I have PCOS at 18. Can diabetes worsen my PCOS/PMOS?

Question

Hello doctor,

I am 18 years old. It was discovered that I have PCOS/PMOS. I have all the symptoms that occur due to the higher male hormonal growth. I was prescribed Norgest. But I need to lose weight too.

I was prescribed Femilon, a birth control pill, and right now I am on Norgest and an iron supplement with vitamin B12. So, my concerns are:

Would it be okay to use Metformin since it increases Insulin resistance?
Will it not worsen in the near future with diabetes, since I have a whole bloodline of diabetes patients as well?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Polycystic ovary syndrome (PCOS)/polyendocrine metabolic ovarian syndrome (PMOS) in young women like you is often linked to hormonal imbalance, irregular periods, excess androgens (male-type hormones), and sometimes weight gain or difficulty losing weight.

Since you also have a strong family history of diabetes, managing insulin resistance early is very important. Metformin is commonly prescribed in PCOS/PMOS, especially when there is insulin resistance, risk of diabetes, or difficulty with weight control.

It works by improving the way your body uses Insulin, which can help regulate menstrual cycles, reduce androgen-related symptoms like excess hair growth or acne, and support weight management when combined with a healthy diet and exercise.

At your age, it can be safely used, but the decision depends on your blood sugar, insulin levels, and overall evaluation. Norgest (Norethisterone) is a hormonal pill that helps regulate cycles and control symptoms, but does not address insulin resistance, which is why Metformin may be a good long-term option, especially given your family history.

Alongside any medication, lifestyle measures are equally important. I suggest the following to protect yourself against diabetes in the future.:

A balanced diet with low refined sugars.
Regular physical activity.
Maintaining a healthy weight.

I would suggest you start Metformin, and check fasting glucose, or HbA1c (glycated hemoglobin) first, and share the result to tailor the dose safely.

I hope this helps.

Always feel free to reach out to me at any time. I am always here to help.

Thank you.