Re: PCOS-MEDICATION digest 774--Dr. Sam, please help!
From: =?iso-8859-2?q?Zalányi Sámuel ?= (anonymous@obgyn.net)
Tue, 2 Apr 2002 02:41:01 +0200
Dear Sue,
I hesitated to comment on dr Chudacoff's remark, b/c I do not want to criticize a colleague publicly (it goes against the rules of medical ethics).
But:
I made an answer to this question and it was a plain no. This answer was based on the entirely different mechanisms of action by which:
a) metformin restores ovulation (in an otherwise anovulting patient), which only renders her similar to other subjects, who are taking oral contraceptives with very high efficacy.
b) contraceptives block ovulation.
I do not want to start a quarrel with anybody, so try to figure out what the truth might be...
Sam M.D., Ph.D.
> >>I am taking metformin and the pill microgyon. Does the metformin have
> any affect on the effectiveness of the pill?..Cheers
>
> Probably decreases the effectiveness because it increases your chance of
> ovulation. Especially if you're taking it for polycystic ovarian
> syndrome.
> --Richard Chudacoff, MD, FACOG
> Chudacoff Obstetrics & Gynecology, PLLC<
>
> I am confused--is this the opinion of a RE? If my understanding of how
> met works on our bodies (those of us with PCO) and the endocinopathy of
> the condition is correct, then this person is underinformed. Let me go
> through what I understand, and Dr. Sam, please confirm or deny my
> explanation.
>
> My understanding is this: we overproduce insulin, and the problems that
> stem from that include anovulation. Met and other insulin sensitizers
> help us use the insulin we produce more effectively and can stem the
> overproduction of it as well. In stemming that overproduction, symptoms
> (including anovulation) usually dissipate. Therefore, met does not
> CAUSE ovulation, but it (ovulation) is a BYPRODUCT of lowering the
> insulin levels in our bodies. Hence, taking a bcp with met would stem
> ovulation that might otherwise take place (and prevent pgy), as the two
> drugs are not working against each other in any way. I was told by my
> RE that if met did induce ovulation in me and I didn't want to be pg
> (for example, when I was taking spironolactone and could do damage
> through that drug to a male baby), that I SHOULD take a bcp to prevent
> pgy. In fact, I did just that and did not get pg while taking met and
> the bcp together.
>
> Dr. Sam--am I right?
>
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