Re: glucophage and bc pill
From: chuck (anonymous@obgyn.net)
Fri, 16 Nov 2001 09:26:10 -0600 (CST)
Jodi:
Thank you very much for your help and insight...You have helped answer
many ?'s my wife and I have had...
Thanks again....Chuck
At Thu, 15 Nov 2001, jodi wrote:
>
>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:
>>
>>hopefully this will be our last gluco ? for a little while....my wife
>>has about 2 weeks of bc pills to take....should she continue them until
>>the end of them before starting gluco, or go ahead and stop the bc and
>>start gluco...
>>
>>any suggestions or ideas?
>>
>>thanks for all your help......chuck
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