Friday, March 15th, 2013. CD3.
So with this “lean PCOS” diagnosis, comes a whole line of decisions yet to be made.
On the one hand, I am having acupuncture, and am using a line of Chinese herbs to help regulate my cycle (which is regular in its timing, but irregular in its awful, terrible, painful heaviness). My acupuncturist is skeptical of some of the Western treatments for PCOS, and feels that since I am of a healthy weight, and am maintaining a healthy diet, that she can regulate my cycle and hormones to a natural balance with the use of herbs and acupuncture alone.
On the other hand, my new RE has offered Metformin. While I don’t appear to be insulin-resistant, there are many studies showing that Met can help regulate the balance of androgens and estrogens, which is a large part of my problem. My testosterone levels are a bit high, and my estrogens are a bit low, which I’m sure is causing crappy eggs to emerge. The husband’s swimmers are turning up their nose at said crappy eggs, or they are attempting to fertilize and failing because they are just so damaged.
Metformin could help over the course of a few months… And so could the herbs and acupuncture combo. What about combining the Eastern and Western treatments? What about adding Pregnitude, which sounds like a more natural alternative to Met? What about adding supplements to my already hefty list of pills? I’ve heard good things about the combination of CoQ10, myo-inositol (one of the ingredients of Pregnitude), and L-Arginine?
If I was younger, I would try each for four to six months until one of them worked, but let’s face it – I’m not getting any younger, and neither are my eggs.
Oy. So many choices.
I sometimes wish that I was the type of person I used to be. The type of person who could just take the doctor’s orders without question and proceed happily.
Not so. Not anymore.
I’m the person who asks questions with every recommendation. I’m the person who brings such a disturbing amount of knowledge into the exam room that the doctor asks what she can do for me, rather than telling me what I’m going to do.
Now, instead of orders, I have options.
Rather than making up my mind, I am going to the internet for help.
I know we talked about this recently, but can anyone out there shed any light on lean PCOS and the effectiveness of Metformin vs. Pregnitude vs. TCM and acupuncture vs. egg-quality-improvement supplement cocktails?
Help, internet! Help!!
Just Stop Trying and It Will Happen... 
Pregnitude is not an alternative to Met. I was also diagnosed with being slightly PCOS (by Dr. B)… and was on both Met and Pregnitude. (So we have learned there are many flavors of PCOS… I had clockwork cycles, not very many follicles, but higher blood sugar and higher androgens/testosterone.) Met is not a hormonal drug at all, it just regulates blood sugars. I say if your RE is recommending it, start on it. It does take several months to make a difference.
Anyway, while you don’t want to throw the entire bucket of ideas at your body, you could still eliminate some of the “vs” in your paragraph above. Continue acupuncture… just ask your RE about the herbs maybe (she may be fine with them until you do a medicated cycle). If/when you do a Western med cycle, I would definitely stop the herbs.
The egg quality cocktails also can continue (imho). Just remember to stop Melatonin after ovulation.
Full disclosure: I did TCM for a year and it didn’t help me at all. But I also never reacted to treatment like you described.
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I hate to be a quitter, especially this early in the game, but I feel like the acupuncture is helping me a lot more than the herbs really are. I want to give it a bit more time, but yes, I am thinking I will go off the herbs before starting a medicated cycle. That would be at least another month from now, though, so I can say I gave it a chance.
I’m waiting for the doc to call me back to schedule my hysteroscopy, and then I will ask for Met. I’m glad to see that you took both the Met and Pregnitude… I had read so many places that people were using Pregnitude as an alternative, but if they both react differently, maybe both at once wouldn’t be so bad… maybe once I’m off the herbs. Hmm.
I’ve read mixed reviews on Melatonin… did it help you, do you think?
I agree on not throwing too many things at my body at once. I’ve done that recently, with completely overhauling my diet, starting new herbs, supplements, and acupuncture, and now considering all of this… I don’t want to shock my system.
Thank you, as always, for your wisdom. 🙂 I seriously don’t know what I’d do without you!!
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I wrote about egg quality supplements recommended by my doctor on my blog- http://nonsequiturchica.blogspot.com/2013/01/doctor-recommended-supplements.html.
Good luck!
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I read this before, and I’m going to check it out again! If you don’t mind, I may even take this list with me to my next appointment to see what the RE says! 🙂
Thank you for compiling that all in a post – it’s so helpful to be able to see it all in one spot!
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Everyone is a little different…. Which some say is great, but I think it sucks. It would be so much easier if there was one fix for everyone! I’m on the low end of the PCOS spectrum. I’ve been on Metformin for about a year. This is my second time on it. I am on a much lower dose than I was the last time- mainly because of the GI symptoms that can occur. Metformin is not fun. I’m tolerating it better on this go around, but I still have days where I can’t even smell carbs without having to sit in the bathroom. But, since everyone is different, you might tolerate it well. I haven’t tried Pregnitude, but I had a friend that did. She seemed to tolerate it well. That’s all I know about that! The decisions suck…. Good luck to you!
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I would absolutely continue with acupuncture while pursuing western treatments. I have a close friend who has PCOS, but doesn’t meet the stereotype — she’s thin etc. She took metformin and is 16 wks pregnant now. I tried Pregnitude and didn’t notice any difference. I’ve also used CoQ10 and l-arginine in the past, without seeing results (as far as fertility is concerned. L-arginine is helpful in preventing heart palpitations though). I think there’s a desire among us infertiles to want to throw as many supplements as we can at the problem in the hopes that one of them will do the trick, but I’ve come to believe that most of them are unnecessary. A prenatal, folic acid, and baby aspirin are all that are needed, in my unprofessional opinion.
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Although, its totally off the subject of fertility…. being a massage therapist and now working on traumatic brain injury and spinal cord injury patients…my patients who are more open to alternative medicine show better progress than those who rely on prescriptions. My client who ive been massaging for almost 3 years now is fully off of prescription meds. She is a parapalegic from the waist down. When i first started working on her she could barely pull herself up on my table. For the last 2 years she has stuck to herbs, vitamin D injections, accupuncture, yoga and massage. She now goes from a sit to stand to get onto my table. Although…its been a long journey thus far she florished when she began accupuncture. Again, totally off topic at hand , but i just wanted to help you with an example of success with alternative meds. I cant imagine the decisions and disappointments you have endured and my heart is always heavy with hope for you. Im not an expert, but i would give the natural meds a try for another month or two to really get into your system to work their “magic”. Xoxo pray and ask God to givd you an answer in your dreams tonight! 🙂
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I also was diagnosed with mild pcos. No insulin resistance but put on met and started regular ovulation that cycle. Concieved my daughter the next. I am not going to lie, it’s tough on my system and makes for having a bathroom nearby a necessity. After many unexplained miscarriages After her I was told to add coq10 and vitamin d to my pill box…email with any questions anytime!
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I also tried out naturopathic remedies, including myo-inositol, acupuncture, and herbs, for a full year before throwing in the towel and going for the Met. My doctor checked my androgens just three weeks after starting and my T went from mid 90’s to within the normal range in that short period. I started ovulating regularly thereafter. As I mentioned on your last post, I am not insulin resistant. I’ve been tested three different times, years apart. I’m also thin. I did some research on PCOS supplements and have it posted on my blog: http://returntogobaby.com/supplements/
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I’m a lean PCOS too, and because of it didn’t get diagnosed until my twenties. Been diagnosed and TTC for 2.5 yrs now. My OB put me on Met for 1500mg. Make sure you get the extended release version because it will hurt your GI system less. My doc didn’t tell me about it, I had to tell him. Met at 1500 helped bring my testosterone down a little, but still just above the acceptable range. Then I went to an RE and he suggested adding Pregnitude. I did, and also lowered my Met dose to 500mg/day and after a few months got blood work taken again, and I was smack in the middle of the acceptable range! So I love the combo, my moods are more balanced, my cycles are regular, and I have no gut issues on the lower Met dose. So high Met helped a little but the low Met/Pregnitude combo works great! I tried doing just Pregnitude, but it didn’t work for me. I have not gotten pregnant, but we just found out it was a hardware issue, and had surgery a month ago to fix it, so here’s hoping! Good luck to you too!
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hi cassie,i have similar problem,i was put on met 500mg twice a day but i feel horrible with it,i was asked by my obyn to combine it with pregnitude,am thinking of calling her to see if i can be taking the met once a day
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