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Menstrual irregularity,no PCOS,glucophage,raised blood insulin,ovarian cyst

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Internal Medicine Specialist
Practicing since : 1998
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Hi
I am 33 yrs old. I am having menstrual irregularities for past 1 year. For which i ve gone to see a gynecologist as well & after a series of tests, she gave me glucophage however i am not diagnosed as a diabetic or PCOS. There are minor changes in my right ovary like PCOS & my blood insulin was slightly raised. As it should be less than 25 & mine was 16. I am worried that why she gave me this drug?
Posted Thu, 26 Apr 2012 in Menstruation and Miscarriage
 
 
Answered by Dr. Jasvinder Singh 39 minutes later
Hello XXXXXXX,

Thanks for posting your query.

PCOS is one of the commonest causes of irregular periods. Since the blood insulin levels were slightly raised and there were minor changes in the ovarian cysts, hence it raises the possibility of PCOS. PCOS is a likely diagnosis for your irregular periods.

It is a problem in which a woman’s hormones are out of balance.So ovaries develop more follicles than normal every month. Other diagnostic tests are 2 hr GTT (glucose tolerance test), serum androgen and testosterone levels, LH-FSH ratio, prolactin levels,TSH levels,17-hydroxyprogesterone levels and ultrasound uterus.

Glucophage is an insulin-sensitizing biguanide commonly used to treat elevated blood glucose levels in people with Type 2 Diabetes and often employed as an off-label prescription for PCOS.

Metformin in Glucophage improves the cell's response to insulin, and helps move glucose into the cell. It also helps in regularizing the irregular periods and hence you will have regularity in periods also.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards


Above answer was peer-reviewed by
 
Follow-up: Menstrual irregularity,no PCOS,glucophage,raised blood insulin,ovarian cyst 3 hours later
Hi
Thanks for a quick reply. I have gone through all of the tests you mentioned above & all of them were alright. I went for ultrasound as well, both pelvic & T/V & they were fine as well. They only showed minor changes like PCOS in 1 ovary. My only concern about taking the metformin or Glucophage is, that i ll have to use it for a prolonged period & will it be alright for my hormonal system? & can i get pregnant taking it? Will it be any harm for the baby if i get pregnant? As we are trying to get pregnant again.
Thanks
 
 
Answered by Dr. Jasvinder Singh 7 hours later
Hello XXXXXXX,

Thanks for writing back.

I can understand your concern for Glucophage when you are trying to get pregnant.

However since you are having menstrual irregularities for the past one year and the ultrasound reports have shown slight PCOS changes in the ovary, you need Glucophage to induce ovulation which will help in conceiving.

Patients with PCOS have hyperinsulinemia which leads to excess androgen (male hormones) production by the ovaries and this causes anovulation.

Metformin sensitizes the cells to insulin thus lowering the body’s production of insulin and consequently reducing androgen production. Once androgen production has been normalized ovulation can often resume.

You do not have to take it for lifelong and once your ovulation cycle has established, then your doctors may stop it.

Also it is not recommended to take this drug when you are pregnant. There are no adequate and well-controlled studies in pregnant women taking Glucophage and once pregnancy occurs, you will be asked to stop taking it.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards
Above answer was peer-reviewed by
 
Follow-up: Menstrual irregularity,no PCOS,glucophage,raised blood insulin,ovarian cyst 9 hours later
HI
Thanks again for replying quickly. I can understand the hyperinsulinemia & the anovulation. & thanks again for making it really easy for me to understand all this. But my doctor suggested that i should keep on taking Glucophage even if i get pregnant. But as you just told me that its not suitable for a pregnant woman & i should stop it once i get pregnant? She told me to take this atleast 6 months to 1 year & then consult again. No matter if i get pregnant during this time. She even said that it might have caused my last miscarriage so if i stop taking this drug, it might ll happen again. So make sure i dont stop it even during pregnancy?
 
 
Answered by Dr. Jasvinder Singh 58 minutes later
Hello XXXXXXX,

Thanks for writing back.

It is true that continuing metformin throughout pregnancy may decrease the likelihood of developing gestational diabetes and also lessens the risk of miscarriages but the treatment of choice in gestational diabetes is Insulin.

Depending on your medical history, your doctor might ask you to continue your medication during pregnancy or to stop it when you learn you’re pregnant. This depends on your blood sugar levels and physical condition at that time.

As mentioned earlier, Glucophage is a FDA category B drug and no adequate and well-controlled studies in pregnant women taking Glucophage are there, so prescribing this drug in pregnancy is the sole decision of your treating gynecologist.

Hope this answers your query.

Wishing you good health.
Above answer was peer-reviewed by
 
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