Metformin — Metformin (Glucophage®) is medication that improves the effectiveness of insulin produced by the body. It was developed as a treatment for type 2 diabetes, but may be recommended for women with PCOS in selected situations.
* Metformin is not usually recommended for women with PCOS who have difficulty becoming pregnant. (See “Treatment of infertility” below).
* An expert group does not recommend metformin for women with PCOS who have excessive hair growth (hirsutism). Birth control pills alone, or in combination with an anti-androgen medication, are a better option. (See “Patient information: Hirsutism (excess hair growth)“).
* If a woman does not have regular menstrual cycles, the first-line treatment is a hormonal method of birth control, such as birth control pills. If the woman cannot take birth control pills, one alternative is to take metformin; a progestin is usually recommended, in addition to metformin, for six months or until menstrual cycles are regular. (See “Progestin” above).
* Metformin may help with weight loss. Although metformin is not a weight-loss drug, some studies have shown that women with PCOS who are on a low-calorie diet lose more weight when metformin is added. If metformin is used, it is essential that diet and exercise are also part of the recommended regimen because the weight that is lost in the early phase of metformin treatment may be regained over time.