Metformin for PCOS
Glucophage (metformin)
Metformin is an insulin sensitizing drug originally used to treat diabetes. It has recently been used successfully in establishing ovulation in
polycystic ovarian syndrome (PCOS) patients. PCOS is common and over 20% of infertile women have the syndrome. It is characterized by elevated male hormone levels,
irregular (or absent) ovulation, obesity, and hyperinsulinemia (elevated insulin levels).
One characteristic of
PCOS patients is that they are often insulin resistant. This means that their bodies do not respond to “normal” amounts of insulin because the cells are “resistant” which then leads to over production of insulin. When insulin levels are consistently elevated, the ovaries overproduce androgens (testosterone) leading to the symptoms of PCOS, including ovulatory disorders.
Metformin “sensitizes” the cells to insulin causing a reduction in insulin levels and therefore reduced androgens. Once androgen levels are normalized, ovulation can occur. Metformin is dosed at 1500 mg total daily.
Clomid or
FSH may be added if ovulation is not established.