Metformin is also known as Glucophage. It is a medication commonly used to treat diabetes that works by improving the body’s sensitivity to insulin. This allows the pancreas to produce a lower amount of insulin to keep the blood sugar regulated. Metformin has been used for many years to treat diabetics, but only became popular for the treatment of infertility in the late 1990’s and early 2000’s. Metformin has also established itself as relatively safe in pregnancy and is considered a category B drug (a better rating than many other medications commonly used in pregnancy).
Metformin is used most frequently in the setting of polycystic ovarian syndrome or PCOS. In this setting, metformin helps to reduce the insulin that can interfere with the production of follicles. There are complex hormones that control the normal growth and maturation of follicles. When insulin is high as in the setting of insulin resistance or hyperinsulinemia, the follicles may not grow properly. This can lead to poor quality eggs and even interfere with ovulation.
Metformin alone has been show to improve fertility and increase a woman’s chances of getting pregnant and having a baby. This treatment is much more effective when combined with dietary changes that lower circulating insulin levels. Our doctors specialize in helping women overcome the challenges of insulin problems and polycystic ovarian syndrome (PCOS) using diet and metformin when necessary.
Metformin is a prescription medication that should be used only as prescribed. 30% of patients may experience nausea, diarrhea, and abdominal bloating. Starting low and building up to the desired dose over several weeks may alleviate these problems. A metallic taste during initial therapy is reported in 3% of patients. 1 in 33,000 people taking metformin develop a build up of lactic acid (lactic acidosis). While this is fatal in 50% of cases, it is not likely to occur in someone without impaired liver or kidney function. The risk of lactic acidosis in a young and healthy population has been estimated to occur in less than 1 in 250,000 patients. Symptoms include: weakness, unusual muscle pain, trouble breathing, stomach discomfort, feeling cold, dizzy or lightheaded, and suddenly developing a slow or irregular heart beat. All patients on metformin should follow up regularly with a physician familiar with metformin.