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Have pcos. Taking metformin ER. Getting irregular periods. Getting tingling sensation in breast. What's going on?

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Practicing since : 1999
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HI i was wondering if you could help me i am so confused!! I am diagnosed with PCOS.I am over weight. I have been taking metformin ER 500mg and have since as of about 6 weeks ago started the weight watchers program and have lost approx 4-5kg's. I have started for the first time in years having a regular period for XXXXXX July & August. My last period was on the 22/08/2012. Around the 7/09/2012 i did have what looked to be fertile cevical mucus so my husband and i BD on the 8th & 9th of September. On the 22/09/2012 i went to bathroom and came across a small amount of brownish mucus kind of stuff. At first i thought it was my period getting ready to set in given that i was due round the 26/09/2012 but nothing happened. I have been feeling rather exhausted and have been having intermittent tingly sensation in my breasts and yesterday on the 27/09/2012 have started have some very dull and mild hardly noticable cramping, not localised. I dont want to read into anything, we have been trying to conceive for over 12 months now with 4 rounds of clomid and no success, however i was not taking the metformin in conjunction with the clomid. I was wondering how long does it take for the metformin to start help maturing the eggs for ovulation and what is going on with me!!!! I cant get a straight answer, here in Australia our Dr's seem to know very little about PCOS and im struggling to find ant answers.. Can you please help me????
Posted Wed, 17 Oct 2012 in Infertility Problem
Answered by Dr. Timothy Raichle 1 hour later
Hello, I would be happy to help you with your question.

Congratulations on your weight loss and apparent resumption of your cycles!! I recommend exactly what you are trying because often it is one of the only things that works - i.e. the WW's.

Now, your doctors are not completely clueless, because PCOS involves insulin resistance, irregular cycles, and infertility. They have recommended weight loss, placed you on hypoglycemic medications, and have combined that with Clomid for ovulation induction. You and they are doing everything right!

With correction of your cycles, consider that the success rate PER cycle is probably not much more than 20%. Also consider that they months where you were likely NOT ovulating did not really "count" because your body was really not working correctly.

So, now that you are cycling regularly, noticing mid-cycle changes consistent with ovulation and timing intercourse, the next step is to be patient and not give up hope. You will likely be successful at some point.

The metformin does not mature the eggs, it corrects the insulin resistance that is leading to non-ovulatory cycles.

If you do not have a positive pregnancy test by day35, call your doctor and ask about:
1. Progesterone to induce a period
2. Increasing your clomid dose by 50 mg per day

I hope this helps! - Dr. Tim
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