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Q: I have been reading about PCOS all night. I was diagnosed several years ago. What I am trying to find out is: Does Metformin shrinks cysts? I have read everywhere that women have a normal menstrual cycle after using it, get pregnant, and reduced chance of miscarriage, helps weight loss.
I just canít find the answer I am seeking. Any help is appreciated.

A: Metformin (Glucophage(R)) does improve PCOS in many, but not all, women who take it. Because it can lower insulin levels, restore regular periods and probably reduce the incidence of miscarriage, it is a great advance in treatment of PCOS. I have not seen a study of its effect on the tiny cysts in the ovary. However the appearance of the ovary on ultrasound is not as important as how the ovary functions. And metformin often does restore ovulation which is the important thing.

Some who take metformin have gastrointestinal side effects such as upset stomach and diarrhea, but most feel fine on it.

Who should take metformin is not yet entirely clear. My own view is that it is for women with evidence of insulin resistance or who need help in getting pregnant. By itself, metformin has only a slight effect on the skin and hair changes associated with PCOS. However, the decision of whether or not to use metformin needs to be decided as part of an overall treatment plan on an individual basis and in consultation with a knowledgeable physician.

Hope this is helpful.


Geoffrey Redmond, MD

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