Insulin-Sensitizing Drugs

If a woman with PCOS is above ideal weight, most physicians will first recommend diet changes, exercise and possibly weight loss. However, insulin-sensitizing or insulin-lowering medications may be used in certain situations as well. Reducing insulin resistance with these medications can help improve ovulation and reduce the levels of androgens in many women with PCOS. The effects of these medications on hair growth and weight are generally small.

There are very few studies showing the results of these medications in women with PCOS.

Before you're placed on an insulin-lowering drug, ask your doctor about how diet and exercise can help your body use insulin more efficiently. Insulin-sensitizing drugs have not been proven safe for pregnant women, so if you are trying to get pregnant, you should also discuss these issues with your doctor.

Metformin

One such drug being used by some women with PCOS is Metformin. Traditionally a drug for people with diabetes, it is also used to lower the levels of insulin of women with PCOS. Metformin has been used in combination with fertility drugs to restore ovulation for women who were previously resistant to those fertility agents. It has been shown to reduce insulin resistance and levels of male hormones in women with PCOS. In individuals with impaired glucose tolerance (“borderline diabetes”), Metformin has been shown to prevent or delay the onset of diabetes. It may have a similar benefit for women with PCOS and impaired glucose tolerance.

Metformin may cause gastrointestinal upset and loose stools or more frequent bowel movements. This is likely the reason for the modest weight loss sometimes associated with Metformin. Lactic acidosis, a rare but potentially fatal condition, has been associated with Metformin use. Talk to your doctor if you are considering taking this medication.