I was diagnosed to have PCOS on March 2015 after a positive ultrasound result and has been dealing an on and off relationship with Metformin from that point. What is PCOS anyway? Why is Metformin used to treat PCOS?
PCOS is the abbreviation for Polycystic Ovarian Syndrome. It is a disease, particularly for the women. PCOS is one of the commonest endocrine disorders affecting women of reproductive age. Women with PCOS experience abnormal menstrual patterns. Some women have oligomenorrhea (i.e., menstrual bleeding that occurs at intervals of 35 days to 6 months, with less than 9 menstrual periods per year) or secondary amenorrhea (an absence of menstruation for 6 months).
I categorized myself to be part of oligomenorrhea team as I usually skip 35-60 days before my next menstrual period arrives. And since I expect it to be abnormal, there are episodes when I experience 2-3 consecutive months of the menstrual period but then are followed by another 1-2 months of its absence. I was prescribed since then with Metformin by my OB-GYN specialist. I admit being not compliant in terms of the medication intake, probably because I was too busy during that time.
I got married on May 2015. My husband and I are in a long-distance relationship as of that moment, hence, we decided to delay our plan in having a baby. By March 2016, I went to another OB-GYN specialist and had her re-assess my status. My ultrasound findings still have the impression of polycystic ovaries. I was again instructed to take Metformin. This time, I was very eager to start because, at the back of my mind, I know my Canadian visa (the hindrance to be reunited with my husband) will be arriving anytime in that same year. But that eagerness lasted only for few weeks and I’m back to my old self of not being mindful about it to the point of ignoring its existence despite the knowledge of the consequences, naming infertility to be one of them.
True enough, my visa arrived and I landed in Canada by August 24, 2016. I enjoyed my first month as a tourist and went on with my career plan. By December 2016, I already have my Ontario health card and that means I am now eligible for the benefits of Ontario Health Insurance Plan, popularly known as OHIP. I paid a visit to my mother-in-law’s Filipino family doctor and I told her my medical history. She again started me on Metformin. By now, as a reader, you must be thinking why use an anti-diabetic medication, Metformin, in the treatment of PCOS? It is because studies have shown that women with PCOS seem to have a form of insulin resistance that is intrinsic (and perhaps unique) to the syndrome and poorly understood. Metformin was then used in clinical studies and showed significant results in women affected with PCOS who are planning to get pregnant.
Now, I was again dedicated to compliance. Later on, I ended up taking it irregularly. I was advised to take it twice daily, yet sometimes I only take it once. There are also some days I forgot to take at least one. Poor compliance at its best. Then, I asked for a refill from a pharmacy. The pharmacist even asked why did it take me so long to refill, and if I was taking the medication as prescribed. Of course. NOT.
By the month of September 2017, I realized it has been a year already here in Canada. Then I thought, now is the time to have a baby. I again faced my fight with PCOS by constantly reminding myself to check on Metformin if I have taken my doses for today. I continued my perseverance despite experiencing the side effects of the medication, which is the gastrointestinal disturbance. Name it, I’ve dealt with it. Nausea, loose stools, flatulence (ask my husband how bad it is lol), bloatedness, constipation, dyspepsia, and the worst part? I was brought to the emergency room one night because of the persistent combination of nausea, loose stools, and abdominal pain.
I gained more strength to endure the side effects after reading some clinical studies about how effective Metformin is in fighting insulin resistance, and in turn, reversing the anovulation crisis in PCOS, which then cancels out the consequence of infertility. It was a horrifying journey, or maybe I am just exaggerating. But, I can definitely tell that there was a point in time I saw myself researching on clinical studies that can be an alternative to Metformin just to avoid its side effects. Those side effects made me go crazy.
December 2017 came, and I went to my family doctor’s clinic to say I can’t take the medication anymore. It seems to be not working on me and I am still not having my menstrual period turn into a regular cycle up to this point. I even had a pregnancy test on the first week of December yet its negative. My family doctor agreed and decided to refer me to a PCOS clinic in downtown Toronto. I left the clinic looking forward to an appointment with a specialist soon.
On January 2018, I noticed some changes in my sleep patterns. There were also some breast changes but didn’t try to observe my whole body and evaluate to know what’s happening to me. Nothing bothers me until February 2018, wherein I noticed that my tummy is becoming bigger and a little heavier but my face and extremities are not showing signs of weight gain. Guess what? Pregnancy test showed positive! My husband and I were surprised. I was so shocked that I was not aware at all. I was probably focused on my waiting game with the PCOS clinic. I was patiently waiting for them to call and work me up instead of looking into my body changes recently.
Despite all of these, I feel so blessed to be given a chance to experience motherhood. I am also fortunate to have people around me supporting me in various ways. Most importantly, I am so grateful to have my “super excited father-to-be” husband who promised to support me in every step of my pregnancy journey — and he does show it since day 1.
International Journal of Clinical Practice. 24 Aug 2017; 71:e12981. https://doi.org./10.1111/ijcp.12981
Polycystic Ovarian Syndrome. (2017, August 28) Retrieved from Medscape: https://emedicine.medscape.com/article/256806-overview