PCOS Questions - Metformin & HSG
I am new to all this so please bear with me. I have a few questions and I?m hoping you guys can help!
I have PCOS and have been working with my dr. about fertility issues. Monday she put me on Metformin. Can someone please explain Metformin to me?really why am I on it from a medical standpoint. These are just some of my questions:
-is it just trying to get some of my crazy levels back to normal?
-Is it going to help me actually get my period?
-Before I went to my gynecologist, my regular family dr said she may put me on Metformin to help with fertility before trying Clomid, do you guys know if Metformin has any fertility impacts?)
My mind was going so fast when I was at my appt that I didn?t get to ask all the questions I wanted to. I feel stupid now for not asking but everything she was saying was a lot to take in and process and then ask questions.
Second, she wants me to have the HSG test. They called to schedule it and said it has to be 7-10 days after the first day of your period. That?s great but I rarely get my period anymore. The scheduler talked to my dr. and she said I can wait 2 months to see if I get it on my own and if I don?t, she will give me a medicine to induce my period. Or I can go ahead and take that medicine now so I get my period and we can get the test done. I don?t know what the medicine is as I wasn?t talking directly to the dr on this. Does anyone know anything about this? We may go down the route of medicine right away to induce so we can keep moving on this process but I don?t want to take unnecessary risks.
I know I can call my dr. with all these questions but I also would appreciate any feedback from personal experiences. Also you guys will probably respond back to me quicker than my dr will! I hope this all makes sense!
Re: PCOS Questions - Metformin & HSG
I think you have some really good questions. I will see if I can answer a few of them.
Metformin is an insulin sensitizing agent. It works to try to get your body's cells to use insulin better to break down glucose. I think this may still be a theory- but in IR, women's cells require more insulin to break down the glucose. Apparently, your ovaries are much more sensitive to the insulin than the other cells of the body- and thus it causes an imbalance that seems to lead to the other hormone imbalances- and the cystic ovaries. The idea is to get your body to use the insulin more efficiently- and hopefully allow your ovaries to not have to deal with the overwhelming levels of insulin.
It may or may not allow you to get your period. It may or may not get you to ovulate. I have been on it since November- and this is the first cycle at the highest therapeutic dose. I did ovulate- but I was also on an infertility drug- Clomid- so it could be a combination, or one or the other...
Metformin has some crazy side effects- so start slowly.
As for using a drug to induce a period- you can start it now (probably Provera)- and start over now- or wait the 2 months to see if you start on your own.
I don't ever ovulate on my own, and never get a period on my own. My longest cycle was 97 days, and it would have been longer- but I used Provera to end it.
One risk of the Provera is if you are already pregnant- it can cause birth defects- but other than that, it is pretty safe, although the hot flashes are pretty intense.
Good luck on whatever you decide and feel free to ask more questions!
I've been on metformin for years. I have insulin resistant PCOS, which basically means my body doesn't use insulin effectively which means I had issues ovulating. It is actually a diabetes medication that helps your body use insulin 'better' and can help balance things out. It does take some getting used to, and diet changes are a MUST, but for me it keeps my cycles regular and I ovulate each month now (more below on that). Get the extended release version as well, it's easier on the tummy.
My doc started me on metformin and wanted me on that 6 months before starting clomid, which is used in MANY women but requires a lot more monitoring. I hadn't had a period on my own at all after coming off BCPs in 2005. Your doc was probably going to give you provera to 'induce' a cycle. I've taken it many times, it's very widely used as well. I've never had any issues with provera at all.
For me now, metformin is enough to regulate my cycle. It is not the case for everyone though. I will say that having 2 kids also seems to have 'helped' things, I'm more regular now than I've ever been in my life and the other symptoms are better as well. But I still have to follow my gestational diabetes diet, etc to keep things in balance.
I hope this helps! I was in your shoes 6 years ago and I know how overwhelming and scary it can all be.
Metformin is used if you have insulin resistance. If this is the case, it can help regulate your levels and bring on normal cycles, however you should go in for a glucose tolerance test to really know for sure if this is an issue. Many women have PCOS without insulin resistance, so metformin would not help in this case.
The drug they give most women to induce a period is either Provera or Prometrium. You will want to do a blood test to rule out pregnancy before starting either of these. If you aren't pregnant, you take them for 10 days and get your period shortly after.
Before starting any meds, I would highly recommend scheduling an appt. with an RE. They will be able to make sure you get all the necessary tests done before starting any meds, and they will monitor you while on the meds to ensure you don't have any nasty side effects.
Good luck!
TTC since 2010
lots of IUIs and 1 IVF all BFNs
FET currently on hold
Metformin is a drug used to treat Type 2 diabetes. It is often prescribed for women with PCOS because they are insulin resistant (meaning their insulin levels are too high). Insulin is considered one of the major body hormones and Estrogen and Progesterone are considered minor hormones, if your major hormone "insulin" is out of whack it messes with your other "minor" hormones, it can also cause your body to over produce the "male" hormones, all of this adds up to sporadic or non-existent ovulation and periods. Metformin is used to treat the insulin resistance and help bring your insulin levels down so that your other hormones can balance out and in many women this helps to regulate their cycle and helps them to ovulate. I have been on this for about 6 weeks now.
HSG test is where they insert contrast material through your cervix so they can x-ray your uterus and tubes to make sure everything is shaped normally and you don't have any blockage in your tubes. This can be painful (mine was pretty painful, but others have reported it was more like bad menstrual cramps).
The medicine they will give you would probably be an oral progesterone pill (can't remember the name right now) that you will take for 14 days, then when you stop, the drop in progesterone levels will bring on your period.
Thank you to all your responses! I can't tell you how much I appreciate it.
Any of you run into your insurance not covering the HSG? Any ballparks on the cost? I have no idea what to expect for the cost and I am one who will be much more at ease with it if I know before getting the bill! In the end, the cost will be worth it!!
My HSG was a while ago but I think the mine was around $1200 (this was in a hospital radiology department), but my insurance did cover it and the discounted insurance cost ended up being around $500 or $600. I did have to pay my $250 deductible before insurance paid anything.