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Taking metformin for polycystic ovary syndrome. Having heavy bleeding than normal. Getting spots on forehead. Caused by medication?

Mar 2013
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Yes please.
I am taking metformin for polycystic ovary syndrome. I get cysts on my ovaries every month with some pain. I have been taking this med for 1 1/2 years. I am 28 years old. My cycles are getting closer to normal but I still bleed heavier than normal and longer than normal although it has gotten a little bit better. Now I am getting dark spots on my forehead and I just got one on my lip. Can this be caused by the medication? Should I see an endocrinologist and what tests should I have done to make sure I am doing the right thing?Thank you for your time and consideration.
Posted Sun, 7 Jul 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Thanks for your query.
You are suffering from PCOS ( polycystic ovarian syndrome ).
It is characterized by basic hormonal imbalance, due to which the ovary is studded with various small cysts, and none of the follicles grow properly each month to form a mature egg.
Hence, women with PCOS commonly experience abnormal bleeding and difficulty in ovulation.
The basic features of PCOS are -
1. Multiple cysts seen on ultrasound
2. Menstrual dysfunction.
3. Metabolic complications such as - raised blood glucose levels due to insulin resistance, high adrenal hormones causing hirsutism, acne ,skin pigmentation and deranged lipid profile etc.
Metformin does not cause skin pigmentation per se, however PCOS causes skin pigmentation due to hormonal dysfunction.
You should definitely consult an endocrinologist and have the following evaluation
1. FSH , LH on day 2 of periods. In addition, DHEAS, serum free testosterone, SHBG, fasting serum insulin, oral glucose tolerance test, TSH, Serum prolactin, lipid profile, C peptide levels - THis will evaluate metabolic severity of the disease.
2. Pelvic transvaginal ultrasound for PCOS evaluation.
3. Follicular monitoring to document if ovulation is occuring - particularly if fertility is an issue.
Regarding PCOS, diet modification and lifestyle modification by way of eating right, exercising regularly is the main therapy.
Even a weight loss of 5 kg. will regularize the menstrual cycle.

Please feel free to discuss further.
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