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Re: glucophage and bc pillFrom: jodi (anonymous@obgyn.net)Thu, 15 Nov 2001 16:27:34 -0600 (CST)
Chuck, I have a feeling you aren't completely sure what all of the medications your wife is taking are used for... hoping this is not a completely off-base conclusion, I'm going to give you a little run-daown. Glucophage is used to help lower insulin levels in the body. Ity works by limiting how much sugar (from meals) is released into the blood stream. Less sugar dumped into the blood stream means less insulin released by the body in response. High insulin levels are thought to be the cause, or one of the causes, of PCOS. High levels of insulin push the ovary to produce more male hormones than they should. This is where the hormonal problems - lack of periods, acne, excess hair - comes from. By lowering insulin levels, some women are able to reduce their levels of unwanted hormones, resume menstruation, etc. Birth control pills do a bunch of things for PCOS. The lower the levels of lutenizing hormone in the blood. They inhibit ovarian activity, directly supressing both hormonal output and ovulation or, in our case, not-quite-ovulation, which means that cyst formation is put on hold. This reduction of ovarian hormonal output is what leads to a reduction in the problems associated with excess hormones, namely acne and excess hair. BCPs also induce regular monthly blleding which reduces the risk of endometrial cancer, something PCOS'ers are thought to be at risk for since we don't shed our uterine linings all that often. For many years I think it was believed that this supression of cyst formation would lead to an increased chance of pregnancy when a PCOSer goes off the BCP... the cycts build up and resultant excess hormones (these cysts pour our androgens) makes completed ovulation difficult. A lot of women have had success getting pregnant by going on the pill for many months then going off the pill - for some women, they are most fertile in the months following stoppage of the pill. Of course, some of us find that we have no periods for months and months after stopping the pill... which is something that happens in normal women as well as PCOSers. Everyone reacts differently to different pills. One drawback to the pill is it can make insulin resistance worse. Insulin resistance is when your body can't use its own insulin correctly, so it pumps out more to compensate. (Quantity to make up for poor quality, if you will... only I don't think it's the insulin that is of poor quality, it is the cells' response to it...) Insulin resistance is what leads to high insulin levels which is what leads to the problems of PCOS. According to my docotr, though, and other doctors, the effect of the BCP on insulin resistance is negligable compared to the insulin resistance already present, and the pill induce worsening ceases in most cases once the pill is stopped. Many women find the benefits of the pill far outweigh this drawback. Additionally, taking an insulin med such as glucophage in addition to the pill can keep this side effect under control. Sprionalactone/aldactone works as an androgen blocker. Depending on who you talk to, it either blocks the effects of testosterone on the skin, leading to less hair and acne, or it flushes testosterone out of the body. The end result is the same - less acne, less hair. Another weird efect of aldactone is it can lead to a resumption of ovulation. It did this to me, and I have read of it happening to others. I am not sure why... I guess that it also reduces the effects of testosterone on the ovaries and allows ovulation to resume. This might sound like a nice side effect but aldactone can cause birth defects, especially in males, so it should not be used as a fertility drug... some method of birth control should be used with it if a woman is taking it and sexually active. Since aldactone can cause erratic bleeding patterns, many women choose to take it with a BCP. As you can see, both BCP and aldactone are temproary fixes... glucophage on the other hand is thought to address the underlying cause of PCOS. Ok? :-) So. It really doesn't matter from a medication standpoint if your wife finishes her BCPs or stays on them while she takes glucophage. Many people take both. I am gathering from your posts that you and your wife are going to try to conceive, so it's really more in your case a matter of do you want to start now? Or do you want to finish out one more pill cycle? Personally, from a cyst-dissolving-improved-fertility standpoint, I would say finish out the pack of BCPs. This really depends on how your wife responds to stopping whichever pill she is on, if she has ever tried it before. I know that when I stopped taking Alesse, I immediately resumed ovulatory periods, which I took to mean the Alesse was doing good things for me. On certain other pills, this was not the case - I would stop and go months without a period. So it really boils down to your wife's personal preference. There is no good reason she shouldn't finish out the pack. If she is just starting the glucophage, it might even be in her favor to start out with a month of lower than normal hormones to begin with. if she stops the aldactone, though, she mioght notice as I did a long carry over effect... I had 5 months of regular ovulatory periods after stopping the aldactone. since you are ttc, that is really the medication you need to worry about her stopping. It's her call... - jodi
At Thu, 15 Nov 2001, chuck wrote:
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