Is Metformin safe for managing both my diabetes and PCOS/PMOS?

Question

Hello doctor,

I was diagnosed with type 2 diabetes three months ago, and I am really struggling to manage my blood sugar levels, especially around my menstrual cycle. I have noticed that my glucose readings spike dramatically in the week before my period, sometimes reaching 250 mg/dL (milligrams per deciliter) even when I follow my diet strictly.

I am currently on Metformin, but I am also dealing with severe PCOS (polycystic ovarian syndrome)/PMOS (polyendocrine metabolic ovarian syndrome) symptoms like irregular periods, excessive hair growth on my face and chest, and significant weight gain around my midsection. My last period was two months ago, and I am concerned about how this unpredictable cycle is affecting my diabetes management.

I have also been experiencing recurrent yeast infections, which my primary care doctor says might be related to my elevated blood sugar. The constant vaginal discharge and itching are really impacting my quality of life and my relationship with my partner.

How do hormonal fluctuations during my cycle affect blood sugar control in diabetes?
Is Metformin safe for managing both my diabetes and PCOS/PMOS symptoms?
Could my recurrent yeast infections be a sign that my diabetes is not well-controlled?
Should I consider hormonal birth control to regulate my periods and help with diabetes management?
What dietary changes can help me manage both PCOS/PMOS and diabetes simultaneously?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

You should know that having PCOS/PMOS means multiple cystic follicles in your ovary, which may be disturbing the normal hormonal patterns in the body. This generally occurs with insulin resistance, which you have, leading to poor glucose control in the body. Since poor glucose control leads to an immunocompromised state, there is a high chance of catching fungal infections like oral or vaginal candidiasis.

You need to control your blood glucose levels to be able to fight all these issues. Start by using oral contraceptive pills. This will help with regularizing your cycles and making them predictable. I advise you of the following treatment.

Add Metformin (biguanide), which comes with the advantage of controlling your sugar spikes and helps with hirsutism (unwanted hair growth in your body) and other PCOS/PMOS symptoms.
For a yeast infection, start using an antifungal like 2% Clotrimazole ointment for local application and keep the intimate area dry and clean.
It is also important to avoid using any intimate washes locally, as it disturbs the pH (power of hydrogen) of the vagina by disturbing the natural flora.

Lifestyle modifications have a great role in controlling both these problems. You should follow the steps mentioned below for a healthy life:

A proper sleep schedule.
Regular exercise.
A healthy diet, which should cut down foods with a high glycemic index and focus more on proteins, healthy fats, and salads, which are more fiber.

I hope this information helps you.

Feel free to ask further queries.

Thank you.