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PCOS Medication Treatments

Glucophage
(metformin) works by suppressing hepatic glucose production and increasing glucose utilization in peripheral tissues. It cannot be used in all women, including those who have kidney or liver disease.

Common side effects include nausea and diarrhea, which usually lessen over time and abate after 3-4 weeks. Dr. Allon prefers to prescribe the extended-release Glucophage (Glucophage XR), as it has lower side effects that can be further minimized if the medication is taken with meals.

Some fertility specialists prescribe insulin-sensitizing medications to women with PCOS regardless of their insulin sensitivity.
In addition, insulin-sensitizing medications can be used while trying to conceive. Although, more studies are needed to firmly establish the benefits, many improvements in symptoms are seen and ovulation usually resumes.

Metformin should not be taken for 24 hours prior to any X-ray procedure in which iodinated compounds will be used, including the hysterosalpingogram (HSG) where contrast dye is injected into the uterus.

If an insulin-sensitizing medication is taken for 2 months without ovulation or pregnancy, than additional fertility medications may be considered. Ovulation stimulation drugs, such as Clomid, letrozole, and FSH, can be taken in conjunction with insulin-sensitizing medication.

Are there any supplements which help alleviate the symptoms of PCOS?

Insulin acts by bringing glucose into the cell via a second messenger called inositolphophoglycan (IPG).

Several studied show that women with PCOS may have a deficiency in IPG,
which contain DCI as well as myo-inositol (MI) and this deficiency contributes to insulin resistance. MI belongs to the B vitamin family found in some citrus fruits, leafy vegetables, almonds, and walnuts. Studies involving insulin resistance showed that women with PCOS had low DCI concentration. DCI is found in several plants and fruits, in buckwheat, carob, and in some melons.

>> DCI had the following effects when given to patients with PCOS for 6-8 weeks at a dosage of 1200 mg per day.

>> It was more effective in obese women with PCOS.

>> DCI decreased testosterone, cholesterol triglycerides and improved blood pressure. 

>> During the study about 86% of women ovulated with DCI treatment. 

>> DCI also improved weight loss. 

Some studies demonstrated that metformin acts are by increasing DCI. DCI is well tolerated and may be a substitute for women who cannot tolerate metformin, or it can be used in combination with metformin.

How does lositol help women with PCOS?

Research has shown that women with PCOS may have a defect in converting Myoinositol (MI) to Di-chiro-inositol (DCI) MI belongs to the B vitamin family found in some citrus fruits, leafy vegetables, almonds, and walnuts. Studies involving insulin resistance showed that women with PCOS had low DCI concentration. DCI is found in several plants and fruits, in buckwheat, carob, and in some melons

Lowsitol is a supplement  which contains a propriety combination of both Myoinositol and DCI to capture the benefits of both forms. This combination has been shown to improve insulin resistance and lower testosterone, which will improve ovulation and normalize the menstrual cycle.

Lowsitol contains the combination of Inositol, D-chiroinositol as well as folic acid not found in other products on the market.  Several studies have shown this combination can improve egg (oocyte) quality, fertilization rate and embryo quality in PCOS women undergoing In Vitro Fertilization treatments. The unique formula of lositol with the addition of fiber can improve cholesterol levels as well as improving gut health.

Women with PCOS have about a 41% incidence of IBS (Irritable bowel syndrome).  Some women with IBS may experience constipation, bloating and even diarrhea. This syndrome may actually exacerbate some of the symptoms of PCOS by the accumulation of gram-negative bacteria, which contain Lipopolysachharide (LPS) in their bacterial wall.

This substance will damage the intestinal barrier by creating a hole in the intestinal wall leading to an increase in the body’s inflammation; dissemination of toxins and promotes other diseases.  Some studies have shown improvement of PCOS symptoms with the addition of bacterial strain called Bifidobacteria. This bacterial strain can produce a substance called short chain fatty acids, which helps reduce the PH of the colonic lumen that will in turn reduce the effects and growth of  bad bacteria.

Lowsitol can help reduce carbohydrate cravings and improve weight loss in women with PCOS.

The potent combination of 10 ingredients including Inositol and D- Chiroinositol  can have a tremendous effect in lowering insulin levels and the response of  insulin spikes with meals. This will in turn normalize glucose levels, decrease carbohydrate cravings and lead to better satiety. With the addition of  banaba leaf  which has been shown to help correct abnormal levels of the hormone leptin (hormone responsible for satiety) seen in PCOS. This will lead to improve food craving and promote weight loss.  The addition of Acetyl- L-Carnitine has been shown to grab fatty acids improve insulin sensitivity and help women with PCOS metabolize fat.

Lositol also contain an ingredient called Choline which is an essential nutrient related to the B group of vitamins. Choline has been shown to improve insulin resistance and the metabolism of fat and linked to grater satiety and decrease in calorie consumption.  

How is the  lositol supplement which contain the ingredients of  Myoinositol and D- Chiro-inositol compared to taking Metformin  ?

In comparison to Metformin 1500 mg daily, the combination of Myoinositol and DCI had higher incidence of resumption of ovulation menstruation which led to higher pregnancy rates and weight reduction. Some studies demonstrated that metformin acts are by increasing DCI. DCI is well tolerated and may be a substitute for women who cannot tolerate metformin, or it can be used in combination with metformin.

PCOS Learning Center

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RESOURCES

Advanced Fertility Center of Texas – Infertility Answers - Dr. Michael Allon

Scientific Research

Luteinizing hormone–independent rise of progesterone as the physiological trigger of the ovulatory gonadotropins surge in the human

Fertility and Sterility
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Recipient outcomes in an oocyte donation programme: should very young donors be excluded?

RBMO Oocyte Donation Programme
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