Most women with PolyCystic Ovarian Syndrome, PCOS have a lot of difficulties losing weight and keeping it off. This is not in their control, completely unfair and can be very challenging.

My patient, Simona* told me that it’s so frustrating to see friends eating burgers, fries, having a rich creamy dessert, and not gain an ounce, while she suffers through salads and still gains weight.

Women with PCOS have a much harder time losing weight because their condition that leads to multiple cysts in the ovaries is caused by an underlying Insulin Resistance.  

In simplified terms means that their bodies do not metabolize carbohydrates in the same way as other women, they are more likely to gain weight and more likely to become diabetic.

What happens with Insulin Resistance:

  • The body converts carbohydrates into blood sugar or glucose
  • Insulin helps transport blood sugar into the cells of the brain, muscle, and other tissues
  • Insulin is like the key that unlocks the door of the cell membrane to allow glucose to get in to provide energy
  • When an Insulin Resistance is present, the cell membrane door is stuck and the Insulin isn’t able to transport the glucose into the cell efficiently
  • With less available glucose in the cells, the person can feel hungry all the time
  • This leads to less glucose in the cells and more in the blood, leading to higher blood sugar levels.
  • With more blood sugar available, the liver converts it to triglycerides, cholesterol and also fat
  • The fat tends to accumulate around the waist
  • All of these factors contribute to a higher risk of Type 2 Diabetes

Metformin’s Use in PCOS

Metformin is not a diet drug, but it works as an insulin sensitizer, which means it helps the body’s own insulin work more efficiently to transport glucose into the cells. This lowers blood sugar and helps reduce weight.
It’s a good idea to ask your provider to check your fasting glucose level, a Hemoglobin A1C, which provides a snapshot of how your blood sugar has been over the last 3 months, cholesterol and triglycerides.

Reducing Carbs with PCOS

The fewer carbs you eat, the better with PCOS, even while taking Metformin. A low carb diet will help the metformin work more effectively. Aim for eating less than 100 grams/day.

If you can see a nutritionist, by all means, do so for help reducing your carbohydrates.

My patients have found that limiting carbohydrates not only helps with their weight loss but also improves their triglyceride & cholesterol levels.

Metformin helps with Fertility in women with PCOS

Women who take metformin also find that as their weight decreases, they may start to ovulate more regularly. This is good news if they want to become pregnant. If ovulation doesn’t occur with Metformin, often other medications are added such as clomiphene or an aromatase inhibitor, Letrozole.

Metformin Used with Birth Control Pills

Combination birth control pills with both estrogen and progesterone are used in women with PCOS to suppress the irregular and heavy periods associated with PCOS. While the birth control pill will also help reduce acne and excessive hair, many women with PCOS find that using the combination of Metformin and the pill further improves acne and excessive hair growth.

2 Great resources for women with PCOS

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