How do I know if Met is working?

[Hilla]

Okay, So I am on day 42 of taking metformin, so its been just about 6 weeks now.. still no AF!
I am kinda frustrated because I am not sure how to know if the Metformin is working?!
Any advice/info/suggestions would be hugely appreciated :)

[landbttc]

Hey Hillary! I find myself asking that question every day. It varies among women. I've read about some people getting pregnant within 2 weeks of met- some it never works.... etc. I did read that on average it can take up to 3 to 6 months to start working. I have been on met for almost 2 full months and about 2 weeks ago I had to take Provera to induce a period. Unfortunately, it's kind of a wait game. You'll get used to it! I was dx in August and I'm still battling it out with patience every day. Some women who have been on met for many months and years can prob give you a better idea but I thought I'd put my 2 cents in. :)

[Hilla]

Hey Liz! Thank you for responding! :) I am going to call the DR about provera within the week because I haven't gotten a period since late August - so technically I am on CD 98! yikes. I dont enjoy the waiting game but as you said I am sure I will get used to it.. haha!

[jcole20]

I'm o provera now. 1 pill a day for 10 days. I read it can take anywhere from a few days to 16 weeks to get a period after being done with provera. I haven't have a period since mid june.

[landbttc]

I usually get it the day of the 10th pill. My "provera periods" are usually pretty short and light. jcole- did you mean 16 days!? :) I'm starting to take charge of my own fertility and if it's been 35 days, no AF, and I KNOW I didn't O from temperatures, my dr. agrees that I need a new start (kindof a cleanse!) and puts me on provera. Everyone is different and I find that dr's handle pcos soooo many different ways. I know that when I told my doctor I had not had a cycle in a few months he immediately put my on provera to get one to shed my uterine lining. I'm finding that I like taking it b/c it's always a fresh start. I'm sure Hilla if you're TTC that your dr will put you on Chlomid soon. Mine tried that before Met... prob b/c I didn't need to lose any weight and met is pretty hardcore. :) CD4 over here- taking chlomid this month even tho it failed miserably the first time. First time taking it on top of met. We'll see how this goes!

[r6bikerchick]

I'm on CD98 (LMP August 12). My doctor hasn't suggested anything to induce a period yet. I started a low-GI diet on October 3 and it looks like (from my temps) I O'd a few weeks ago. My temps just came down today, so hopefully I will get my period soon.

I know you asked about Metformin, but a low-GI diet can (for mild cases) have the same impact on insulin resistance. So, it looks like ~7 weeks for me! (Hopefully)

[jcole20]

I'm on provera to shed my lining too. Then i'll start bcp the sunday after.I thought i read it took someone 16 wks to get thier pd after being done w/ provera.I know everyones different. It wasn't on this forum. Its crazy ain't it. You used to hate when your pd comes now you just pray that it comes every month without meds. My lmp was mid June 2010.

[Dr. Mark]

I think there are a few very important points here:

First, no woman with PCOS should go more then 3 months without a period. I don't care what your doctor says, they are wrong. This is dangerous and could lead to endometrial cancer (cancer of the lining of the uterus). You could even need a hysterectomy if cancer.

@r6bikerchick, I'm on CD98 (LMP August 12). My doctor hasn't suggested anything to induce a period yet. I started a low-GI diet on October 3 and it looks like (from my temps) I O'd a few weeks ago. My temps just came down today, so hopefully I will get my period soon.

When you ovulate you ALWAYS get your period within 12-14 days. When a cycle goes long it is because the first portion before ovulation occured lengthened. Therefore, regardless of what your temps say, if you think you ovulated 3 weeks ago, you should of had a menses a week ago, if you didn't you didn't ovulate. Second, 98 days without a menses is dangerous. I hope if there is one thing I can empower the women on this forum with it is the mindset that it is never ok to go more then 3 months without a period. Demand your doctor do something. The only exception to this rule is if your on a birth control that has a progestin: Birth control pills, Mirena IUD (not the copper one), Iplanon.

@jcole20, I thought i read it took someone 16 wks to get thier pd

You should get your period within about a week or two after getting done with the last pill of the Provera or Prometrium. If you don't I would talk to your doctor. There are many reasons why you might not, but it isn't because the medication takes that long to work. What causes the menses is women who don't ovulate don't release progesterone. It is the rise and then fall in progesterone that causes the menses. When it occurs naturally it comes from a corpus luteum (from ovulation) and occurs 12-14 days after ovulation.

Metformin does not protect you when you are not having a period. So if you are on Metformin and you have not had a period in 3 months you need to talk to your doctor. Metformin will not prevent you from getting endometrial cancer.

Hopefully that helps!

Dr. Mark

[Hilla]

Thank You all for your input and all the information! It is still quite the learning process for me so I really appreciate it :)

[Ovarianna]

I was put on Metformin in june 2010, and on oct 31st (halloween morning), I got my period for the first time in a year without birth control!, so it took about 4 months of me taking it straight, no lapses. then 2 weeks after i got my period i got my period again... the doctor said it is just because my hormones are fluctuating and because i hadnt had my period in such a long time before this. *pregnancy here we come*! *crosses fingers* :D

[Dr. Mark]

I was put on Metformin in june 2010, and on oct 31st (halloween morning), I got my period for the first time in a year without birth control!, so it took about 4 months of me taking it straight, no lapses. then 2 weeks after i got my period i got my period again... the doctor said it is just because my hormones are fluctuating and because i hadnt had my period in such a long time before this. *pregnancy here we come*! *crosses fingers* :D

Going a year without a menses is a risk factor for developing endometrial cancer. Anytime a period is irregular in the setting of no menses for a long period I would be concerned of hyperplasia of the endometrium. Metformin does not protect you from endometrial cancer. If this continues, I would ask your doctor to evaluate the abnormal bleeding (endometrial biopsy). What could be happening is the lining has build up and now it is bleeding but not because of a period but because of the build up. However, if this continues, I would not assume this is hormonal and be more concerned of pathology.

Dr. Mark

[dawndalebout]

I haven't had my AF since around April/May. I had a very large cyst on my right ovary which was almost 7 CM (we've been tracking for at LEAST a year or so). Usually my doc gives me Provera to enduce and it varies for me.Somtimes within only a few days of starting Provera I get AF, and other times it takes a day or two after taking it for the 10 days. I will say though, that last year right after taking Provera is when I became pregnant..before I m/c :( . Then in May/June my doc put me on Seasonique (? howevr it's spelled) as she said there COULD be a small chance it could have decreased the size of my cyst. Well, end of August came along, never had my AF like I should have.. my lining did thin a little bit, but cyst did not decrease. After talking about surgery with her for quite some time (was trying to put it off as I was scared to death!) I finally agree'd and had my surgery this month. Right ovarian cyst, and right ovary removed.HSG as well as D&C. (that was on the 8th of this month) She then a day after it put me back on Metformin (was on it this past spring for the first time but s/e were awfull! couldn't stop going to bathroom! :O ) So now, back on Met no s/e as of yet (THANK GOD!) Thought I started AF on the 12th, but I think it was just spotting (she said I wo uld have spotting after the surgery, and that I SHOULD get AF with in a few weeks) However, she did say that if I DIDNT get AF before I see her (which I see her tomorrow actually!) She said she'd then give me Provera to enduce, and also start me on Clomid, finally!!!. So.. i'm praying and hoping she does indeed give me the Clomid, and I pray that I get a BFP soon! .. As for "is the Met working?" I'm not sure how to answer that either.. Like I mentioned I've only been on it again for a few weeks now, but even before I stopped it this spring/summer I was on it for a few months.. and besides the s/e I didnt know if it was working either! i wish there was a way to know haha.. My doc said after my surgery my periods SHOULD be a bit more regular.. I sure do hope so because for the past few years I NEVER get AF unless I'm on Provera.. so usually that's what I take every 3months or so.. I hope it's more regular now.. although, I hope after seeing her tomorrow and going on Provera and Clomid I hope i dont get it for 9 months :) that would be sooooo niiiiiiiiiiiiiiiice. Good Luck and BabyDust to you all! :)

[sdthacker]

This has helped me I have been on metformin for 2 and 1/2 wks and was wondering when would it work. ;)

[missmissy]

Have your doctor order a fasting insulin test. It will tell where your levels are.

[Dr. Mark]

Fasting Insulin levels are not a good predictor of insulin resistance unless they are elevated. If they are not, it could give a false negative. The gold standard is a Euglycemic Clamp Test, however this is done for research purposes only. Most will use an Oral Glucose Tolerance Test where you check both glucose and insulin every hour for 3 hours after a 75 gram glucose load. This is the best test with the least amount of false results.

Dr. Mark

[kpow777]

I suffer with BPD and I'm pretty sure that isnt the only the reason she acts like that. She may have other personality disorders BPD rarely comes by itself. I'd be kinda but u may want to have a calm talk with her about how u feel. Remember be calm don't start screaming in her face.

[MrsStewie]

I'm on day 25 of my first round of Metformin. I've lost 7 pounds so far and couldn't be happier, even if a few of the days I was unbearably miserable! On Monday I'll start Provera and then I'm going to take my first round of Clomid. I'm so happy to have finally found a doctor I like, this is the third gynecologist I've seen since being diagnosed with PCOS 3 years ago.