PCOS without cysts or insulin resistance?

July 16, 2008

Hi All,

I have a question about the use of Metformin to treat suspected PCOS *without* insulin resistance.

I have twice been told that I probably have PCOS (once about 5 years ago and again just recently), but both times when tested I have not been insulin resistant or had elevated androgens or had any cysts on my ovaries.

I am 33 years old, not obese (5'8 and 155 lbs), but I have always had extremely irregular cycles (in the last year from 29 days to 75 days) and since a miscarriage last year I have been unable to conceive and have had anywhere from a few days to a few weeks of spotting or light bleeding in the middle of every cycle.

I also have a bit of adult acne and heavier/darker hair growth than many women, but I am of Mediterranean descent and I am not significantly hairier than other women of the same ethnicity.

So my current doc has prescribed Metformin and Clomid. The Clomid I understand, but why Metformin if I am not insulin resistant and have only one definite symptom (irregular cycles) of PCOS?

Pretty much everything else has been ruled out - thyroid is normal and I don't have any polyps or fibroids - so I get the feeling my doc is just trying to treat *something* because she doesn't really know what is going on.

Is this really a good idea or are there potential risks to taking Metformin if I am not insulin resistant?

Thanks in advance for any guidance you can offer!

July 16, 2008

Recently, fertility opinion is swinging in the direction your mentioning, that outside of insulin resistance, metformin may not necessarily be a good choice to take on it's own or with Clomid for ovulation induction/ttc...

This is only in the last few months these thoughts have been published, but prior to this, the treatment Rx was the mainstay and would talkto your doc more about this

July 23, 2008

Minna,

Your situation sounds exactly like mine. Doc told me he thought I had PCOS but I am not insulin resistant and there has been no detection of cysts on my ovaries. Also, I am 5'3", weigh 112 lbs, and exercise regularly. The only thing that I have that may indicate PCOS is darker body hair (I, too, have some middle-eastern decent) and I have started to get mild acne (mostly on my forehead) since I stopped taking the pill 2 years ago. But that's really all--aside from periods every 36-45 days)

I was prescribed Metformin also. I took 4 rounds of Clomid alone (no ovulation) and then this last cycle my doc had me take Metformin, too. I have taken it for a little over a month. The first 2 weeks were horrible. I was nauseous all day long. I did some online research to see why Metformin is prescribed and I got really mad and called my doc and asked why he put me on the meds if I wasn't insulin resistant!!! He said that studies show that Metformin works in conjunction with Clomid regardless if you are insulin resistant or not. I don't know if that is true--I still did not ovulate on this cycle.

I have an appointment with my RE on Monday and plan on telling him that I am not up for taking the Metformin anymore. I would like to move toward injectables since Clomid has not worked for 5 cycles.