PCOS Messages for January, 2002: Re: question about anticonvulsants such as Depakote and PCOS (also new to this list) and metformin alternatives

Re: question about anticonvulsants such as Depakote and PCOS (also new to this list) and metformin alternatives

From: Belle (anonymous@obgyn.net)
Thu, 31 Jan 2002 18:47:21 -0600 (CST)

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Decreased glucose metabolism is a known side effect on *all* oral contraceptives that I have seen. I have linked the prescribing information for a couple of birth control pills for other people on this board. Here are some examples for you to see. Package insert for Ortho Cyclen and Ortho Tri-cyclen: http://www.ortho-mcneil.com/products/pi/pdfs/cycltri.pdf. The information for Diane-35 and Dianette: http://www.inhousepharmacy.com/bcp-hormones/diane-35-information.html. Yasmin: http://www.yasmin-us.com/home.html. Those are all of the BCPs that I can think of right off of the bat, but all of these mention decreased glucose metabolism as a possible side effect.

Weight loss is a known side effect of metformin but not everyone gets it.

If you have a syndrome or a disease process that already incorporates a decrease in glucose metabolism you would be wise not to take a medication that has a known side effect of making it worse. This is the same for women with liver dysfunction -- I would not recommend metformin.

I suspect that Dr. Speroff was speaking about women in general, not the 8% - 15% of women who potentially have PCOS.

We are not talking about women getting diabetes from the pill, but based solely on the information that you have provided in this post, 1 in 8 women getting diabetes during their childbearing years is frightening and is a very large proportion, whatever the cause. According to the American Diabetes Association, only 5.9% of the American population has diabetes. That would be 1 in about 18 people would have diabetes normally. I assume that the overwhelming majority of the general population of women who take the pill will never have the side effect of decreased glucose metabolism great enough to notice, since they know that another side effect is weight gain.

Most women can take the pill without worring about the decreased glucose metabolism but then again, most women can eat pasta without gaining 5 pounds or feeling crummy, wiped-out and starving the next morning. :-)

At Wed, 30 Jan 2002, Victoria wrote: >
>Hi Belle,
>
>I think that in Dr. Speroff's book on "Clinical Gynecologic Endocrinology and
>Infertility", published in 1999 by Lippincott, Williams & Wilkins, (and I
>suspect his Contraception book, its been a while since I read it) that he states
>that BCP do not always show a decrease in glucose metabolism. I would also
>suggest that one of the Australian studies I have seen on the subject said that
>2 out of 16 subjects got diabetes, but it does not state how they controlled the
>study so that they proved whatever pills they were on gave them the diabetes.
>
>--
>Victoria

-- Hope this helps,

Belle

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