Endocrinologists, gynecologists, and weight management specialists at CLS Health work collaboratively to address every aspect of your health—hormones, metabolism, fertility, and emotional well-being. Some patients use it in combination with other treatments for enhanced results. PCOS interferes with how your body uses insulin—the hormone that regulates blood sugar. Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions affecting women. Metformin treatment in women with PCOS throughout pregnancy could increase the possibility of term delivery, VD and reduce the risk of EPL, preterm labor, pregnancy complications such as GDM and PIH, with no serious side effects.The time it takes to see weight loss results with Metformin can vary from person to person.The longest prospective study lasted 4 years and reported initial weight reduction in the first year followed by stabilization of weight along 4 years, particularly in women with BMI over 25 kg/m2 .Data suggest that orlistat promotes a significant reduction in BMI/weight in overweight/obese PCOS women.Prospective studies investigating the impact of metformin on T2D risk specifically in women with PCOS are lacking (6).In the COM group, 7 patients (16.67%) had a history of one live birth, and 2 patients (4.76%) had experienced two or more live births.If gastrointestinal side effects make oral metformin difficult to tolerate, consider alternatives like topical metformin. The lack of information on improvements in free testosterone and SHBG which represent directly the androgen activity of the whole body should be addressed in future studies. It is noteworthy that previous studies investigating combination therapy of liraglutide and metformin did not show more frequent cases of nausea or vomiting than studies of liraglutide only (47). Treatment with GLP-RAs and metformin frequently results in gastrointestinal adverse effects including nausea, vomiting, and diarrhea. Therefore, a long-term study is required to further assess the effectiveness of beinaglutide combined with metformin in lipid metabolism. This difference was likely due to no lifestyle intervention in that study and different metformin dosages. Additionally, by improving insulin sensitivity, Metformin can help reduce the fat stored in the body, particularly around the abdomen. In this article, we will explore how Metformin works, its impact on weight, and its role in managing PCOS symptoms. One of the potential benefits of Metformin that has garnered interest is its effect on weight loss. For many women, this approach offers a more manageable and effective way to address PCOS symptoms over time. If you're looking into PCOS treatment options, it’s worth discussing this with your healthcare provider. Five (42%) of these women had normal glucose tolerance after 3 months of treatment (one on MET, three on LIRA, and one on the COMBI).It also depletes the body of vitamin B 12, which is really important.Secondly, the duration of follow up is short and further changes in endocrine and metabolic parameters are expected over time in chronic metabolic disease like PCOS.For this reason, birth control pills that contain a low-androgenic progestin that does not activate these side effects are more effective at treating the symptoms of PCOS.9Multicollinearity diagnosis for glucose, insulin and IR, excluded them from the model.Vitamin B12 deficiency is another possible side effect of long-term metformin use. Metformin is a common treatment option for PCOS in overweight individuals. Other more rare, but serious side effects of metformin include issues with B12 absorption and lactic acidosis. To avoid severe side effects your doctor will gradually administer metformin and slowly increase your dose based on the severity of side effects. Comparison of characteristics of patients in short-term (ST) group at baseline and after 6 months of withdrawal Androstenedione was measured by specific double antibody RIA using 125 I-labeled hormones (Diagnostic Systems Laboratories, Webster, Tx). At the entry point and at the end of the study they completed The Three-Factor Eating Questionnaire-R18 (TFEQ-R18) for assessment of eating behavior . Prior to inclusion, short-term (ST) group had been treated with metformin for 1 year (1.03 ± 0.13 years), long-term (LT) group continuously for at least 3 years (5.07 ± 2.52 years). Adherence to metformin in preinclusion period was checked by patient’s self-report. In both groups, a remarkable improvement in HRQOL was reported with regard to aspects of PF, RP, GH, VT, and PCS in participants who had lost ≥ 5% of their initial weight. Furthermore, at baseline, women participating in that trial had high scores of HRQOL so there was little room for enhancement . This study has some limitations; the participants were not blinded to the endpoint of the research so there is a risk of over-reporting of HRQOL measures. This effect can help individuals with PCOS consume fewer calories and make healthier food choices, supporting weight loss efforts and improving overall metabolic function. By targeting insulin resistance, Metformin indirectly aids in weight loss for individuals with PCOS. However, it has garnered attention as a potential solution for weight loss in women with polycystic ovary syndrome (PCOS). The combination of hormonal imbalances, insulin resistance, and metabolic changes in PCOS can make weight management more challenging for affected individuals. Obesity-related dyslipidemia combined with altered insulin release in adolescents with PCOS illustrates the tight interconnection between metabolic and hormonal disruptions . Furthermore, patients showed improvements in clinical hyperandrogenism and reductions in ovarian volume. Metformin responders showed a ≥ 20% decrease in the insulin area under the curve values post-treatment. Metformin further levels the bioavailability and biological activity of insulin-mediated IGF-I, thereby mitigating its pro-androgenic effects on theca cells. However, hyperinsulinism and insulin resistance amplify intra‐ovarian hyperandrogenism and induce excessive early follicular growth, ultimately resulting in follicular arrest in women with PCOS . At the cellular level, metformin acts on hepatic mitochondria and inhibits mitochondrial respiratory chain complex I, leading to a reduction in intracellular adenosine triphosphate (ATP) synthesis and concomitant rise in cellular levels of adenosine monophosphate (AMP) . If you are struggling with PCOS weight loss, a provider on Sesame may be able to help. A diet that meets many of these nutritional needs for weight loss is the Mediterranean diet. This resistance makes it hard for your body to move sugar out of your blood, which leads to high blood sugar levels. Insulin is a hormone that helps your body convert glucose (from food) into energy. Moreover, hyperandrogenism is central to the presentation in adolescents, while there may be no consistent phenotype in postmenopausal women . Also, depending on the presentation, other disorders such as acromegaly, androgen-secreting tumors, primary ovarian insufficiency, and Cushing’s syndrome should be excluded before confirming a PCOS diagnosis . Polycystic ovary syndrome (PCOS) is a complex disorder of ovarian dysfunction, but it may seem to be a relatively simple clinical condition. However, more research is needed to reveal the clinical complexity of PCOS and develop more effective treatment options. Following randomization, the patients were treated with either 1.2 mg LIRA alone or 1.2 mg LIRA combined with metformin for 12 week; the COMBO group lost on average 6.5 kg compared with 3.8-kg loss in the LIRA group (12). When compared with orlistat, only higher doses of 2.4 and 3.0 mg were significantly more effective in reducing body weight. In a multicenter, placebo-controlled 20 week trial, treatment with LIRA led to dose-dependent weight loss that was significantly greater than that achieved with placebo at all doses (9). What percentage of women with PCOS are affected by insulin resistance? To define PCOS, 11 studies used the revised 2003 consensus diagnostic criteria, 1 study applied the 1990 National Institutes of Health criteria and another study employed the Rotterdam criteria (1996).Women taking oral contraceptives and spironolactone were not excluded from the study as a considerable number of women with PCOS receive these medications as part of their routine medical care.Its cost/benefit as a fertility treatment is also tenuous given the alternatives.In addition, women with PCOS who also had the metabolic syndrome at baseline seemed to derive more metabolic benefits from metformin.It varies from person to person, and researchers are still trying to understand the method of action that allows metformin to alter the gut microbiome in the first place.The main inclusion requirement also included no therapy that impairs ovarian or insulin sensitivity throughout the first three months of the study.When there is too much glucose in the blood, the pancreas sends a message to the liver and tells it to stop producing more glucose. Only 11.2% of Cysters taking metformin see improvements in their weight, ovulation, and pregnancy. Truthfully, I don’t think metformin is the best treatment option for PCOS longterm. These added symptoms can make you feel like you are spinning wheels with your PCOS healing process, almost as if you’re trading one set of side effects for another! Metformin also helps manage appetite and reduce food cravings, which are common challenges for women with PCOS. This combination has the potential to ease symptoms such as hormonal imbalances, acne, and unwanted hair growth, offering a more holistic approach to managing PCOS. Oana Health’s treatments are designed with your specific needs in mind, using science-based methods to complement dietary adjustments. For those seeking extra guidance, Oana Health provides personalized, science-driven support for managing PCOS symptoms. For a plan tailored to your specific needs, it’s always a good idea to consult with a healthcare provider, like the experts at Oana Health. By improving insulin regulation, reducing inflammation, and supporting muscle development, they can have a profound impact on managing PCOS. These diets focus on addressing the underlying causes of androgen excess rather than just masking the symptoms. High-protein diets can play a significant role in helping women with PCOS achieve better hormonal balance. The differences between time intervals (baseline, 3 months) were analyzed with the multilevel analysis (linear mixed model), by which method the variance of the dependable variables is analyzed on multiple hierarchical levels (between different arms – COMBI, LIRA, and MET). Homeostasis model assessment of insulin resistance (HOMAIR) score calculation was applied as a measure for IR. They were also instructed to report any side effects during the treatment. According to American Diabetes Association criteria, hypoglycemia was defined as symptoms suggestive of low blood glucose confirmed by self-monitored blood glucose measurement below 3.9 mmol/l (17). All patients were provided with glucose-monitoring devices, medication supplies, and educated on their use. Lower insulin levels help decrease androgen production, restore regular ovulation, and improve menstrual cycles. When cells become more sensitive to insulin, the body produces less of it, reducing the overstimulation of the ovaries. For instance, Victoria A., a patient with Oana Health, reported better metabolism and reduced hair growth after focusing on improving her insulin levels . With less SHBG, active testosterone levels rise, intensifying symptoms such as acne, unwanted facial hair, and hair thinning. Nutrition, exercise and medication options for PCOS weight loss The molecular mechanism underlying the efficacy of lifestyle interventions and its effects was recently explained in a rodent model study . Early initiation of exercise alone, or in combination with dietary energy restrictions, helps in improving reproductive and metabolic indicators in women with PCOS and obesity 1,6. The Endocrine Society clinical practice guidelines suggest the use of exercise therapy along with diet modification as the first-line treatment to manage obesity in adolescents and women with PCOS . This can increase the risk of acute myocardial infarction and stroke in overweight women with PCOS . About 70% of women with PCOS face menstrual problems due to not ovulating. These come from a hormonal imbalance, mainly with insulin and androgens. Common signs include irregular menstrual cycles, too much hair, acne, and gaining weight. This condition brings many symptoms that can really change one’s life. Polycystic Ovary Syndrome (PCOS) affects 5-15% of women of childbearing age. Research shows that up to 80% of women with PCOS experience insulin resistance, and metformin can help by lowering fasting insulin levels, leading to an average weight loss of about 5.8%. Interestingly, a recent randomized controlled trial, done on 100 women with GDM who did not attain euglycemia with diet, were randomized to receive therapy with insulin or oral metformin concluded that metformin was better suited than insulin for prevention of fetal macrosomia, especially in lean or in moderately overweight women developing GDM in late gestation, and insulin was preferred therapy for women with considerable obesity, high fasting blood glucose levels and an early need for pharmacological treatment. This study aimed to evaluate metformin treatment’s immediate and long-term efficacy in adolescent patients with polycystic ovary syndrome (PCOS) and hyperinsulinemia and the subsequent metabolic evolution post-treatment discontinuation. From the data collected from 159 women, there was evidence that metformin had beneficial effects on body weight and glucose homeostasis, plus improved androgen levels and menstrual regularity. One study went on to report that many women seeking to become pregnant naturally conceived after the restoration of their menstrual cycle. Most studies found that most patients were successful in achieving a significantly lower BMI about 12 months after their bariatric surgery. As part of your weight loss plan, you will receive support from a team of professionals that will help monitor your progress, make adjustments if necessary, and keep you on track. The Batash Endoscopic Weight Loss Center in NYC can create a customized weight loss plan that considers your PCOS diagnosis. One of the most challenging aspects of managing PCOS is the difficulty in losing weight. Stay on top of latest health news from Harvard Medical School. 25 Gut Health Hacks is yours absolutely FREE when you sign up to receive health information from Harvard Medical School. Get the latest in health news delivered to your inbox! Regarding further pregnancy outcomes, our data documented a cumulative low rate of early spontaneous abortion, hypertensive disorders, and preterm birth in comparison with those reported in the literature describing PCOS patients not treated with metformin. The close longitudinal monitoring of patients was also the background for a novel result from our study, the high rate of GD diagnosis in an early phase of pregnancy. This could imply that the putative efficacy of metformin in preventing GD could be amplified by an ultimate overestimation of the PCOS diagnosis and, therefore, of the metabolic risk among participants. It is also noteworthy that previous studies in this field are often retrospective and multicentric, and, in most of them, diagnostic tests were managed and assessed in collaboration with personal obstetricians of the patients. And it sometimes helps people with diabetes lose excess weight. For decades we've known that metformin does more than just help lower blood sugar in people with diabetes. Metformin was rediscovered decades later and approved as a treatment for diabetes in Europe in the 1950s. Metformin helps reduce liver glucose production, while myo-inositol enhances insulin signaling. Combining metformin with myo-inositol offers a targeted way to manage PCOS, addressing both metabolic and reproductive challenges. Patients with kidney issues, liver disease, or a history of lactic acidosis should work closely with their healthcare provider to evaluate whether metformin is appropriate. Below, we explore strategies to manage metformin’s side effects and examine the safety of myo-inositol. Sustainable lifestyle changes not only enhance the benefits of metformin and myo-inositol but also lower cardiovascular risks and promote overall health. When your body isn’t storing sugar as fat and you finally kick cravings to the curb, losing weight becomes much easier. As blood sugar levels balance, you’ll probably see relief from symptoms like fatigue, intense cravings, frequent urination, and yeast infections. This is because your body is actually able to process glucose into energy, rather than storing it as fat. And then just continue living your life, according to whatever CS, you know, whatever allows you to not see such horrible symptoms. It’s genetic it’s passed down genetically, most women and their sisters and mothers have DCOS. And so they’re combined in a ratio of 40 to one, which is similar to the ratio that they should be found in your body. The Site may contain health- or medical-related materials that are sexually explicit. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The Content is not intended to be a substitute for professional legal or medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health personnel and ask your doctor any questions you may have regarding a medical condition. These hypotheses are to be tested in future studies. Both moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) have been shown to enhance cardiorespiratory fitness in women with PCOS. Opt for healthier cooking methods like baking, grilling, boiling, or roasting instead of frying. Start by focusing on whole grains and legumes, which help stabilize blood sugar and improve insulin sensitivity. When it comes to managing PCOS, the right diet can make a big difference, especially when paired with metformin. This combination represents an excellent therapeutic choice for those obese women with PCOS who do not want to take HCs . An association between myo-inositol and alpha-lipoic acid was established recently in women with PCOS. It is also known for its anti-inflammatory, antioxidant and insulin-sensitizing activity. There is a proposed link between inositols, the new insulin-sensitizing molecule, and other compounds that can increase their therapeutic effect. These clinical trials highlight the beneficial effects of inositol supplementation in improving several of the hormonal and reproductive disturbances of PCOS as well as obesity linked with PCOS. Activities such as walking, jogging, cycling, or swimming can be beneficial for cardiovascular health and calorie burning. Drinking plenty of water is vital for overall health and can aid in feeling full, which can help prevent overeating. Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting an estimated 6% to 12% of women of reproductive age. The vital thing to consider is your own health before starting a restrictive diet. For metformin, the starting dose is often 500–850 mg once or twice daily, gradually increasing to 1,500–2,000 mg per day as tolerated. When starting combination therapy, low doses are typically used to balance effectiveness with minimal side effects. Routine follow-ups are equally important to fine-tune the plan and address any side effects. For instance, the Federation of Obstetric and Gynaecological Societies of India (FOGSI) officially recommends combining metformin and myo-inositol for managing PCOS-related infertility. Approximately 50%-70% of all women with PCOS have some degree of IR, and this hormone insensitivity is likely to lead to the hyperandrogenism that is responsible for PCOS signs and symptoms. It is noted that 81% of women with frequent fetal loss have defects in LH secretion, and among those with recurrent miscarriages, both with and without PCOS elevated androgen levels have been reported. This syndrome manifests as common metabolic traits and leads to serious long-term consequences, including type 2 diabetes mellitus, cardiovascular disease, and endometrial hyperplasia . The central paradox in the pathophysiologic association between hyperinsulinemia and hyperandrogenemia in PCOS is that the ovary remains sensitive to insulin activity and subsequent androgen production, despite a systemic state of IR, setting the stage for the “selective insulin resistance” theory . Managing PCOS can feel overwhelming, but there are several alternative treatments that can help alleviate symptoms and support your journey towards better health. At Minimal, we emphasize a holistic approach to personalized weight loss solutions, integrating weight loss prescriptions, tailored fitness, nutrition guidance, and alternative methods for lasting health improvements. In addition to medication, lifestyle changes play a crucial role in alleviating symptoms of PCOS and supporting weight loss. Additionally, Metformin should not be used for weight loss during pregnancy unless specifically prescribed by a healthcare provider. However, healthcare providers may prescribe it off-label for weight loss in certain situations. As metformin remains a cornerstone in the management of reproductive health in PCOS, further high-quality studies are warranted to explore its impact on pregnancy outcomes, including miscarriage rates, teratogenicity, and live birth rates. Several observational studies and meta-analyses have reported a significant association between chronic metformin treatment and an increased prevalence of malabsorption and deficiency of vitamin B12. Greff et al. assessed the safety and efficacy of inositol in PCOS by conducting a systematic review and meta-analysis of 26 randomized controlled trials, including data from 1691 patients treated with inositol, metformin, and placebo . While MYO has demonstrated the ability to reduce BMI, its impact is less consistent when compared to metformin, particularly in women with higher baseline BMI. Weight management is also crucial; even losing 5–10% of body weight can lead to noticeable improvements in insulin sensitivity, menstrual cycles, and other PCOS symptoms. A retrospective study involving 68 women found notable improvements in several areas, including menstrual regularity, BMI, blood sugar levels, and androgen levels, across all treatment groups. Metformin focuses on the metabolic aspect - helping regulate blood sugar levels and enhancing the body’s insulin response. Both treatments showed significant improvements in insulin levels during glucose tolerance tests and helped regulate menstrual cycles. Combining Metformin with Lifestyle Changes We included randomised controlled trials of metformin compared with placebo, no treatment, or ovulation inducing agents in women with polycystic ovary syndrome. Results Meta-analysis showed that metformin is effective in achieving ovulation in women with polycystic ovary syndrome, with odds ratios of 3.88 (95% confidence interval 2.25 to 6.69) for metformin compared with placebo and 4.41 (2.37 to 8.22) for metformin and clomifene compared with clomifene alone. Combining metformin with healthy lifestyle adjustments can play a key role in supporting weight loss and managing PCOS symptoms. It provides the same benefits for managing weight and insulin resistance but with fewer gastrointestinal side effects, making it easier to stick with treatment. Clinical studies show that it can lead to an average weight reduction of about 5.8%, reflecting meaningful metabolic progress. For example, studies show that metformin can reduce fasting insulin levels by 40%, which helps promote fat loss and restore hormonal balance. Instead, it makes the body’s existing insulin work better, breaking the cycle of insulin resistance that contributes to many PCOS symptoms. 524 studies were included for initial analysis and after removing duplicated reports, 189 remained. A flow diagram of the meta-analysis conducted in this study is shown in Fig. The search strategy focused on randomized controlled trials (RCTs) comparing treatment with a combination of GLP-1RAs and metformin or placebo. After deducting control group effects, the Emax of metformin on BMI were -5.88% and -11.8% in metformin monotherapy and metformin combination therapy, respectively. However, its effects on preventing gestational diabetes or high blood pressure are less clear, with mixed results across studies. During pregnancy, metformin is considered safe for use in women with PCOS and may lower the risk of early pregnancy loss and preterm birth. There have been many studies of myo-inositol alongside dietary intervention in women with PCOS, some of these are very encouraging with regard to weight reduction.Weight management is also crucial; even losing 5–10% of body weight can lead to noticeable improvements in insulin sensitivity, menstrual cycles, and other PCOS symptoms.When women with PCOS are treated with metformin, ovarian hyperandrogenism is attenuated and sustained, eventually resulting in lower serum testosterone levels26.Metformin has an additive effect on fasting serum insulin levels but not fasting serum glucose levels.Semaglutide has shown even greater results in weight reduction.This showcases the effectiveness of metformin in weight management for those with PCOS.An endocrine disruptor is any manmade chemical that interferes with your body’s hormone balance.In our study, more than 30% of the subjects experienced gastrointestinal symptoms in COMB treatment arms, which are consistent with previous studies of GLP-1RAs with 11-48% incidence of nausea (1).Dr. Thigpen explains what PCOS weight gain looks like and how you can minimize the impact of PCOS on your life. Tosca et al. concluded that, in rat pituitary cells, metformin decreases gonadotropin secretion and MAPK3/1 phosphorylation induced by GnRH and FSH release. Cardiovascular risk including markers of sub-clinical inflammation, and dyslipidemia may also be improved by metformin therapy . These results were of similar magnitude to those of non-PCOS, except the measurement of fasting insulin, which in non-PCOS was improved by a mean of 16.1% . Fasting insulin decreased by 5.7%, although the difference did not reach significance. Clinical and laboratory characteristics of the study population with test of variances for repeated measures Society for Endocrinology - a world-leading authority on hormones Combining metformin with a healthy diet and regular exercise can also boost its weight loss effects. Yes, metformin for PCOS without diabetes can reduce insulin resistance, helping with weight loss when combined with lifestyle changes. PCOS metformin and weight loss is a hot topic for women battling polycystic ovary syndrome (PCOS). The effects of metformin on menstrual function and infertility may be caused by decreased insulin resistance and lowered testosterone levels. Minimize the intake of foods and beverages high in added sugars, as they can lead to blood sugar spikes and hinder weight loss efforts.Telehealth makes managing PCOS with metformin much easier by connecting you with specialized care right from your home.Therefore, we suggest recommending lifestyle modifications actively to women with PCOS if they do not have indications for metformin.In a large meta-analysis, Salpeter and colleagues reported no statistically significant difference between PCOS and non-PCOS or obese and nonobese patients with regard to the effect of metformin on their metabolic risk Salpeter et al. 2008.This hormonal imbalance contributes to weight gain and difficulty losing excess pounds.Some women with PCOS may start to notice weight loss within a few weeks of starting metformin, while others may not see significant results for several months.We’ll also discuss other treatment options if you decide Metformin isn’t for you.Medicines containing guanidine, such as metformin and phenformin, were developed to treat diabetes. A normal insulinemic response to OGTT was defined by a threshold AUC value of 15,000 μIU/mL/240 min, as previously described (13). Insulin, C-peptide, and glucose responses to the stimuli are expressed as the area under the curve (AUC). Insulin, glucose, and C-peptide were assayed in all samples. Blood samples were collected basally and, after the ingestion of 100 g glucose, at 30, 60, 90, 120, 180, and 240 min. An OGTT with 100 g glucose was performed after 48 h of standard diet and after overnight fast. It makes your body more sensitive to insulin, and decreases the amount of glucose your liver releases. Certain medical conditions such as being overweight or having PCOS can cause insulin resistance. If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. This insulin resistance can progress into type-2 diabetes and other long-term complications if left untreated. Dr. Batash understands that weight loss can be a challenging journey, and his team of professionals will work closely with you to develop a personalized plan tailored to your specific needs and circumstances. With their proven expertise in weight loss, they can provide the guidance and support you need to reach your goals effectively. While it is possible to see improvements in PCOS symptoms after losing weight, the timeline can vary for each individual. Both Suture Sculpt endoscopic sleeve gastroplasty (ESG) and the Orbera gastric balloon are minimally invasive weight loss procedures that have been proven to offer significant weight loss results. The process starts with a quick 5-minute online visit, where you fill out a detailed intake form about your medical history and symptoms. Unsaturated fats from foods like olive oil, avocados, nuts, and seeds not only support heart health but also help reduce inflammation. If you prefer plant-based options, tofu and legumes are great choices, offering not only protein but also fiber to help keep blood sugar levels steady. If cells become resistant to insulin, blood sugar levels can rise, and the body may make more insulin to try to lower them. Finally know exactly what to eat to stabilize blood sugar, reduce symptoms, and support weight loss—customized for your preferences and goals. Yes, Metformin is effective in managing various PCOS symptoms beyond weight loss. Metformin Weight Loss PCOS treatment is often part of a broader strategy to manage PCOS symptoms, and discontinuing it could lead to a return of symptoms or weight gain if not managed properly. While it might be tempting to stop Metformin after achieving your weight loss goal, it's important to consult with your healthcare provider before making any changes. Similar trends were seen in BMI with reductions of 1.8 kg/m2 (4.7%) and 3.5 kg/m2 (9.7%). In this brief report, electronic records of 183 adult patients with PCOS–O were reviewed between January 2020 and April 2021. Weight loss facilitated by GLP-1 agonists in patients with PCOS–O is not well characterized. Continuing follow-ups in randomized prospective trials and in real life settings would provide further information on putative long-term benefits of metformin and whether they are homogeneous across subgroups. The further research needs to firstly identify and then prioritize those groups who will benefit most from being treated with metformin. And it seems to be doing more harm than good for women with PCOS. And then it reduces the levels of sugar produced by the liver, as well as the amount of sugar, your stomach and intestines absorb. It helps your cells respond to insulin. I believe like almost every woman that gets diagnosed with peace shores, they either get prescribed the birth control or Metformin from everybody’s story. This is not a randomized controlled study and we do not have a control group of women treated with placebo for 3 years. Metformin appears to have decreased the prevalence of metabolic syndrome in a PCOS population to a prevalence rate closer to that of a normal, non-PCOS population. Baseline clinical and biochemical characteristics in the metabolic syndrome group differed from the non-metabolic group, as expected. Women with the metabolic syndrome at baseline were demographically similar to those without (Table 1). We recalculated the prevalence of the metabolic syndrome at follow-up with these assumptions. They were treated with dinae-35, low dose of liraglutide (0.6 mg QD) and metformin (0.85 mg BID) for 12 weeks.They also come with a whole slew of side effects like nausea and diarrhea, and can be very dangerous for an unborn baby if you accidentally conceive while taking it.This fat is metabolically active and has been linked to worsened insulin resistance and a higher risk of cardiovascular issues, especially for women with PCOS (polycystic ovary syndrome).Furthermore, patients showed improvements in clinical hyperandrogenism and reductions in ovarian volume.Too high too fast often causes intolerable side effects.Plus, Pilates is considered a mind-body exercise that can also reduce stress. Mindful Eating and Portion Control By stabilizing blood sugar levels, metformin helps prevent the spikes and drops that often lead to cravings.The Endocrine Society clinical practice guidelines suggest the use of exercise therapy along with diet modification as the first-line treatment to manage obesity in adolescents and women with PCOS .In conclusion, metformin improved the metabolic profile of women with PCOS over a mean follow-up of 36.1 months, particularly in HDL cholesterol, diastolic blood pressure and BMI.By choosing foods that cause a slow, steady rise in blood sugar, you are directly managing the insulin resistance that drives weight gain and other symptoms.Metformin can cause unwanted gastrointestinal side effects, so be sure to work with your physician to slowly increase your dosage to reach the effective dose without experiencing discomfort.The primary outcome of the study was the change in metabolic syndrome parameters before and after metformin treatment.Metformin is a common medication for managing PCOS, but it often comes with gastrointestinal side effects like nausea, diarrhea, stomach pain, or bloating.Metformin does several things in your body, such as reducing how much glucose (sugar) your liver releases into your body.Incorporating protein, healthy fats, and fiber into every meal can help prevent the blood sugar spikes that worsen insulin resistance. In this analysis among patients with PCOS–O, we sought to determine associations and absolute differences in weight loss in patients treated with metformin versus GLP-1 monotherapy over a six-month period. In this single-center retrospective study, we determined weight loss in patients with PCOS–O with GLP-1 monotherapy versus metformin. We conclude that, in agreement with the latest recommendations (7), metformin should not be withheld from treatment of PCOS in overweight-obese women with normal fasting glucose and normal glucose tolerance. All patients were managed in the single center using a standardized treatment protocol with 2000 mg metformin that had been introduced in all overweight-obese women regardless of their glycemic status unless contraindicated since 2006, and thus any possible selection bias had been eliminated. Potential goal of long-term treatment with metformin in overweight-obese women with PCOS should therefore be a stabilization of BM through the years rather than weight reduction itself. Nausea occurred predominantly during the increase in metformin dosage in the COMBO group, and during the first 2 weeks of LIRA dosage increase in both treatment groups. Adverse effects in the present study were observed in 38% of individuals in the LIRA group and 45% of individuals in the COMBO group. In addition, the existence of direct beneficial effects of metformin on the androgen profile mediated via regulation of ovarian steroidogenesis were not excluded. In patients treated with LIRA only, free testosterone and SHBG levels changed significantly. Ozempic and metformin are prescribed to manage blood sugar in people with type 2 diabetes, although weight loss is a side effect. Both metformin and Ozempic can help treat the symptoms of polycystic ovary syndrome (PCOS). These medicines can lead to even more weight loss – about a 10% to 20% drop in body weight after a year. Although metformin and Ozempic aren't prescribed for weight loss, both medicines can cause you to lose weight. Glucose metabolism measures Have you discussed your PCOS management plan with your healthcare provider recently? Incorporating low-glycemic foods and maintaining an active lifestyle will enhance insulin sensitivity and help you achieve better results. If you experience severe or persistent side effects, you should consult your doctor. The exact time frame can vary depending on individual factors such as diet, exercise, and how your body responds to the medication. Metformin makes the body more responsive to insulin, which helps manage blood sugar levels. It helps the body use insulin better, which is crucial for controlling blood sugar levels. About 50% to 70% of women with PCOS have insulin resistance. For women with PCOS, managing symptoms and weight is hard. Metformin offers a range of significant benefits for women with Polycystic Ovary Syndrome (PCOS), and understanding these can be a vital step on your journey to better health. At Minimal, we offer comprehensive care without the need for insurance, with personalized weight loss solutions starting at just $99.99/month. Epidemiological studies have shown varying prevalence rates of polycystic ovary syndrome across different populations, underscoring the need for tailored approaches in management. Metformin side effects Prior the inclusion, metformin restored menstrual cycles in both groups of our cohort. It is known that the higher CR scores as opposed to lower CR scores might be related to a greater propensity for dieting and that low restrainers had reduced preference for “healthy” food, such as fish, vegetables, and fat-reduced food . Mechanistically, metformin might counteract adipose tissue expansion through direct inhibition of adipogenesis with the specific role of metformin on visceral fat mass as opposed to subcutaneous fat compartments . This leads to higher insulin levels, which can increase appetite and promote fat storage, making weight loss more difficult. Most women see initial weight loss within 4-8 weeks of reaching their optimal metformin dosage for PCOS. Finding the right metformin dosage for PCOS weight loss is crucial for achieving optimal results while minimizing side effects. These patients are at an increased risk of metabolic syndrome, type 2 diabetes mellitus (T2DM), cardiovascular disease, and unopposed estrogen effects on the endometrium . Evaluating each SR using the AMSTAR 228 and ROBIS29 will enable health decision-makers to identify high-quality SRs, even those based on observational studies, of metformin use in pregnant women with PCOS. As a result, SGLT2 inhibitors are a viable alternative to Metformin for the majority of women with PCOS who are trying to lose weight irrespective of insulin levels (or resistance). Meta-analysis of the total cholesterol (A), HDL (B), LDL (C) and TG (D) levels found in this study. In terms of reduction in total cholesterol, 10 studies (with 335 and 237 subjects from the experimental and control groups, respectively) were included for analysis. In terms of the reduction in FAI, 6 studies (with 195 and176 subjects from the experimental and control groups, respectively) were included in the analysis. In terms of the reduction in total testosterone, 9 studies (with 264 and 223 subjects from the experimental and control groups, respectively) were included in the analysis. In terms of the reduction in SHBG, 5 studies (with 151 and 153 subjects from the experimental and control groups, respectively) were included in the analysis. The following are tips to ensure a smooth transition into metformin treatment for PCOS. It is important to discuss appropriate dosing with your medical provider if you are on metformin for PCOS and have questions about the best dose to help with losing weight. Patients taking 2,500 mg of metformin daily lost about twice as much weight as those taking 1,500 mg daily over the same time frame. The encouraging news is that women who lost this weight could also keep it off. The anti-androgen medications block the effects of male hormones. Body mass index is also called BMI, and it is the ratio of your height to your weight. The doctor will weigh you and check your waist size and body mass index. Insulin resistance occurs when your body isn’t responsive to insulin. However, you may be able to lose weight with the right treatment plan. Polycystic ovary syndrome is a hormonal condition that affects around 6-13% of women between the ages of 15 and 49. Metformin cannot replace the need for a proper modification for lifestyle among overweight obese and overweight PCOS women. The increase in menstrual frequency was statistically significant from V1–V7 when compared to baseline (Fig. 2B). Comparisons to pretreatment values were calculated using Wilcoxon test for paired samples. From V5 up to V10, no significant change in BM was observed when compared with baseline (Fig. 2A). Greater capacity to lose weight in patients with higher BMI than in patients with slighter obesity was confirmed also in another real-life setting investigated metformin use in PCOS (28). Although several women that were eligible for the study reported mild-to-moderate nausea and diarrhea at first year of follow-up, the symptoms were transient and disappeared after 4–8 weeks. Change in body weight (A), number of menstrual cycles (periods) (B), total plasma testosterone levels (C) and plasma androstenedione levels (D) during the time. There was no correlation between body weight change and fasting plasma glucose level or hormonal status (level of LH, FSH, DHEAS, androstenedione, total and free testosterone). Switching to extended-release metformin offers several advantages for managing PCOS. From there, the dosage is gradually increased, often reaching 1,500–1,700 mg per day, depending on how well your body tolerates the medication and responds to it. With PCOS affecting 5% to 7% of women of reproductive age, access to specialized medical care can make a big difference in managing this condition successfully. Regular check-ins with a healthcare provider ensure that any changes are safe and effective while keeping your progress on track. It’s crucial to have ongoing medical supervision when adjusting your metformin dosage. Discussing your overall health status is also important. Your path to better health begins with regular visits to healthcare professionals. Each patient's response and health profile can vary greatly. This partnership is crucial for creating effective metformin regimens. Additionally, metformin is often used in conjunction with other medications or lifestyle interventions to manage PCOS more effectively. Metformin, a commonly prescribed medication for PCOS, can have a significant impact on hormone regulation in women with this condition. Consult with a registered dietitian or nutritionist who specializes in PCOS to develop a personalized meal plan that meets your specific nutritional needs and supports your overall health goals. It's important to remember that metformin is not a magic solution, and its effectiveness can vary from person to person. Eligibility criteria and study selection However, it must be noted that neither metformin nor flutamide, per se, is a weight loss drug. Norman et al9 argue that weight management should be a first-line treatment option for overweight or obese women seeking fertility, and this should comprise a range of strategies including diet, exercise, and behavior modification. Lemay et al’s17 study of rosiglitazone + diet vs oral contraceptive (EE/CPA) + diet was not primarily aimed at weight loss, and this lack of emphasis may explain the lack of weight change. Weight loss with metformin and PCOS weight loss is typically gradual.The largest number of objectives was 360, almost 9-fold of the smallest number and only 3 studies had the number of objectives more than 200.Combined statins and metformin therapy can improve lipid and inflammation parameters, but cannot effectively improve insulin sensitivity and hyperandrogenism in women with PCOS, when compared to metformin alone .A weight change of −7.7% was achieved within 10 months in women receiving a 1500-kcal/d high-protein diet plus metformin therapy.Several effects have been reported as related to metformin in PCOS patients including restoring ovulation, reducing weight, reducing circulating androgen levels, reducing the risk of miscarriage and reducing the risk of gestational diabetes mellitus (GDM).However, the inclusion of patients who responded poorly to metformin did not provide sufficiently appropriate controls to infer conclusive results regarding the additive effect of metformin and LIRA treatment in PCOS.Metformin for PCOS is generally recommended for decreasing weight and also reducing the risk of developing gestational diabetes mellitus.Metformin can be considered as an additional treatment but has subtle additive effect. When paired with specific lifestyle changes, metformin delivers better results. This real-time data sharing complements personalized treatment plans and makes ongoing care more accessible. Certain symptoms, like muscle pain, difficulty breathing, abdominal discomfort, or feeling generally unwell, could signal lactic acidosis - a rare but serious condition. These evaluations help your provider determine whether adjustments to your dosage or additional treatments are needed. Routine assessments, including fasting and post-meal blood glucose checks as well as HbA1c testing, are typically conducted every 3 to 6 months. Our data suggests that GLP-1 agonists are likely better agents to facilitate meeting this weight loss threshold in patients with PCOS–O and can translate into long-term benefit. 84.2% and 57.8% achieved greater than 5% and 10% weight loss with GLP-1 monotherapy, respectively, versus metformin (25% and 16.6%). Mean duration of treatment was 27.8 weeks and overall improvement in weight loss was similar to that seen with monotherapy in our cohort. Additionally, over 90% of women who used metformin for at least six months experienced a return to regular menstrual cycles. Using metformin to manage weight for PCOS requires more than just taking the medication - it calls for a combination of tailored lifestyle adjustments and consistent medical guidance. Dr. Amber Wheeler underscores the importance of pairing metformin with healthy lifestyle habits. For these patients, providers avoid pushing metformin doses to the maximum limit. Several long-term studies on orlistat in overweight diabetic patients have shown significant weight loss and improved metabolic and cardiovascular indices as compared to pursuing lifestyle changes alone . On average SGLT2 inhibitors help obese women with PCOS lose approximately 1.5% of body weight, after 6 months of treatment, leading to a mild improvement in both insulin and testosterone levels (Table 6). On average GLP-1 analogs help obese women with PCOS lose approximately 5% of body weight, and improve insulin resistance, after 6 months of treatment (Table 4). Together, a low-calorie diet (LCD) and metformin, often produces a more favorable outcome on testosterone levels, hirsutism, body fat, lipid profile, insulin resistance and menstrual cycles for women with PCOS and IR (Table 1). In this present study, the combination therapy of metformin and beinaglutide demonstrated synergistic larger effects on the loss of body weight and BMI. Of the 64 overweight/obese women with PCOS starting on treatment,60 patients completed the study (Figure 1). Additionally, the published studies provide convincing evidence that liraglutide combined with metformin is substantially more effective than metformin alone in weight loss, improving menstrual cyclicity, ovulation rate, androgens, and insulin sensitivity (9). Elevated glucose levels can lead to glucose intolerance, resulting in weight gain and an imbalance in other hormone levels that may exacerbate the symptoms of PCOS. Yes, metformin has been shown to help with losing weight in women with polycystic ovary syndrome PCOS. This article will explore how metformin impacts weight loss in women with PCOS and the research behind these claims. In a large meta-analysis, Salpeter and colleagues reported no statistically significant difference between PCOS and non-PCOS or obese and nonobese patients with regard to the effect of metformin on their metabolic risk Salpeter et al. 2008. The findings from our meta-analysis suggested that GLP-1RAs were effective in improving the anthropometric parameters such as BMI, body weight, WC, WHR and AG, particularly when compared to the patients given either metformin or placebo.Consistent observation, especially of kidney function and vitamin B12 levels, is crucial for individuals on metformin, ensuring safe and effective management of the condition.You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.Metformin has been shown to help reduce weight in women with PCOS, with weight loss ranging from 0.7 to 3.8 kg (1.5 to 8.4 lbs), depending on the dosage and duration of treatment.Emerging research, including preclinical and early-phase clinical studies, has shown the potential benefits of new medications like glucagon-like peptide 1 (GLP1) agonists and SGLT-2 inhibitors for PCOS .Mild digestive issues like nausea or bloating are common, but if you experience severe diarrhea or persistent vomiting, contact your healthcare provider right away.For specific medical advice, diagnoses, and treatment, consult your health care provider.Moreover, approximately 70% of treated patients responded to metformin therapy.If you experience persistent or severe side effects, inform your healthcare professional. In another cohort study by Glueck et al13 on the effects of metformin + diet vs metformin + diet + pioglitazone in metformin nonresponders, pioglitazone had little effect on weight loss. The results of Crosignani et al study compared favorably with Glueck’s15 cohort study of sustainability of weight loss on metformin + diet, in which at 12 months, weight loss of −8.1% was found in 89 participants who completed the intervention. Sustainability of weight loss was a primary aim.In another cohort study by Glueck et al13 on the effects of metformin + diet vs metformin + diet + pioglitazone in metformin nonresponders, pioglitazone had little effect on weight loss. Inclusion criteria were all prospective long-term (12 months) studies of women with a diagnosis of PCOS and mean body mass index (BMI) ≥28 kg/m2, where weight loss was a primary or secondary outcome measure. Some studies have tried to identify the patients that are most likely to benefit from metformin, yet again the results have not been forthcoming. It was also reported that discontinuation of metformin led to the worsening of the total LDL-C that quickly returned to the pre-treatment levels Palomba et al. 2007. In another meta-analysis, no significant effect was found in total cholesterol levels between those receiving the COC pill or metformin Costello et al. 2007. Several studies have reported that metformin had a favourable effect on dyslipidaemia in PCOS women Fleming et al. 2002; Ng et al. 2001; Moghetti et al. 2000. They have also been proven effective for gradual and long-term weight reduction in other populations with obesity, whether or not they have diabetes (6). Lifestyle intervention is recommended as the first-line therapy for weight management but is difficult for patients to persist. Polycystic ovary syndrome(PCOS) is the most common endocrine disease in women of reproductive age, affecting 6–15% based on the subjects investigated and the diagnostic standards applied (1). Additionally, LaMoia and Shulman demonstrated that metformin reduces visceral and ectopic fat accumulation in hepatic and skeletal muscle tissues by activating AMPK-dependent pathways that promote fatty acid oxidation and inhibit lipogenesis 15,16,26. These neuroendocrine changes improve leptin and insulin sensitivity, increase incretin production, and enhance vagal signaling, collectively contributing to enhanced satiety and decreased food intake. At the CNS level, metformin inhibits hypothalamic AMPK activity, thereby reducing the expression of orexigenic neuropeptides such as neuropeptide Y (NPY) and agouti-related peptide (AgRP), while enhancing anorexigenic pathways mediated by pro-opiomelanocortin (POMC) 15,26. A diet rich in low-glycemic index foods, lean proteins, and plenty of vegetables can help keep insulin levels stable and support weight management efforts. When using metformin for PCOS weight loss, it's essential to monitor your progress regularly. Metformin is just one of many treatments available for managing PCOS, particularly when it comes to weight loss. Exercise not only helps burn calories but also improves insulin sensitivity, which can amplify the weight loss benefits of the medication. This process helps lower high androgen (male hormone) levels, rebalancing your hormones and creating a healthier metabolic environment for weight loss. It is a well-researched option for insulin resistance, though some natural compounds, such as those found in berberine for PCOS weight loss, have also been studied for similar effects. For many women with PCOS, metformin is a prescription medication that can be a powerful tool to help break the cycle of insulin resistance and weight gain. This suggests that semaglutide, independently of its effect on body weight, may represent a good alternative to metformin for improving insulin resistance and preventing type 2 diabetes in PCOS. The mean weight loss observed after treatment with semaglutide was larger than that reported with metformin 2,7,8 or liraglutide 9,10,11,12 and was obtained using low doses of the product with very few side effects. Our patients who showed a defective peripheral glucose utilization already during the first determination experienced a further decline in insulin sensitivity. Results from clamp examination indicate that metformin does not prevent the appearance of physiologic insulin resistance during pregnancy. Three cases of hepatosis occurred, one in a woman with GD since the first trimester and two in patients who did not show any alteration of glucose tolerance and who continued metformin until delivery. No major maternal adverse effects possibly or probably related to metformin were observed during the study. The greatest reduction in body weight was achieved during the 8th to the 12th week of the observation period in the COMBI treatment arm. Although we did not identify any baseline characteristics that might have predicted the degree of response to liraglutide treatment, a robust weight loss in a subset of individuals was apparent after 4 weeks of treatment and continued to the end of the study. Thirty-eight percent of participants lost a significant amount of weight, defined as 5% or more of their initial body weight; 22% of those were on the COMBI treatment compared with 16% on LIRA. For P values, T, overall effect after all treatments; M, MET; L, LIRA; C, COMBI; NS, not significant; BP, blood pressure; HOMA-IR, homeostasis model assessment of insulin resistance; Glu, glucose; TG, triglyceride; SHBG, sex hormone-binding globulin; VAT, visceral adipose tissue. In this study, we report the results of a 12-week open-label, randomized, prospective study designed to investigate the effect of liraglutide on weight loss in obese nondiabetic women with PCOS who had lost For the subgroup analysis, the studies were classified based on if the patients from the control group received metformin or placebo. For the subgroup analysis, the studies were classified based on whether the patients from the control group received either metformin or placebo. A meta-analysis of BMI changes found in this study (A), body weight changes (B), WC (C), WHR (D) and AG (E). For anthropometric measurements, we compared the results of reduction in BMI, body weight, BMI, WC, WHR and AG. By using the data from multiple studies, in this analysis we attempted to clarify the role of IR in the pathogenesis of PCOS and assess the efficacy of GLP-1RAs in improving both the reproductive and metabolic outcomes for patients with PCOS. Overall, these guidelines underscore metformin’s critical role in improving metabolic health and managing insulin resistance in PCOS. The International PCOS Network’s October 2023 update recommends metformin monotherapy for adults with a BMI of 25 kg/m² or higher, focusing on addressing insulin resistance, as well as abnormal glucose and lipid levels. Notably, around 30% of participants in these studies lost over 5% of their body weight within the first year, with some reporting an average weight loss of 13 to 15 pounds while taking metformin. In one study involving 116 women, those taking 1,700–2,550 mg/day for six months saw noticeable improvements in their waist-to-hip ratios, particularly among overweight or obese participants with normal insulin levels.