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when to stop metformin during pregnancy pcos

If you are someone who is planning to extend your family or are already expecting your first child, a healthy pregnancy is all you want right? And the first thing that comes to your mind is whether prescription medications like metformin are safe for you. And if you are someone with PCOS the risks increase […]

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Posted on June 20, 2023 ·

If you are someone who is planning to extend your family or are already expecting your first child, a healthy pregnancy is all you want right? And the first thing that comes to your mind is whether prescription medications like metformin are safe for you. And if you are someone with PCOS the risks increase and you need to take more precautions to keep your pregnancy safe and ensure a healthy birth. It is important to know that certain genetic birth defects have nothing to do with your PCOS and cannot be prevented. But there are some that you can prevent or lower the chances of by taking proper prenatal vitamins, supplements and maintaining a healthy weight and healthy lifestyle. If you’re taking the prescription drug metformin, you might have concerns about how the drug will affect your pregnancy. Let’s explore the benefits and risks of using metformin while pregnant.

About Metformin for PCOS

For those of you suffering from PCOS who do not know what metformin is, it is an FDA-approved oral medication that is often prescribed to women with PCOS to lower their blood glucose levels especially if they have Type 2 diabetes. It works best when combined with diet and exercise changes. You can consume metformin in the form of an oral solution, immediate-release (IR) tablets or ER tablets. 

If you are a PCOS warrior who wants to maintain her blood sugar level during your pregnancy, metformin can be your go-to medication considering there are no complications. Metformin helps in maintaining a healthy blood sugar level while you are pregnant. It also helps reduce the risk of birth defects and other complications in your pregnancy. One of the biggest reasons why metformin is often advocated for women with PCOS who want to get pregnant is because it can help them conceive. As we all know PCOS makes it harder for women to get pregnant, along with causing missed or irregular periods and the possibility of small cysts growing on your ovaries. Also, it may prevent you from ovulating every month, and if you don’t ovulate, there’s no egg to fertilize, and thus, no pregnancy. This is where metformin steps in as it helps with your ovulation, increasing your chances of getting pregnant.

Considering Metformin Use During Pregnancy

Various researchers have stated that there is a lack of evidence in support of the statement that metformin causes any form of congenital anomalies or increases your risk of pregnancy loss. Also, a randomized control trial conducted in 2020 showed that pregnant women who took metformin to treat type 2 diabetes gained less weight compared with the placebo group. Although the trial did show that the newborns of the women who went through a metformin treatment had less fat and lower birth weight.

Metformin has been generally considered safe to be taken during pregnancy and is known to reduce the risk of gestational diabetes and even type 2 diabetes later in life. However, if you are currently on metformin, it is recommended not to stop taking it without consulting your doctor.

Potential Benefits

As mentioned before metformin helps in controlling your blood sugar levels in people with diabetes. Keeping your blood sugar levels in check is important to reduce the likelihood of ill effects caused by diabetes like damaging your blood vessels, nerves and eyes. Also, aggravated type 2 diabetes during your pregnancy increases your chances of miscarriage, birth defects in the baby and stillbirth. If your gestational diabetes is not kept under control it can also affect the size of your baby, cause delivery complications and problems with the baby’s blood sugar levels after birth.

Pregnant mothers who take metformin in place of insulin have a lower risk of gaining excess weight. The more practical reason behind taking metformin is that it is also easier and more affordable for many women to take metformin instead of insulin.

A review conducted on 35 studies that surveyed over 8,000 pregnancies looked at the impact of metformin compared to other diabetes medication regimens. They concluded that women who took metformin during pregnancy had a lower risk of preeclampsia. Preeclampsia is a pregnancy complication caused by high blood pressure and increased protein levels in urine. When left untreated, preeclampsia can progress to a more severe problem called eclampsia which in turn can result in seizures and death.

Potential Risks and Considerations

Like every medication in the world metformin too has risks and side effects. If you are taking metformin as per your doctor’s recommendation in the correct dosage, the chances of you experiencing any side effects are very low. However, some people will experience mild side effects. The most common side effects of metformin include:

  • Heartburn
  • Diarrhoea for a few days
  • Nausea and vomiting
  • Other gastrointestinal changes

If you are already pregnant these side effects may make the feeling of morning sickness worse. A doctor may prescribe the lowest effective dose to help reduce or prevent side effects with metformin. Although it is very rare, metformin can also sometimes cause hypoglycemia, which has the following symptoms:

  • Feeling exhausted
  • Fatigued 
  • Experiencing headache
  • Experience dizziness
  • Experience irritability
  • Increase your heart rate
  • Shivers 
  • Disrupted appetite
  • Sweating or chills

Metformin may also cause more serious complications in rare cases, such as lactic acidosis. If a person feels they have any serious symptoms or signs of lactic acidosis, they should contact an emergency medical team immediately. Symptoms of this condition vary greatly but may include:

  • Strong stomach pains
  • Nausea and vomiting
  • Irregular heart rate
  • Dizziness, weakness or feeling light-headed
  • Tiredness or extreme fatigue
  • Trouble breathing
  • Muscle pains
  • Difficulty sleeping

Consult Your Health Care Provider

Metformin is one of the safest and most effective ways to manage blood glucose levels, however, metformin alone will not help treat blood sugar imbalances. Professionals and experts recommend pregnant women continue eating a healthy diet and holistic exercise routine to promote a healthy pregnancy and even to manage PCOS. Whether you are taking metformin or not, lifestyle changes are the sustainable solution to reducing insulin resistance and lowering blood sugar levels. Your doctor will recommend if you need metformin or other insulin-sensitizing drugs before or during pregnancy.

Learn More With Veera

The experts and care managers at Veera always encourage you to be detailed when going through a consultation so that we can assess your specific situation accurately.

BY Team Veera

Medically Reviewed


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