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  • Metformin and Polycystic Ovary Syndrome: a Closer Look

    Understanding Pcos: Symptoms and Diagnosis


    Polycystic Ovary Syndrome, widely recognized as PCOS, is a complex hormonal condition that affects millions of women globally. Its manifestations are diverse, ranging from irregular menstrual cycles to excessive hair growth and acne. Many women may experience weight gain, while others may struggle with infertility, making the symptoms both varied and distressing. The diagnosis of PCOS is multifaceted, often requiring a careful evaluation of symptoms, blood tests to assess hormone levels, and ultrasound imaging to identify polycystic ovaries. The complexity of its presentation demands a thorough and personalized approach to diagnosis.

    Symptom Description
    Irregular Periods Infrequent or prolonged menstrual cycles
    Excessive Hair Growth Increased body or facial hair
    Acne Severe or persistent skin outbreaks

    While the path to diagnosis can be challenging, understanding the symptoms is the first step toward effective management. Each woman's experience with PCOS is unique, underscoring the importance of individualized care and treatment strategies.



    How Metformin Works: Beyond Diabetes Management



    Metformin, traditionally known for its role in managing type 2 diabetes, has mechanisms that extend its benefits far beyond blood glucose control. At the core, metformin works by enhancing insulin sensitivity and decreasing hepatic glucose production. These actions not only help manage blood sugar levels but also address insulin resistance, a common underlying issue in many women with PCOS. By targeting insulin resistance, metformin can indirectly improve reproductive and metabolic abnormalities seen in PCOS patients.

    Moreover, metformin's ability to influence androgen levels is pivotal. Women with PCOS often experience elevated androgen levels, leading to symptoms such as hirsutism and irregular menstrual cycles. Metformin's impact on insulin sensitivity helps lower these androgen levels, contributing to symptom relief and improved ovulatory function. This mechanism illustrates metformin's versatility beyond its original purpose.

    Finally, metformin has shown potential benefits in weight management, a key concern for those with PCOS. By promoting weight loss and ameliorating metabolic dysfunction, this medication offers a multi-faceted approach to managing PCOS symptoms. Although primarily a diabetes medication, metformin's diverse actions make it a valuable tool in the comprehensive management of PCOS, demonstrating its expansive therapeutic scope.



    The Role of Metformin in Managing Pcos


    Metformin, a medication originally developed to treat type 2 diabetes, has emerged as a valuable tool in the management of Polycystic Ovary Syndrome (PCOS), primarily due to its ability to address insulin resistance, a common underlying factor in this condition. PCOS often leads to elevated insulin levels which can exacerbate symptoms such as irregular menstrual cycles and weight gain. By enhancing the body's sensitivity to insulin, metformin helps regulate blood sugar levels, which may contribute to more regular menstrual cycles and improved metabolic profiles in women with PCOS.

    Furthermore, metformin may play a role in aiding weight management for women with PCOS, as insulin resistance often contributes to weight gain and difficulty in losing weight. Although not a weight-loss drug, metformin can indirectly assist by improving how the body processes sugar and fat, potentially making it easier to shed excess weight. Additionally, some studies suggest metformin can help lower androgen levels, hormones that are typically elevated in PCOS and contribute to symptoms such as acne and excessive hair growth, thereby offering a more balanced hormonal environment.

    While metformin does not cure PCOS, its role in managing insulin resistance and symptomatic relief makes it a cornerstone in PCOS treatment strategies. It’s important for patients to work closely with their healthcare providers to tailor a treatment plan that considers individual needs and responses to the medication, taking into account any side effects and the overall health objectives of the patient.



    Potential Benefits of Metformin for Women with Pcos



    Metformin has become an essential ally for women with Polycystic Ovary Syndrome (PCOS), offering a range of potential benefits beyond its original purpose. One of its primary advantages is its ability to improve insulin sensitivity, a common issue in PCOS. By enhancing the body's response to insulin, metformin helps regulate blood sugar levels, which can subsequently lead to a reduction in symptoms such as irregular menstrual cycles and weight gain.

    Furthermore, metformin has been linked to improved fertility rates in women with PCOS. By restoring hormonal balance, it can promote regular ovulation, increasing the likelihood of conception. Many women experience a decrease in androgen levels while on metformin, which can alleviate issues such as excessive hair growth and acne.

    Finally, another potential benefit of metformin is its role in weight management. Women with PCOS often struggle with weight-related challenges, which can exacerbate their symptoms. Metformin can aid in weight loss or maintenance, offering a holistic approach to symptom management. While results may vary, many find that incorporating metformin into their treatment plan provides meaningful improvements in their quality of life.



    Possible Side Effects and Considerations of Metformin


    Navigating the journey of using metformin requires awareness of its side effects, a task often accompanied by a learning curve. While many find metformin effective, some may experience gastrointestinal issues, including nausea or diarrhea. Typically, these symptoms can subside over time as the body adjusts to the medication.

    It’s also crucial to monitor blood sugar levels regularly, as metformin can lower these levels, potentially leading to hypoglycemia. Women with certain conditions, such as liver or kidney dysfunction, should utilize caution and consult professionals before beginning treatment.

    Moreover, regular follow-ups with a healthcare provider are advised to ensure the medication aligns well with individual health needs. Alternative treatments and lifestyle adjustments may work alongside or substitute metformin, depending on personal health circumstances and professional advice.

    Possible Side Effect Consideration
    Gastrointestinal issues Symptoms often subside as the body adapts
    Hypoglycemia Monitor blood sugar regularly



    Alternatives and Complementary Treatments to Metformin


    Lifestyle modifications, such as diet and exercise, play a crucial role in managing PCOS symptoms. A balanced diet rich in low-glycemic index foods can help regulate insulin levels, while regular physical activity promotes weight management and enhances insulin sensitivity. Herbal supplements like inositol have gained attention for their potential to promote ovulation and improve metabolic profiles in women with PCOS. Additionally, acupuncture may offer complementary benefits by aiding in hormonal balance and reducing stress levels. Other options include hormonal contraceptives, which can regulate menstrual cycles and alleviate symptoms like acne. Working closely with healthcare providers can help tailor a comprehensive approach that best suits individual needs.





ARIZONA PSYCHIATRIC SOCIETY 2024-2025 EXECUTIVE Board

President: Nicholas Ahrendt, MD President-Elect: Margaret Balfour, MD, PhDVice President: Brenner Freeman, MDTreasurer: Robert Rymowicz, DOSecretary: Chiranjir "Ravi" Narine, MD Co Resident-Fellow Member Representatives: Nehal Samra, MD Creighton Matthew Mitchell, MD UA-PhoenixGagan Singh, MD UA-Tucson
APA Assembly Representatives: Jason Curry, DO (serves term concluding 2024) Jasleen Chhatwal, MBBS, MD (two-year term concluding 2024)Payam Sadr, MD (one-year term concluding 2024) Past President Gagandeep Singh, MD, DFAPA Stephen "Larry" Mecham, DO The Society thanks these members for their leadership.

Celebrating our members

Chase was born and raised in Phoenix, AZ, and attended ASU for a bachelor’s degree in business then attended KCUMB for medical school in Kansas City. He was excited to return home to AZ when he found out he'd been matched with UACOM – Phoenix for his psychiatry residency.
He was first drawn to the field of psychiatry during his years in medical school as he found the psychiatric subject matter and the patients to be the most engaging and interesting of all his studies. He quickly came to realize that without a healthy mind, one is unable to thoroughly experience life constructive way. He wanted to be the person to help those struggling with mental illness as he found these cases and experiences to be the most rewarding in medicine.
Dr. Crookham said he has been lucky enough to have been matched at a great psychiatric residency program where he gets to learn from great mentors and colleagues every day. He believes his passion for psychiatry along with the relationships he's developed with his colleagues and mentors will carry him to be a lifelong learner and devoted psychiatrist for his future patients.
Meghan is a graduate of Lincoln Memorial University, DeBusk College of Osteopathic Medicine.
She received her Bachelor of Arts from the University of Denver in French and Biology with a concentration in Cognitive Neuroscience.
She is currently a chief resident at UACOM-Tucson in her final year of psychiatry training and will be starting a fellowship in Addiction Medicine at the University of Arizona, Tucson in July.
Her professional interests include physician mental health, adult consult liaison and addiction psychiatry.
In her personal time, she enjoys home design projects, spending time with family, learning about plants, and exploring new places.
Dr. Hintze is currently honeymooning in Japan! Congratulations!!
Danny is originally from Phoenix. Graduated from Brophy, ASU, and UA Tucson Medical School. His background is in economics, philosophy of science, and rational decision-making.
He was drawn to psychiatry because of the conceptual complexity and the profound impact even relatively simple pharmaceutical, medical, and psychotherapeutic interventions can have to empower patients and their families.
As a mentor, he wanted to recognize the many people within the Arizona Medical Community, particularly at UA Tucson, Valleywise, and within organized medicine who have worked to protect and promote medicine as a joyful, compassionate, and healing experience for patients and for all of us who help care for them.

ARIZONA PSYCHIATRIC SOCIETY past presidents

Otto L. Bendheim, M.D. 1960-1961Warren S. Williams, M.D. 1961-1963T. Richard Gregory, M.D. 1963-1964Boris Zemsky, M.D. 1964-1965 Hal J. Breen, M.D. 1965-1966Joseph M. Green, M.D. 1966-1967Irene M. Josselyn, M.D. 1967-1968Hubert R. Estes, M.D. 1968-1969Richard H. Bruner, M.D. 1969-1970Thomas F. Kruchek, M.D. 1970-1971David S. Burgoyne Sr., M.D. 1971-1972Marshall W. Jones, M.D. 1972-1973Harold D. Haeussler, M.D. 1973-1974William B. Haeussler, M.D. 1974-1975Edward S. Gelardin, M.D. 1975-1976Hugo L. Cozzi, M.D. 1976-1977Robert F. Meyer, M.D. 1977-1978James E. Campbell, M.D. 1978-1979Stuart M. Gould, M.D. 1979-1980Elliot M. Heiman, M.D. 1980-1981Stephen V. Shanfield, M.D. 1981-1982Jerry A. Biggs, M.D. 1982-1983Robert C. Shapiro, M.D. 1983-1984Dennis C. Westin, M.D. 1984-1985John H. Jarvis, M.D. 1985-1986James G. Hill, M.D. 1986-1987Robert P. Bevan, M.D. 1987-1988Eugene J. Kinder, M.D. 1988-1989 James M. Campbell, M.D. 1989-1990David S. Burgoyne II, M.D. 1990-1991
Stuart W. Hollingsworth, M.D. 1991-1992Kevin J. Leehey, M.D. 1992-1993Stephen S. Brockway, M.D. 1993-1994Michael H. Stumpf, M.D. 1994-1995Lauro Amezcua-Patino, M.D. 1995-1996David S. Burgoyne II, M.D. 1997-1998Glenn Lippman, M.D. 1998-1999Lisa Jones, M.D. 1999-2000David J. Coons, M.D. 2000-2001James M. Campbell, M.D. 2001-2002Bradley Johnson, M.D. 2002-2003David W. Leicken, M.D. 2003-2004Thomas N. Crumbley, M.D. 2004-2006Jeffrey L. Schwimmer, M.D., M.P.H. 2006-2007Stephen O. Morris, M.D. 2007-2008Jack L. Potts, M.D. 2008-2009Elizabeth A. Kohlhepp, M.D. 2009-2010Michael E. Brennan, M.D. 2010-2011Gretchen Alexander, M.D. 2011-2012Tariq M. Ghafoor, M.D. 2012-2013Joanna K. Kowalik, M.D., M.P.H., 2013-2014Payam M. Sadr, M.D., 2014-2015Roland Segal, M.D., 2015-2016Gurjot Marwah, M.D., 2016-2017Aaron Wilson, M.D., 2017-2018Mona Amini, M.D., 2018-2019 Don J. Fowls, M.D., 2019-2020 Jasleen Chhatwal, M.B.B.S., M.D., 2020-2022 Stephen Larry Mecham, DO, 2022-2023 Gagandeep Singh, MD, DFAPA 2023-2024
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