Q&A: Is it okay to take Glucophage for irregular cycles?

The real determination of PCOS (Polycystic Ovarian Syndrome), which 5% of all women have, is whether you have insulin resistance. This is possibly a precursor to real diabetes years in the future, in that you're not sensitive enough to the insulin you make, so you make extra, which is great for controlling your sugar, but rough on other tissues, like blood vessels.

There can be so many subtle hints of PCOS that sometimes treating a person for one of the symptoms without proving the syndrome by "official" standards can make sense, especially for someone who may be in a rush to seek pregnancy. We are only now beginning to understand the true nature of PCOS, and you may want to check out the PCOS article on BabyZone.

Why treat this at all? Besides the inconvenience of irregular cycles, doctors are beginning to suspect that untreated PCOS--or insulin resistance--could increast the risk of heart disease later on, so it's not a bad idea. And if it gets your cycles going normally again, there's an added plus.

You're right, though, if you feel that Glucophage is a waste without insulin resistance. And treating a syndrome before proving it may be putting the cart in front of the horse, but as I said above, you may have it without it having been proven by today's "provable" methods. This sort of thinking is also starting to be used to justify giving Lupron for endometriosis before a surgery proves endometriosis--an argument supported by the spirit of conservatism, especially in young girls and women seeking to avoid surgery.

The other ways to treat PCOS are birth control pills (not good if you're seeking pregnancy or can't tolerate the pill) and Clomid (an ovulation inducer--not good if you want contraception). The Glucophage is another approach, hitting directly at the problem, by counteracting insulin resistance.

Your doctor has individualized treatment just for you, and the fact that he or she even "gets it" (recognizes the connection of insulin resistance), means that your care is modern and up to date, even if it is a guess at this particular moment. Ask your doctor for a deadline after which you need to establish regular cycles (say...six months), the failure of which would require you to either prove or disprove PCOS with all of the current diagnostics available.