovulation in some women with polycystic ovarian syndrome by lowering both LH and male hormone levels.
PCOS is characterized by numerous small cysts on the ovaries and high levels of androgens which leads to excess body hair, a classic “pear shaped” body appearance” and anovulation.
Metformin reverses insulin resistance by sensitizing the cells to insulin thus lowering insulin levels, reducing androgen levels, and enabling ovulation. Metformin is usually administered at a dose of 500 mg three times daily (1,500 mg daily). It may be combined with Clomid if ovulation does not occur.
The most common side effects of Metformin are nausea and diarrhea.