Re: PCOS & Metformin worry (long post, sorry)
From: anonymous@obgyn.net
Mon, 16 Dec 2002 02:01:28 -0600 (CST)
Hi Tia,
will try to answer some of your concerns - but really most likely you
are worrying for nothing - sorry, not for nothing - but you are making
this metformin issue much bigger than it needs to be.
Expecting that you will get sick is a surefire way to make sure that you
don't feel well when you start the meds - particularly as you have been
worrying about this for a year now!
But - many women do not have side effects from this med. I for one went
straight up to 1,500 mg and then 2,000 mg with nary a feeling of nausea.
The vast majority have some, but not serious side effects, which
generally reduce over the period of days to a couple of weeks. The best
way to start is slowly. As you are so concerned - start with just 1/4
pill at your largest meal. Also try not to eat too many carbs at that
same meal. Then after a few days, a week or whatever you feel
comfortable increase that to 1/4 twice a day (am and pm), or 1/2 pill at
the same original meal. Build up just as slowly as you like. There is
no race.
Diet and exercise are just as important as meds. Some people can manage
without meds, but some find they need them. That will be for you to
find out.
Regarding alchohol, limited alchohol consumption (and what you describe
is minimal) is ok with metformin. If you are unsure, just skip the met
dose before you drink. Take your next dose at its regular time. I
drink one glass of red wine every day (with the blessing of my doctor) -
even though I do take met. However, binge drinking - on or off met is
definitely to be avoided.
PCOS is not nice, but it is definitley something that it is possible to
live with - and there are far worse things to have. I am currently
doing lasar for hair removal - and I think I am going to be very happy
with the results. Weight loss is possible - though difficult - with
diet and exercise.
You know, I am worried that if I get this too well under control I may
have trouble finding a doctor who will beleive me about this condition
when I leave from here (in a couple of years I guess) and have to find a
replacemet for my current supportive and completent dr.
But, it is important that you have a good relationship with your doctor
and have regular checkups and health monitoring - particuloalry things
like cholesterol, blood pressure, diabetes and heart disease risk
factors, liver and kidney function indicators (just a simple blood
test), etc. This is preventative medicine and is important for all
women with PCOS - actually - all women.
Please learn as much as you can about POCS. The more you know the less
scarey it becomes. Really!
Very bests wishes
Sally
At Sun, 15 Dec 2002, Tia wrote:
>
>After suffering with centralised weight gain, mild hirsutism and
>occasional ovary-sited pain for five or six years, I was diagnosed with
>PCOS last December. My new doctor was the first to pay attention to my
>lack of periods - I've had probably five periods in the last three
>years, and when I went to my previous doctor worried about not having
>had a period for eight months, she told me in a quite matter-of-fact
>tone, "I don't know what you're complaining about - some girls would be
>quite happy not to have periods!" I avoided going to the doctor again
>for three years, until moving to a new part of London.
>
>After my diagnosis, in January, I saw a gynaecologist, a PCOS specialist
>consultant, and in February, on my second visit, I was prescribed with
>Metformin on a gradually increasing dosage. When my consultant
>prescribed the Metformin, she mentioned that one of the major side
>effects is nausea, and since I was ten days away from moving house, she
>advised me to wait until I'd settled into the new place before beginning
>the course.
>
>Maybe she shouldn't have said that. Since then there has been one
>excuse after another - always another reason not to start the regime.
>People coming to stay, weekends away, important meetings. There was
>never a convenient time to feel nauseous, and this has meant that now, a
>year after my initial diagnosis, I haven't yet begun the course.
>
>I'm scared.
>
>I don't know if this is related to the diagnosis, or the illness, or
>other life stresses, but soon after my initial diagnosis, I suffered my
>first panic attack, and since then, though I've only had one other, I've
>been almost constantly anxious about having another one. I worry about
>being ill and not being able to cope, or not being able to handle my
>busy work commitments, and the idea of inflicting nausea on myself by
>taking this medication makes me reticent to even begin.
>
>I was all ready to start the medication in May. I talked myself into
>it, and sat on the edge of the bed with my partner to read the packet
>insert, and discovered in stern letters that ALCOHOL MUST BE AVOIDED.
>Now, I don't drink much at all - part of the anxiety/worry thing means
>that I am not comfortable with being out of control, or feeling ill the
>next day. I drink probably a couple of pints or glasses of wine a
>month, maximum. But somehow, the idea of having to avoid alcohol
>altogether felt so limiting that I was loathe to begin the Metformin.
>Maybe I was looking for excuses.
>
>On a Tuesday in June, I made another attempt. I actually took the half
>tablet I was supposed to begin with, and I felt horrible. The idea of
>feeling like that for another month at least, if not the rest of my
>life, was not very tempting. My partner (who is incredibly supportive)
>was going away at the end of that week, and I didn't want to be alone
>and unwell, so I didn't take it again.
>
>In August, I had a conversation with a work colleague about the illness.
>It transpires that she has also had PCOS for ten years, but decided to
>stop taking the medication a year ago. The side-effect of this,
>however, was that she has put on a lot of weight and has substantial,
>noticeable facial hair growth. This panicked me, because it seems to
>indicate that once you start taking Metformin, that's it, forever. You
>have to keep taking it because if you decide to stop, all the weight and
>hair come rushing to overtake you. Forever feels like a long time.
>Taking something, depending on a drug forever feels like an enormous
>commitment.
>
>Since then, I haven't tried again. The way I see it is that I'm feeling
>a lot better now - the weight is still there, though I'm going to the
>gym regularly, and trying to eat sensibly. I have constant battles with
>dark facial (chin and neck) hair (my tweezers are my best friends,
>practically) and the anxiety has pretty much completely subsided. It
>doesn't feel like complete control, but it feels like I'm comfortable at
>the moment - treading water. I know I should take the Meformin, but I'm
>scared to upset the delicate equilibrium I've constructed for myself in
>my lifestyle.
>
>I'm 28, and I'm also taking the pill - Microval (p.o.p). I don't want
>to get pregnant now, but I'd like to have the opportunity to do so
>eventually. I don't want a gun to my head about reproduction or my
>health. I want to be well and I want to be able to cope with my path to
>wellness. I don't like taking drugs in general - even for headaches -
>and I don't like depending on artificial substances to get through life
>- and in my mind, this includes Metformin.
>
>Will it make me feel completely horrible? How long for? Should I just
>bite the bullet and do it and feel lousy? When will I start to see
>results? Will I need to take it forever? Are there any alternatives? I'm
>embarrassed to go back to my gyno now and say I was too scared to start
>the course she prescribed for me.
>
>It just feels like an awful lot to cope with, and while I'm feeling
>(mostly) fine and looking (mostly) OK, the temptation is to just ignore
>it. I just want to be able to cope without making an enormous life
>changes, or feeling dreadful. Is this silly? Is this normal? I don't
>know what to do, and I'd really appreciate any advice anyone has.
>
>Thanks
![[ PCOS Discussion Forums ]](../../images/pcos_at_obgyn.gif)