PCOS - Metformin or Spironolactone

nighat_asl

Just wondering which one is better to deal with PCOS ??? Metformin or Spironolactone???

Have just 10lbs to lost and have tried metformin as per my gynae's instruction but nothing worked......infact i'd say metformin has given me a girft of CHRONIC CONSTIPATION

seeking guidance

BTW: Ladies taking spironolactone............whts ur daily dosage of it girls???

ShrinkinMel

That is strange I have the opposite issues with Metformin.;) I don't think it has helped much overall with PCOS symptoms(for record I've never been diagnosed PCOS but have had symptoms since my cycles started) but I was put on to drop my elevated A1C back down to normal. I'm running 5.8 to 5.9. I am sure I have some form of insulin resistance. I kinda want to get back off this med. I'm on the lowest dose and don't care for side effects.

nighat_asl

bump

jenifr818

Metformin made me sick as a dog. I haven't tried Spiro yet, have the tablets (25mg/day) but haven't started taking them yet, trying to avoid medication since I don't like the idea of using drugs to make my body behave itself.

Sabine_Stroehm

If you don't get a lot of replies here, consider re-posting this here:

http://www.myfitnesspal.com/forums/show/3087-p-c-o-sis

good luck!

JLHNU212

Bump so I can check out that link (my work is blocking it)!!! Thanks for asking the question! I have been on Metformin and it made me super sick, I was taking it for diagnosed PCOS.

bellesouth18

I tried Metformin--my blood sugar became totally unstable and plunged below 60 several times a day. I was queasy and dizzy all the time, too. My doctor told me to quit taking it after a month. I never had problems with my blood sugar levels to start with, just all the other stuff, so I don't know why he put me on it in the first place. I still take 50 mg spironolactone twice a day. Now that I've lost weight and cut back on my sodium intake, my BP is low normal. Yippee!

I'd say follow your doctor's recommendations and go from there. Everyone's different.

edited for dosage information.

Pandora_King

I started trying Metformin after I was diagnosed. It put me into the hospital. They figured it was allergies. I did my own research and found Spironolactone and asked my doctor for it. I took it for about a year and then got another ab scan. The cysts were gone (and there were a lot of them!). They haven't come back either. That was around 5 years ago.

kenzietate

I have taken both and I find they did different things. I am insulin resistant so that may make a difference.

I was on Spiro first and I noticed the following:
1) Decreased/Slowed hair growth
2) Higher Energy levels
3) No weight loss, still gained weight if I wasn't completely vigilant about working out every day.
4) No change in acne
5) Periods did improve i.e. less cramping and pain, lighter flow
6) No change in cysts either direction

I started to have side effects like severely decreased appetite and some other things that I am not sure were related but the doc took me off anyway. After that they tested me for insulin resistance and I tested for that so they put me on 1500mg metformin/day.

This actually helped me more positively:
1) Same higher energy levels as the spiro
2) Small amounts of weight loss but also, maintaining when not trying to lose as opposed to gaining weight without even trying
3) Periods continued to improve in same manner
4) Acne improved to some extent on my face but not on my chest or back
5) Had some side effects of the loose stool variety but they went away if I watched my carb intake
6) Not sure if cysts changed b/c I didn't have an ultrasound after I started taking it.

I actually had better success just cutting down my carbs than I did on either medication alone. I was on metformin when I cut down my carbs and I had the following results:

1) Lost 10-12 lbs within 2 months!
2) Had to decrease my metformin dosage due to getting low blood sugar
3) My acne went away almost completely within 2 weeks of the low carb diet
4) My periods because 100% bearable
5) I actually started ovulating on my own (got pregnant on month 3)
6) Hair growth on my head increased
7) Hair growth elsewhere was severely decreased (no 5 o'clock shadow on my legs lol)
8) Energy levels were through the roof!!
9) Not sure if cysts changed much here...only ultrasound was for the baby

cafeaulait7

Spiro doesn't cover the range of issues like metformin does. It does nothing for insulin resistance, especially.

I didn't like that I had to watch my electrolytes with spiro, and I kept getting salt licks on me every time I sweated. I swear a deer herd was going to flock to me and lick me to death. It was very odd and embarrassing (I had visible salt all over me in the summer!).

nighat_asl

wowwwwwwwwwwwww 10-12lbs in 2 months....thas great....i am taking metformin 1000mg and have to lose just 6lbs but nothingis owrking in my case

I have taken both and I find they did different things. I am insulin resistant so that may make a difference.

I was on Spiro first and I noticed the following:
1) Decreased/Slowed hair growth
2) Higher Energy levels
3) No weight loss, still gained weight if I wasn't completely vigilant about working out every day.
4) No change in acne
5) Periods did improve i.e. less cramping and pain, lighter flow
6) No change in cysts either direction

I started to have side effects like severely decreased appetite and some other things that I am not sure were related but the doc took me off anyway. After that they tested me for insulin resistance and I tested for that so they put me on 1500mg metformin/day.

This actually helped me more positively:
1) Same higher energy levels as the spiro
2) Small amounts of weight loss but also, maintaining when not trying to lose as opposed to gaining weight without even trying
3) Periods continued to improve in same manner
4) Acne improved to some extent on my face but not on my chest or back
5) Had some side effects of the loose stool variety but they went away if I watched my carb intake
6) Not sure if cysts changed b/c I didn't have an ultrasound after I started taking it.

I actually had better success just cutting down my carbs than I did on either medication alone. I was on metformin when I cut down my carbs and I had the following results:

1) Lost 10-12 lbs within 2 months!
2) Had to decrease my metformin dosage due to getting low blood sugar
3) My acne went away almost completely within 2 weeks of the low carb diet
4) My periods because 100% bearable
5) I actually started ovulating on my own (got pregnant on month 3)
6) Hair growth on my head increased
7) Hair growth elsewhere was severely decreased (no 5 o'clock shadow on my legs lol)
8) Energy levels were through the roof!!
9) Not sure if cysts changed much here...only ultrasound was for the baby

kenzietate

Yeah I had the same issue before I lowered my carbs. It is really difficult at first bit the results were so worth it and I will do it again after I give birth. It is called the LCHF or ketogenic diet. I also had limited success with eating low GI. I hope you find something that works for you!

wowwwwwwwwwwwww 10-12lbs in 2 months....thas great....i am taking metformin 1000mg and have to lose just 6lbs but nothingis owrking in my case

I have taken both and I find they did different things. I am insulin resistant so that may make a difference.

I was on Spiro first and I noticed the following:
1) Decreased/Slowed hair growth
2) Higher Energy levels
3) No weight loss, still gained weight if I wasn't completely vigilant about working out every day.
4) No change in acne
5) Periods did improve i.e. less cramping and pain, lighter flow
6) No change in cysts either direction

I started to have side effects like severely decreased appetite and some other things that I am not sure were related but the doc took me off anyway. After that they tested me for insulin resistance and I tested for that so they put me on 1500mg metformin/day.

This actually helped me more positively:
1) Same higher energy levels as the spiro
2) Small amounts of weight loss but also, maintaining when not trying to lose as opposed to gaining weight without even trying
3) Periods continued to improve in same manner
4) Acne improved to some extent on my face but not on my chest or back
5) Had some side effects of the loose stool variety but they went away if I watched my carb intake
6) Not sure if cysts changed b/c I didn't have an ultrasound after I started taking it.

I actually had better success just cutting down my carbs than I did on either medication alone. I was on metformin when I cut down my carbs and I had the following results:

1) Lost 10-12 lbs within 2 months!
2) Had to decrease my metformin dosage due to getting low blood sugar
3) My acne went away almost completely within 2 weeks of the low carb diet
4) My periods because 100% bearable
5) I actually started ovulating on my own (got pregnant on month 3)
6) Hair growth on my head increased
7) Hair growth elsewhere was severely decreased (no 5 o'clock shadow on my legs lol)
8) Energy levels were through the roof!!
9) Not sure if cysts changed much here...only ultrasound was for the baby

MickeyBoo

It's unlikely that Metformin would give you constipation, it is notorious for causing severe diarrhea. I've been on it for close to 7 years and find that it helps a lot with weight loss. I have PCOS but am also diabetic so the metformin works for both conditions and helps to control them both, when the dosage is right and my diet is good then the weight usually just falls off, but it is a lot more effective with daily exercise, gives the system a natural push in the right direction.

JessyLovesJCS

I'm been on Metformin for PCOS for years and years. The only issue I have had with it is that if I eat too many carbs - like over 200g - I will have some belly rumbles and a bout of diarrhea. It keeps me in check, although 200g of carbs is more than I typically consume.

RxKetogenicRx

Depends on what symptoms you are trying to alleviate
Metformin to improve insulin sensitivity, spironolactone to treat hirsutism and acne

Metformin side effect wise: weight neutral or weight loss associated, transient diarrhea and stomach pains (tolerance develops), chronically can deplete cyanocobalamin, has no hypoglycemia as mono therapy
Spironolactone side effect wise: hypotension, polyuria, hyperkalemia, gynecomastia (not good for men, but some women may want this...)

It's going to come down to what your lab values indicate...hyper aldosterone use spironolactone, HbA1C use Metformin. Spironolactone is normally used for heart failure and post myocardial infarction.
Both are renally excreted but spironolactone would require more monitoring for serum creatinine and electrolytes.

Hopefully I have confused you!

Funny/True story, we had a transgender former male using spironolactone off label to get gynecomastia...Adams Apple and scarves are dead give aways.

cafeaulait7

^^^ The metformin actually usually brings the testosterone in line itself in women with PCOS. Pretty cool, no? I still think we PCOS girls probably need more progesterone (and I take Prometrium) to counteract the overabundance of estrogen that can still result, but otherwise metformin seems pretty widely effective for our issues, imho.

I'd definitely do Met over Spiro, but I haven't been on Met long enough to see if it helps the hirsutism like Spiro did. That was pretty effective (still not enough for me to not have to do cosmetic interventions, so meh for me personally).

SkimFlatWhite68

I reversed the effects of my PCOS by limiting carbs to less than 75g per day (non-starchy vegetables and berries), cutting out grains and walking every day. Less than 50g is recommended, but personally, I found that really hard to adhere to long term.

I have never taken Metformin, even though my Endocrinologist prescribed it for me. The side effects listed are horrendous and I thought I should take charge of my lifestyle before I pumped all those drugs into my body, and then had to take more drugs/vitamins to make up for the accompanying imbalances. I had already done IVF and years of fertility drugs was bad enough.

So, I'm sorry for not answering your question of which drug to use. I know this is a personal thing, but perhaps try a low carb diet first and in a month see how you feel.

TheChocolatePrincess

I just started Metformin 2 days ago. Periods were horrible and I HAD to do something about it since I am getting married in 8 months...

Anywho, so far so good. I have no complaints.

I am on 500mgs to start in addition to a progesterone to get the bleeding to stop, then I start BCs again on Sunday, even though the doc says that it will be temporary since I am trying to ween myself off of birth control.

I am combining all them drugs with a low carb diet...I have lost 3lbs so far though the doc said I would experience water loss because he said that the PCOS causes water retention. He expects that with the metformin and a low carb diet I should be able to lose 10lbs within 2 weeks or so (mostly water, he thinks only about 4lbs of that will be actual fat loss)...So that is what my goals are.

He isn't really "strict" because this isn't about "weight loss" per se, but about getting my PCOS in control.

He has me on a 2000 calorie diet, though I am pushing for less than that and has asked me to start exercising.

I will keep you posted on how it goes.

cebreisch

I haven't taken spironolactone, but I have taken metformin. With the metformin (that's the generic, Glucophage is the brand name), it never caused constipation for me (quite the contrary, in fact), but it did cause low-blood sugar.

To keep if from causing low-blood sugar, I took it about 3/4 of the way through my meals, and make sure you drink lots of water throughout the day.

I've taken as low as 500 mg, and as much as about 2000 mg/day when I was trying to get pregnant.

badfairy00

Spironolactone made my period last a month. Metformin makes me nauseous. Either way I figured I'm screwed

cafeaulait7

Spironolactone made my period last a month. Metformin makes me nauseous. Either way I figured I'm screwed

Aww! Progesterone (Prometrium) helps with the reproductive hormone balance and can help a lot. It doesn't help with any insulin issues, though.

I started taking metformin recently, and I think it made me have my hell-period even though the Prometrium had all but stopped them! Aack. I'm hoping that's just a settling-in thing, because I am so through with my periods! I have endometriosis, too, and I just can't take it any more.