PCOS and Metformin: Improving pregnancy outcomes

Tamara HunterBlog

PCOS is thought to be the main cause of infertility. The diabetes medication metformin is one way to treat the symptoms of PCOS and help to improve the chances of a healthy pregnancy

Understanding PCOS and how to manage it

A distressing and all-too-common condition affecting women of reproductive age is an endocrine disorder called polycystic ovary syndrome (PCOS). The cause of PCOS is abnormally high male sex hormones, known as androgens. I see many young women in my practice with this distressing disorder. It can affect your menstrual cycle, lead to weight gain and excess fat around your waist, abnormal facial and body hair, and acne. There has been a lot of research into how best to treat PCOS, especially during pregnancy, including with metformin, a treatment for type 2 diabetes. How exactly does metformin and pregnancy go together?

metformin

What do you do if you have PCOS?

My approach to PCOS and fertility issues is to first begin with lifestyle management, including diet and exercise to control your weight, as well as managing sleep deprivation and helping you kick habits that can exacerbate your PCOS, such as your sugar intake. Another treatment can involve ovulation-inducing drugs. In some cases, I will also prescribe the diabetes drug metformin to improve your chances of ovulation and falling pregnant.

Metformin in pregnancy has had proven results when it comes to managing women with PCOS. The reason for this is that metformin relieves insulin resistance and PCOS is associated with insulin resistance. Often patients with PCOS develop other conditions, including diabetes, pregnancy induced high blood pressure, miscarriage, or premature delivery, so managing your symptoms is crucial for a healthy pregnancy.

When should metformin be used to help with pregnancy?

Studies into the effects of metformin and pregnancy have found that the drug has limited benefits when prescribed initially in the first trimester. However, women who are prescribed metformin before conceiving and through the majority of their pregnancy had fewer complications, such as gestational diabetes and gestational hypertension. It’s also thought that use of metformin in pregnancy may reduce the risk of early miscarriage (Effects of metformin use in pregnant patients with polycystic ovary syndrome, Kumar P and Khan K, J Hum Reprod Sci, 2012)

Working towards a successful pregnancy with PCOS

If you have PCOS, it’s important to get your condition under control before you try to fall pregnant. Aside from helping you to manage lifestyle-related issues, I will discuss metformin and pregnancy with you. Metformin is generally thought to be safe during pregnancy and may well help you to conceive, have a healthy pregnancy, and reduce the risk of an underweight or overweight baby (Kumar et al).

There are many ways that I can help you get your PCOS under control, address your fertility issues, and safely fall pregnant. For example, I will generally prescribe metformin to women with PCOS who are going through ovulation induction or IVF. Metformin before and during pregnancy for women with PCOS is a helpful aid in pregnancy, but just one step in returning you to good health.

Video: Little known facts about PCOS

Useful links

Read about other Fertility related problems and other challenges on your fertility journey that I can assist with.