Metformin + PCOS

This article was written by my previous Nutrition Grad Student, Kimmie Singh. She is a fat woman of color who experiences PCOS. You can find out more information about her work now as a dietitian here.

“But I don’t have high blood sugar? Why am I on the diabetes drug Metformin?”

Metformin, aka Glucophage, is a common treatment option for PCOS and many wonder why it is chosen.

{Side note: in order to understand the role of Metformin, you might want to review the previous post on PCOS and insulin.}

The state of insulin resistance so common with PCOS promotes an environment where extra glucose and lots of insulin hang out in the bloodstream. That glucose wants to get in your cells to give you energy (and that’s why you are so tired all the time!). Those very high insulin levels seen in PCOS drain you even more and are behind the acanthosis nigricans, carb cravings, irregular periods, and even affects your sleep.





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Metformin steps in making your cells more sensitive to insulin: that’s why it’s referred to as an insulin sensitizer. It helps the glucose actually get in your cells, giving you the energy you need. Many report having more energy and less carb cravings after starting metformin.

Metformin has another job: it stops the liver from making and sending out so much glucose. Most people connect Metformin with blood sugar since it is a common diabetes drug.

Although it affects blood sugar, most people with PCOS on metformin have normal blood sugar levels. Also, insulin levels are MUCH higher in PCOS than diabetes so more Metformin is necessary compared to people with diabetes.

Metformin affects more than just insulin and glucose.

In addition to reducing blood glucose and insulin levels, Metformin has been shown to improve menstrual irregularities, fertility, and ovulation rates.

Metformin may also slow the progression of type 2 Diabetes and improve blood pressure and cholesterol levels.

When taken at it’s current therapeutic dose of 1500-2000 mg, Metformin can play a major role in managing PCOS. A lot of people swear by it, yet others can’t tolerate it.

I’m one of those people that can’t tolerate Metformin. It left me with GI distress, energy crashes, and dry skin. If Metformin doesn’t work for you, supplemental inositol is another great insulin sensitizer.

To reduce the side effects of Metformin, Julie recommends:

  • Take it with a meal (like a whole meal not a snack)
  • Follow your doctor’s instructions
  • Start at a smaller dose and build up
  • Stay hydrated

Want to explore more non diet options to help manage your PCOS, promote health AND healing?

Click here for details on Julie’s PCOS and Food Peace course.



Campbell, R., White, J. R., & Saulie, B. A. (1996). Metformin: a new oral biguanide. Clinical Therapeutics, 18(3), 360-371. doi:10.1016/s0149-2918(96)80017-8

Diamanti-Kandarakis, E., Economou, F., Palimeri, S., & Christakou, C. (2010). Metformin in polycystic ovary syndrome. Annals of the New York Academy of Sciences, 192-198. doi:10.1111/j.1749-6632.2010.05679.x

Mathur, R., Alexander, C., Yano, J., Trivax, B., & Azziz, R. (2008). Use of metformin in polycystic ovary syndrome. American Journal of Obstetrics and Gynecology,596-609. doi:10.1016/j.ajog.2008.09.010

Ozcimen, E. E., Uckuyu, A., Ciftci, F. C., & Zeyneloglu, H. B. (2009). The effect of metformin treatment on ovarian stromal blood flow in women with polycystic ovary syndrome. Archives of Gynecology and Obstetrics, 280(2), 263-269. doi:10.1007/s00404-008-0904-0