Medication Monday

Since this blog is coming nearly a year after my journey with infertility began, there is some catch up to do, especially in the way of medication and medication options. Medication is a daily reality for infertiles, to the point that it often becomes ridiculous. I have never had any qualms about taking medication but now, I take so many pills everyday it is crazy. I even have to use a special pharmacy for the infertility drugs. If my current treatment doesn’t work, the medications will become more numerous and more of a pain in the ass (literally at some point…).

I am currently on one medication daily and then there is the protocol for cycling (not biking, TTCing in any given month or cycle) which is not daily and will change if it is not successful. PLUS, I am taking a ton of different vitamins. I even got one of those weekly pill organizers which really made me feel like I am only steps away from the Early Bird Special. Here is a rundown of my medications at the moment.

Daily: Metformin (2000mgs), Prenatal Vitamin, Vitamin D (2000iu), Folic Acid

Monthly: Clomid (5omgs for 5 days), Ovidrel (1 injections 250mls)

Today we will talk about Metformin.

Metformin is a drug originally intended to help diabetics who are insulin resistant. Since not much is known about PCOS, new ideas are coming forward all of the time and one recent theory is that insulin resistance is a part of PCOS. Insulin is regulated by hormones so since PCOS is a hormonal imbalance it actually makes sense. When I read this, I decided to present my general practitioner with the studies and ask to try Metformin (or as it is lovingly referred to among infertiles, Met) out.

I am not insulin resistant according to my blood tests but I was barley in the “normal range”.  It didn’t matter though because studies show that even in PCOS without insulin resistance, Met is shown to reduce the growth of cysts, and in some cases restore normal menstrual cycles.  In October, after about 3 months on Met, I finally got my period after over 6 months of waiting!This is an important step in taking charge of PCOS.

Met also regulates the intake of insulin. Once I started taking it I could feel the difference in my body immediately. I used to crave sugar and carbs and could eat a pound of pasta by myself if I wanted to. I always felt like I wanted to eat and couldn’t stop at a normal sized portion. Once one the Met, that all changed. I had no appetite, wasn’t craving anything and could barely force myself to eat unless I really needed to.

Basically, before the Met, I would eat something like pasta and my body would change the carbs and sugars into insulin for energy. But since I was almost insulin resistant, my body wouldn’t absorb it and therefore would send a message to my brain saying “Hey! We need insulin RIGHT NOW! Pasta, Pasta, Pasta, Bread, Bread, Bread” and I would feel hungry again. All of that unabsorbed insulin turned into fat. Not just any fat, belly fat. It made me feel disgusting and caused me to gain nearly 30lbs since graduating from college and was impossible to get rid of.

Now my appetite is mostly back, I can enjoy food again at least. But I don’t want as much of it at all. I have lost about 17lbs since going on Met in August 2010 from the medication alone, no exercise more than normal and no restrictive dieting. It is great but the best part is NO CYSTS! When I have had ultra sounds, my ovaries are smooth and show up as a black blob. Before, I could see tiny white dots all over them but the Met has made those go away.

Now, this might sound like a miracle drug to you and you might be thinking “I want that! I want to lose some weight too!” Not so fast, it is not all rainbows and butterflies. The downside to Met is that is causes havoc to your digestive system. Let’s just say I went through many boxes of Imodium AD when I first started. For that reason, you must start Met gradually with 500mgs at first and moving up to 1000mgs when your body (and stomach) have gotten used to it. I eventually hit 2000mgs a day and for the most part no longer experience bad side effects unless I eat something totally gross and greasy that my body can’t process anymore.

I have no problem taking Met for the rest of my life to keep my weight and cysts under control if that is what it is going to take. I really think the pros outweigh the cons. I am looking forward to hearing more research on Met such as its effects on miscarriage rates. In some studies it has shown to reduce miscarriage in PCOS patients. In some it is shown to have no effect. The jury is still out.

Next Medication Monday: Everything You Ever Wanted to Know About Clomid