Doc doesn't want to prescribe metformin

[smiley]

Hi Everyone,

I'm new here. I am 29 and jsut got diagnosed with PCOS. Went off the pill last nov and got periods for a few months and then stopped. I've got mild-mod acne and mild hirsuitism. Relatively skinny ;)

We went to a fertility specialist and he said in light of my BMI (23-24), he didn't think that metformin was effective. Also, he wants to start me on femara b/c it has better results.

I've been reading lots of books and info online and it seems that so many people are on metformin, regardless of weight.

Am I missing out? In light of the fact my immediate goal is getting pregnant, I will be focussing on what he says but I wanted to get a second opinion as well.

Thanks for your help.
Anna

[Vero]

I don't think what your doctor said makes any sense :(

I'm skinny (BMI 19) and they gave me Metformin precisely because I cannot "lose" weight to improve my Insuline Resistance... Femara is a drug to help with fertility, but it will do nothing for your Insuline Resistance, which is the underlying cause of PCOS... I would definitely look for a second opinion!

Good luck! ;)

[aimee]

I agree with Vero. It doesn't make sense if you are trying to help the insulin resistancy as well as getting pregnant. Femara will hopefully work for your fertility issue but it won't do anything for your insulin issues. Good luck!

[smiley]

It's interesting b/c the fertility doc doesn't seem to be interested in the rest of PCOS. He is looking at it from the perspective of pregnancy only! Which is fine for the short term but in the long term....
:confused:

My fasting glucose is normal, so i'm curious if I have insulin resistance or not??

Aimee, how was femara? I am a little nervous about starting all this. I'm planning on starting my prometrium on sunday and then we'll see how it goes!

Thanks so much for your replies, Aimee and Vero :D

[sweetsunshine72]

You can have a "normal" fasting glucose, and still have IR. In fact, that's how it is with me, most of the time I get tested!

Glucose tests aren't really the right ones for IR, but they will tell the doc if your IR is progressing towards diabetes. Really, you want to look at insulin levels, preferrably both fasting, and at several points after a glucose load (usually done as part of a 2 hr Glucose Tolerance Test). Even then, you may still need to "read between the lines" to pick up on it. You also don't necessarily have to be overweight to have IR - there are many women with a "normal" BMI who stay that way only because they eat like birds and work their rear ends off!!!

The other thing to think about is that, while almost all of us have IR as the cause of our PCOS, some of us (Thin Cysters especially) seem to have a thyriod issue, sometimes along with the IR. You should definately get evaluated for thyriod as thyriod levels can affect a developing fetus!

I think you should sit down with this doctor and discuss your plan of action with him. Let him know that, yes, you want a child, but that you want to actually treat your PCOS as well. If his way of thinking doesn't match yours, you may want to find another doc who DOES think the way you do! Personally, I wouldn't want to go to a doc who is in the "baby business", instead of there to treat his patients, but that's just me.

My other personal opinion, is that taking 3 months to work on the underlying issue is not that long, bio-clock-wise, but it CAN put you in a much healthier position, which is likely to help you to not only become pregnant, but have a lesser risk of miscarriage, and a healthier, happier pregnancy and delivery. Also, some PCOS women find that they have milk supply issues - the ones who've taken Metformin or otherwise treated their IR seem to have a better time of it. You can check that out on the Pregnancy and Mom boards.

Anyways, you do what you need to do - only you can decide what's right for you. Take care, and I hope this helps!!!

[aimee]

smiley- Femara wasn't bad at all. I had no side effects but everyone is different. I started with 2.5mg I believe and AF came early so RE immediately started me at 5mg and monitored my follie growth every few days. Once they were ready I actually triggered with ovidrel and got my BFP!! Good luck and lots of baby dust to you!

[IowaGirl]

I also did Femara. Clomid did nothing for me. Other than a few headaches, I really had no side effects.

You may want to see if there's a PCOS clinic nearby. I go to the one at University of Iowa and it's fabulous. It really helps to be dealing with docs who deal with it everyday.

You may want to look into cinnamon until you can get metformin. It's a natural supplement that is used to lower blood sugars and help with IR.