The purpose of the Metformin when one has pcos actually doesn’t have as much to do with the blood sugar levels as it does in controlling the pcos itself thereby improving hormone levels as well as to help protect the ovaries from further cysts and to help reduce the odds of miscarriage as those with pcos have a 30% chance of miscarriage which is higher than that of the normal population.
Further the studies show that good insulin levels show little to no reduction in that miscarriage rate. They do not know why. However, having blood sugar levels under control is clearly important for ovulation, getting pregnant, and hopefully reducing the chances of Gestational diabetes.
Metformin is often prescribed also because it can help 30% of women with pcos ovulate when they normally have annovulatory cycles and this ratio is even higher when the treatment is combined with ovarian stimulating meds such as clomid, femara, or injectables. The Metformin is also desired, again, for it’s protective properties in that it can protect the ovaries from overstimming or forming cysts due to the stims.
Okay so having said all that what you are really looking for it something that can help aid not only in controlling your A1C levels (if they are pre-diabetic or diabetic) and with insulin resistance issues as often seen in those with pcos, to help protect the ovaries from further damage from cysts or overstimming, and to reduce the chance of miscarriage since the rate is higher among those with pcos.
Therefore, my recommendation would be to add vitamin D (5000IU’s per day) as vitamin D is a prohormone that is vital to aiding the balance of other hormones. It is also important with helping to balance blood sugar levels and in insulin resistance (which is also common among those with pcos). It also has the added benefit of helping to reduce the rate of preterm labor, delivery, gestational diabetes, among other pregnancy related complications while you are pregnant.
You will also want to make sure that your Doctor either supplements your luteal phase with progesterone or check your luteal phase and pregnancy progesterone levels should you become pregnant as low progesterone is another common issue with pcos and as such can cause a luteal phase defect (where one starts AF too soon after ovulation thereby flushing out an embryo before it has the chance to implant into the uterus) and is one of the reasons/causes for the higher miscarriage rate even if pregnancy does manage to occur because the embryo relies on what the corpus luteum (collapsed follicle from ovulation) produces to sustain the baby until the placenta takes over it’s production, but if the level is too low then the pregnancy cannot be sustained without supplementation.
Eating a diabetic diet would also help to keep you sugars under control. I have gestational diabetes and I have personally found that when there are lows there are also highs that typically follow so it is important to keep the blood sugar more level throughout the day. It really isn’t all that tricky once one is trained. It is mostly about eating often enough to keep sugar from getting too low and about eating the right amounts so that the sugars don’t get too high. In this case, depending on how high and low your sugars are getting and what your A1C is showing (that is pre-diabetic or diabetic or insulin resistant or any combo) it may be worth seeking a nutritionist to teach you how to monitor and control it since you are allergic to the metformin. Ask your Doc about it too because if you qualify they may be able to refer you and thus your insurance may pay for it so you aren’t out of your pocket for this part.
There are alternatives to Metformin for the purpose of diabetes or for cases of specifically controlling sugars. However, that is not why Metformin is used for those with pcos and thus those alternatives are not able to be used for the reasons Docs prescribe it for pcos. Hope that makes sense. Also, if one has an issue with low blood sugar and not highs then Metformin or any alternative for controlling blood sugars would not be beneficial as they are used to reduce blood sugar levels and often have the side effect of making low blood sugars more common so they wouldn’t help for that anyway. You would just need to eat more often and monitor for lows so that you can keep them higher without being too high. Again where a nutritionist would come in.
Good Luck! :flower: Hope you are able to find a resolution and get your BFP! :babydust: