Diabetes drug at 8 could shield girls from infertility

[brittone2]

As a woman w/ PCOS who conceived her children thanks to metformin, I thought this was interesting.

http://www.msnbc.msn.com/id/43841970/ns/health-womens_health/

I do not think I had any of the early warning signs other than starting my period at age 11. I had a tough time getting diagnosed even as an adult, so I am certain I probably wouldn't have been flagged as someone who could benefit.

Interesting to think about for my own DD as she matures.

eta: It would be interesting to see how a long term LC diet would help these girls as compared to metformin.

[megs4413]

huh...I didn't realize I would have been considered at risk....My mom had terrible problems conceiving, though, and I still wonder if that was a PCOS thing or not.

I had really low birth weight (as a preemie) and started menstruating at 10. I can't tolerate metformin now, though. I had problems with it when I was on it a few years ago.

[tiapam]

This is interesting, thanks for posting it.

So do these girls typically go through all of puberty early or just some parts of it? I am struggling with whether or not to tell a friend that I think her DD could be at risk for early puberty. My friend acknowledged a long time ago that her DD is overweight. I am noticing other changes that worry me but I am afraid to bring it up because even though we are close she has gotten defensive in the past when I brought up other health issues when I have been concerned about her or one of her kids. She and I are polar opposites when it comes to attitudes towards doctors, she does not like to research and bring her own research to docs, whereas I question every thing and want to understand things not just follow orders.

WWYD? Keep quiet or potentially start WWIII?

Sorry to hijack, maybe I should start my own thread, but would like to have the perspective of someone with PCOS.

[DrSally]

Interesting!

[cntrymoon2]

This is interesting, thanks for posting it.

So do these girls typically go through all of puberty early or just some parts of it? I am struggling with whether or not to tell a friend that I think her DD could be at risk for early puberty. My friend acknowledged a long time ago that her DD is overweight. I am noticing other changes that worry me but I am afraid to bring it up because even though we are close she has gotten defensive in the past when I brought up other health issues when I have been concerned about her or one of her kids. She and I are polar opposites when it comes to attitudes towards doctors, she does not like to research and bring her own research to docs, whereas I question every thing and want to understand things not just follow orders.

WWYD? Keep quiet or potentially start WWIII?

Sorry to hijack, maybe I should start my own thread, but would like to have the perspective of someone with PCOS.

I have PCOS and a strong family history of endocrine disorders. I strongly suggest keeping quiet. There is no way I would want to hear even a good friend tell me her opinion on my daughter's risk for early puberty based on her weight issues, etc. I think there are soooo many ways that conversation could go wrong, and it would severely, if not permanently, damage a friendship for me.

[megs4413]

This is interesting, thanks for posting it.

So do these girls typically go through all of puberty early or just some parts of it? I am struggling with whether or not to tell a friend that I think her DD could be at risk for early puberty. My friend acknowledged a long time ago that her DD is overweight. I am noticing other changes that worry me but I am afraid to bring it up because even though we are close she has gotten defensive in the past when I brought up other health issues when I have been concerned about her or one of her kids. She and I are polar opposites when it comes to attitudes towards doctors, she does not like to research and bring her own research to docs, whereas I question every thing and want to understand things not just follow orders.

WWYD? Keep quiet or potentially start WWIII?

Sorry to hijack, maybe I should start my own thread, but would like to have the perspective of someone with PCOS.

I wouldn't say anything at all. It's really not your place at all, IMO.

FWIW, I was NEVER overweight as a child. I'm not sure when that comes into play typically, but I didn't put on weight until after my DD was born (I put on 60lbs in 3 mos post partum).

[mypa]

huh...I didn't realize I would have been considered at risk....My mom had terrible problems conceiving, though, and I still wonder if that was a PCOS thing or not.

I had really low birth weight (as a preemie) and started menstruating at 10. I can't tolerate metformin now, though. I had problems with it when I was on it a few years ago.

Will you elaborate on how you couldn't tolerate metformin? I just started on it. Thanks.

[brittone2]

You can have PCOS without being overweight. The insulin resistance that goes hand in hand with PCOS can make it easy for some to gain weight. However, there are many women w/ PCOS who are thin or in the normal weight range for PCOS. I was always one of the tiniest kids in my class as a child, and have never been overweight, but I have PCOS.

Personally I would not say anything to a friend about their child. I'd cross my fingers that their doc was aware of the situation.

Metformin can definitely be...unpleasant...when you are first starting out. I remember ramping up my dose when we were ttc DS1 and it was the worst nausea I've ever experienced in my entire life. I couldn't look at food, had 0 appetite, and was just absolutely miserable. It got better within a few weeks thankfully. Once I got pg I remember thinking that m/s was a cakewalk in comparison to starting met. A few years later I restarted met when we were thinking about ttc my 2nd child and I went on a higher dose, but extended release. That was much, much easier for me to ramp up to. Much. I still take 2000 mg of XR as it helps me cycle. I didn't do XR originally because back then the research on met for PCOS was fairly new and endos weren't sure if the XR was going to be as effective. At that point the studies were all being done w/ regular met.

Another bright spot in all of this is that met is very affordable (usually covered by many places on their $4/month list of generics). I don't know if the XR is usually on those lists.

[WolfpackMom]

You can have PCOS without being overweight. The insulin resistance that goes hand in hand with PCOS can make it easy for some to gain weight. However, there are many women w/ PCOS who are thin or in the normal weight range for PCOS. I was always one of the tiniest kids in my class as a child, and have never been overweight, but I have PCOS.

Personally I would not say anything to a friend about their child. I'd cross my fingers that their doc was aware of the situation.


I have always been one of the thinnest amongst my peers and was also quite short until post-puberty....although I did have a brief weight gain due some medication in college but that was short lived. I didn't have a low birth rate, I didn't start my period until I was 14.5 and seriously didn't remotely have boobs until 16ish. I still have PCOS and spend mid-cycle hunched over in pain. There was no issue diagnosing me at all, I told the Dr what I was experiencing, they did an ultrasound and it was completely obvious, but I was very blessed not to have to do anything to treat the PCOS to conceive DS, and I know I may not be that lucky next time around.

I definitely wouldn't give my daughter metaformin unless she were diabetic, or it was confirmed she had PCOS after she began menstruation, I am wary of this study being done with such a small group of individuals.

Also definitely wouldn't mention anything to a friend about their daughter unless they brought it up specifically, that probably wouldn't go over well and I think you should mind your own business honestly.

[brittone2]

I definitely wouldn't give my daughter metaformin unless she were diabetic, or it was confirmed she had PCOS after she began menstruation, I am wary of this study being done with such a small group of individuals.


I wasn't implying it was something I was planning to do or thought anyone else should do. Rereading my post I can see how it might seem that way though LOL. I'm just intrigued by the concept, and I'm curious where the research on this will go. It would be interesting if there was more data on this in the next few years.

I'm short too (5'2.5" or so) and did not have a low birth weight (was 7lbs 8 oz, but I was born 11 days after my mom's EDD).

[WolfpackMom]

I wasn't implying it was something I was planning to do or thought anyone else should do. Rereading my post I can see how it might seem that way though LOL. I'm just intrigued by the concept, and I'm curious where the research on this will go. It would be interesting if there was more data on this in the next few years.

I'm short too (5'2.5" or so) and did not have a low birth weight (was 7lbs 8 oz, but I was born 11 days after my mom's EDD).

Oh no I didn't think you were saying that you would, that was more a general statement on my part not directed at you at all! :)

[hellokitty]

That's an interesting article. I bet that I would have benefited from met as a pre-adolescent girl. My RE diagnosed me with PCOS and put me on met. However, the met (other than bad side effects) was not helping me (I did not have issues with irreg periods to begin with) and I did not have wt loss with it. We moved to an area that didn't have any REs and my ob disagreed with the RE's PCOS diagnosis. He gave me the option to stop taking the met and let me try clomid instead and I got pg with the clomid. He felt that while I had a few PCOS symptoms, it wasn't enough for a diagnosis. The issue is that my dad's side of the family has a HUGE endocrine issue, basically ALL of my dad's siblings have diabetes and I wouldn't doubt that most of my aunts had PCOS-type of symptoms. I should go see an endo, just to get thyroid ruled out (I suspect I've got some hypothyroid issues) and to get an opinion on pcos, even though I am finished having children. I put on wt as soon as I started AF at the age of 11 and have a dickens of a time trying to maintain wt and lose wt. Even in high school, when I weighed 115 lbs (the lowest I could go, even though I was on the tennis team and not eating much compared to other girls my age), ppl always assumed I weighed closer to 130 lbs. Oh and don't get me started on the hair, I think that is probably one of the reasons why my RE diagnosed me with pcos.

[tiapam]

thanks for the advice, i will keep my mouth shut unless she brings it up.
i just hate to think of her DD having possible health issues that the doc does not catch. i am not impressed with her peds. once she did bring up something else to me (that i was thinking of mentioning to her) about her other DD and i took the opportunity then to tell her i had noticed it and it worried me. that did not go too smooth but our friendship survived.

I can understand her side of it but i feel like she only wants me to care about her kids "this much". it's hard for me to do that, esp when health issues are involved. i don't want her kids to be sick, but i also don't want to find out in a few years that they have serious health problems that could have been prevented or at least minimized if caught early.

[brittone2]

That's an interesting article. I bet that I would have benefited from met as a pre-adolescent girl. My RE diagnosed me with PCOS and put me on met. However, the met (other than bad side effects) was not helping me (I did not have issues with irreg periods to begin with) and I did not have wt loss with it. We moved to an area that didn't have any REs and my ob disagreed with the RE's PCOS diagnosis. He gave me the option to stop taking the met and let me try clomid instead and I got pg with the clomid. He felt that while I had a few PCOS symptoms, it wasn't enough for a diagnosis. The issue is that my dad's side of the family has a HUGE endocrine issue, basically ALL of my dad's siblings have diabetes and I wouldn't doubt that most of my aunts had PCOS-type of symptoms. I should go see an endo, just to get thyroid ruled out (I suspect I've got some hypothyroid issues) and to get an opinion on pcos, even though I am finished having children. I put on wt as soon as I started AF at the age of 11 and have a dickens of a time trying to maintain wt and lose wt. Even in high school, when I weighed 115 lbs (the lowest I could go, even though I was on the tennis team and not eating much compared to other girls my age), ppl always assumed I weighed closer to 130 lbs. Oh and don't get me started on the hair, I think that is probably one of the reasons why my RE diagnosed me with pcos.

Yeah, PCOS has health implications that go way beyond fertility, so it is good to know what you are dealing with for sure. (obviously thyroid is the same...good to know since it can affect so many other things)..

I use met even when not TTC (along w/ LCing).

I had a similar situation as yours. OB said there was no way I had PCOS. (this was about 8 years ago). I had higher end of normal bloodwork (OB didn't really do as much bloodwork as he should have, and tested things like total testosterone but not free testosterone, which is more of a problem w/ PCOS than total.) and enlarged ovaries, but because I didn't have many external symptoms he told me to "gain weight" and I'd start ovulating.

I did clomid under his care but eventually got into an RE and got dx'd right away.

I'm thankful I didn't get pg right away or I think I might have missed some important clues about my health long-term. The OB was hyperfocused on getting me on clomid so I could get pg, but was missing the underlying cause.

They changed the criteria few years ago for dx of PCOS. I know right around that time some OBs were still using the "old" criteria, etc.

eta: This piece has links where you can compare the NIH criteria to the Rotterdam criteria to those of the Androgen Excess Society (table 1). I don't know if they've been updated again since that time...haven't been following that closely.
http://www.medscape.com/viewarticle/568395

[megs4413]

Will you elaborate on how you couldn't tolerate metformin? I just started on it. Thanks.

I developed pancreatitis. As far as I know, this is a very rare complication and was probably caused by an underlying kidney problem (which is still not exactly diagnosed...it's obvious that when my kidneys are challenged, they fail.)

I am sad that I can't take the metformin. I lost 25lbs in the first few weeks I was on it. I was only on it for a month total.

[Tanya]

That's interesting. I worry about my kids' fertility since I struggled with getting pregnant for all of them. I wish we could tell in advance though, but I didn't really have any of the typical symptoms.

I have always been thin, didn't have abnormal hair growth, got my period at 13, ultrasounds didn't show cysts, bloodwork was fine. I had regular once a month periods. I just couldn't get pregnant.

My RE later diagnosed me with PCOS after she saw how sensitive I was to the injectible fertility drugs. And after I had IVF and she retrieved so many eggs and I ended up with OHSS, it seemed obvious.

I hated taking metformin though. I had to gradually increase my dose and then if they wanted me to stop taking it for a procedure and then go back on it, I couldn't without doing it gradually or I had major digestive issues. I wasn't even on a very high dose compared to many. The extended release was much much better once my doctor switched me to that after I had so many problems.

[brittone2]

My RE later diagnosed me with PCOS after she saw how sensitive I was to the injectible fertility drugs. And after I had IVF and she retrieved so many eggs and I ended up with OHSS, it seemed obvious.


I had that problem. Did not respond to clomid at any dose, but my first round of injectibles on a very low dose I had 40 follicles on each ovary and my cycle was cancelled. We were going to move directly to IVF to minimize our risk of high order multiples, but they decided to give an even lower dose and see if we could get things under control. It went better, and I got pg, and then my ovary swelled to the size of a softball due to OHSS. Fun. All or nothing kind of response!

I did much better ramping up my metformin dose on the XR. Much more tolerable than the regular. I never saw improved cycles on 1500 but moved and saw a new doctor (not an RE, but an endo who specializes solely in PCOS at a large academic medical center). We chatted and decided to try 2000 mg to see if I cycled on that (I already had my oldest child, and was thinking we'd give met a year at a higher dose to see what it did w/ my cycles). 3 months into the 2000 mg of XR I was frustrated I didn't have a period yet. Well...I was pg :love-retry:

Yeah, the whole not responding to clomid and then over-responding to injectables wasn't fun. I remember it being soooo frustrating at the time!