Insulinoodporność, metformax i ciąża?

30.08.04, 11:43
Dziewczyny

czy któraś z was bierze może metformax lub metforminę? Zastanawia mnie
dzienna dawka i wskazania do brania. Moja insulina jest minimalnie
podwyższona po obciążeniu glukozą (75g), ale lekarz twierdzi, że podawanie
tego leku może skutecznie wpłynąć na zajście w ciąże.
Czy któraś z was stosuje to albo zaszła w ciąże???
pozdrawiam
F.
    • Gość: kasia Re: Insulinoodporność, metformax i ciąża? IP: *.neoplus.adsl.tpnet.pl 30.08.04, 12:30
      podciągam, też mnie to interesuje
    • ikrol1 Re: Insulinoodporność, metformax i ciąża? 30.08.04, 13:09
      Osobiście znam osobe której takia terapia pomogła. Stosowała przez 6 miesiecy
      metforminę i w 7 zaszła naturalnie w ciażę przy braku owulacji przed terapią.
      Niestety wiecej szczegółów(tzn dawki i wyników badań) nie pamiętam. Wklejam
      artykuł w którym opisuje sie badania prowadzone na kobietach z PCOS w ogólności
      nawet bez wczesniejszego badania insuliny.

      PCOS AND THE USE OF METFORMIN

      Polycystic ovarian syndrome (PCOS) occurs in 5-10% of women of reproductive age.
      The condition is characterized by abnormal ovarian function (irregular or absent
      periods, abnormal or absent ovulation and infertility), androgenicity (increased
      body hair or hirsutism, acne) and increased body weight �body mass index or BMI.
      The morphology (structure shape and size) of the ovaries is characterized by
      multiple micro-cysts under the ovarian capsule and an overgrowth of ovarian
      connective tissue i.e, stromal hyperplasia. PCOS is also often associated with
      insulin resistance high blood insulin levels (hyperinsulinemia) and non-insulin
      dependent Diabetes mellitus which could play a key pathogenic role in its
      development, contributing to the development of obesity, an abnormal lipid
      profile, and cardiovascular disease. Women with PCOS are also at a slightly
      increased risk of developing uterine, ovarian and possibly also breast cancer
      and accordingly should be evaluated carefully on an annual or more frequent basis.

      There has in recent years been a flurry of interest in the possible benefits of
      using Metformin derivatives such as Glucophage to treat women with PCOS in the
      hope of improving ovulation function, restoring menstrual cyclicity, reduce
      androgenicity an d improve fertility potential. It has also been speculated that
      Metformin, by lowering blood insulin levels and regulating cellular metabolism,
      might reduce the long term risks of heart disease, stroke and diabetes mellitus
      in women in women with PCOS.

      So, what is really known about the potential benefits of Metformin (500 mg TID
      for 3-6 months at least) with regard to treating PCOS in general, and enhancing
      fertility in specific? What follows is an attempt to put this in some perspective:

      1) 50% of women with irregular periods and about 25% of women with absent
      periods will experience a restoration of normal menstrual cycles.
      2) In about 25% of cases, ovulation is restored with 10% of the women conceiving
      spontaneously within a 6 month period of treatment.
      3) In most cases where the blood testosterone level is raised, there will be
      about a 30% reduction in serum testosterone levels within 3-6 months, with
      levels plateauing thereafter. It is believed that this feature of Metformin
      activity could play an important role in improving ovulation function and/or
      response to fertility drugs (such as clomiphene citrate and/or gonadotropins) as
      well as accounting for a modest reduction in androgenicity (5-8%).

      Metformin�s mode of action probably relates to an improvement of the blood
      insulin level by decreasing bowel absorption of glucose, improving glucose
      uptake into the cells and increasing the number of insulin receptors on the
      surface of cells.

      PCOS women who have the following features represent the ones that are most
      likely to benefit from Metformin therapy:

      � Raised serum insulin levels (hyperinsulinemia) or insulin resistance.
      � Irregular rather than absent menstrual periods.
      � Raised serum testosterone levels.
      � An LH/FSH ratio greater than 2:1.

      Metformin therapy can be used safely in conjunction with IVF in women with
      insulin resistance. There is no evidence that it is harmful if taken during
      pregnancy.

      Pozdrawiam. Ilona
      • fulvia16 Re: Insulinoodporność, metformax i ciąża? 30.08.04, 14:12
        dzieki Ilonasmile

        ja niestety nie mam wszystkich "objawów", o których piszą na końcu artykułu -
        tzn. stosunek lh/fsh mam prawidłowy, a insulinę nieznacznie powiększoną po
        obciążeniu (na czczo jest ok, a po obciażeniu ok. 30. Byłam nawet u
        diabetologa, ale ten stwierdził, że to żadna insulinoodporność i powiedział, że
        branie tego leku jest szkodliwe dla płodu i w żadnym wypadku mam go nie brać.
        Tak czy siak posłuchałam gina i biorę 500 dziennie (poczytałam też trochę
        postow na bocianie, ale jest ich mało). Chodzi mi raczej o to, czy lek ten
        odniósl skutek w postaci uzyskania ciąży u dziewczyn, które nie miały
        specjalnej insulioodporności. A oto co dziś znalazłam w sieci:

        Polycystic Ovary Syndrome...
        Treatment with Insulin Lowering Medications
        by Mark Perloe, M.D.

        INTRODUCTION:
        Polycystic ovary syndrome is characterized by anovulation (irregular or absent
        menstrual periods) and hyperandrogenism (elevated serum testosterone and
        androstenedione). Patients with this syndrome may complain of abnormal
        bleeding, infertility, obesity, excess hair growth, hair loss and acne. In
        addition to the clinical and hormonal changes associated with this condition,
        vaginal ultrasound shows enlarged ovaries with an increased number of small (6-
        10mm) follicles around the periphery (Polycystic Appearing Ovaries or PAO).
        While ultrasound reveals that polycystic appearing ovaries are commonly seen in
        up to 20% of women in the reproductive age range, PolyCystic Ovary Syndrome
        (PCOS) is a estimated to affect about half as many or approximately 6-10% of
        women. The condition appears to have a genetic component and those effected
        often have both male and female relatives with adult-onset diabetes, obesity,
        elevated blood triglycerides, high blood pressure and female relatives with
        infertility, hirsutism and menstrual problems.
        HYPERINSULIN & PCOS?
        As of yet, we do not understand why one woman who demonstrates polycystic
        appearing ovaries on ultrasound has regular menstrual cycles and no signs of
        excess androgens while another develops PCOS. One of the major biochemical
        features of polycystic ovary syndrome is insulin resistance accompanied by
        compensatory hyperinsulinemia (elevated fasting blood insulin levels). There is
        increasing data that hyperinsulinemia produces the hyperandrogenism of
        polycystic ovary syndrome by increasing ovarian androgen production,
        particularly testosterone and androstenedione and by decreasing the serum sex
        hormone binding globulin concentration. The high levels of androgenic hormones
        interfere with the pituitary ovarian axis, leading to increased LH levels,
        anovulation, amenorrhea, and infertility. Hyperinsulinemia has also been
        associated high blood pressure and increased clot formation and appears to be a
        major risk factor for the development of heart disease, stroke and type II
        diabetes.
        DIAGNOSIS
        There is little agreement when it comes to how PCOS is diagnosed. Most
        physicians will consider this diagnosis after making sure you do not have other
        conditions such as Cushing's disease (overactive adrenal gland), thyroid
        problems, congenital adrenal hyperplasia or increased prolactin production by
        the pituitary gland. TSH, 17-hydroxyprogesterone, prolactin and a dexamethasone
        suppression test may be advisable. After reviewing your medical history, your
        physicians will determine which tests are necessary. If you have irregular or
        absent menstrual periods, clues from the physical exam will be considered next.
        Your height and weight will be noted along with any increase facial or body
        hair or loss of scalp hair, acne and acanthosis nigricans (a discoloration of
        the skin under the arms, breasts and in the groin). Elevated androgen levels
        (male hormones) androstenedione, DHEAS or testosterone confirm the diagnosis. A
        fasting insulin and glucose level will be obtained. Many physicians tell their
        patients that insulin values are normal, when in fact the value indicates that
        insulin may be playing a role in stimulating the development of PCOS. Most labs
        report levels less than 25-30 miu/ml as normal, while in fact, levels over
        10miu/ml on a fasting blood sample suggests that PCOS may be related to
        hyperinsulinism. As women with polycystic ovary syndrome may be a greater risk
        for other medical conditions, testing for blood lipids, diabetes and PAI-1 (a
        blood factor that promotes abnormal clotting).
        NEWER METHODS OF TREATMENT
        Traditional treatments have been difficult, expensive and have limited success
        when used alone. Infertility treatments include weight loss diets, ovulation
        medications (clomiphene, follistim, Gonal-F), ovarian drilling surgery and IVF.
        Other symptoms have been managed by anti-androgen medication (birth control
        pills, spironolactone, flutamide or finasteride).
        Ovarian drilling can be performed at the time of laparoscopy. A laser fibre or
        electrosurgical needle is used to puncture the ovary 10-12 times. This
        treatment results in a dramatic lowering of male hormones within days. Studies
        have shown that up to 80% will benefit from such treatment. Many who failed to
        ovulate with clomiphene or metformin therapy will respond when rechallenged
        with these medications after ovarian drilling. Interestingly, women in these
        studies who are smokers, rarely responded to the drilling procedure. Side
        effects are rare, but may result in adhesion formation or ovarian failure if
        the procedure is performed by an inexperienced surgeon.
        But recently promising new treatment options have become available. Drs.
        Velazquez, Nestler and Dunaif have shown that lowering serum insulin
        concentrations with metformin (Glucophage 1500 mg a day) or troglitazone
        (troglitazone, Rezulin has recently been withdrawn from the market because of
        lifethreatening side effects) ameliorates hyperandrogenism, by reduction of
        ovarian enzyme activity that results in male hormone production.
        For women in the reproductive age range, polycystic ovary syndrome is a
        serious, common cause of infertility, because of the endocrine abnormalities
        which accompany elevated insulin levels. There is increasing evidence that this
        endocrine abnormality can be reversed by treatment with widely available
        standard medications which are leading medicines used in this country for the
        treatment of adult onset diabetes, metformin (Glucophage 500 or 850 mg three
        times per day or 1000mg twice daily with meals), pioglitazone (Actos 15-30 mg
        once a day), rosiglitazone (Avandia 4-8 mg once daily) or a combination of
        these medications. These medications have been shown to reverse the endocrine
        abnormalities seen with polycystic ovary syndrome within two or three months.
        They can result in decreased hair loss, diminished facial and body hair growth,
        normalization of elevated blood pressure, regulation or menses, weight loss and
        normal fertility. We have seen pregnancies result in less than two months in
        woman who conceived in their very first ovulatory menstrual cycle. By six
        months over 90% of women treated with insulin-lowering agents will resume
        regular menses.
        The medical literature suggests that the endocrinopathy in most patients with
        polycystic ovary syndrome can be resolved with insulin lowering therapy. This
        is clinically very important because the therapy reduces hirsutism, obesity,
        blood pressure, triglyceride levels, elevated blood clotting factors and
        facilitates reestablishment of the normal pituitary­ovarian cycle, thus often
        allowing resumption of normal ovulatory cycles and pregnancy. We know the
        polycystic ovary disease is associated with increased risk of heart attack and
        stroke because of the associated heart attack and stroke risk factors,
        hypertension, obesity, hyperandrogenism, hypertriglyceridemia, and these are to
        a large degree resolved by therapy with these medications.
        ARE T
    • Gość: juna1 Re: Insulinoodporność, metformax i ciąża? IP: *.bochnia.pl / *.bochnia.pl 30.08.04, 16:00
      Na forum "bociana" jest dziewczyna, która zaszła po metformaxie. Miała
      przepisany, mimo iż nie miała stwierdzone insulinoodporności. Jej ginekolog
      stwierdziła, że ten lek świetnie wpływa na jajniki i chyba w 2 czy 3 miesiącu
      zażywania go zaszła w ciążę.
    • Gość: cetka Re: Insulinoodporność, metformax i ciąża? IP: *.aster.pl / *.aster.pl 30.08.04, 18:20
      mi po tym leku wyregulowaly sie @, ale w ciazy jeszcze nie jestem.
    • Gość: masza76 Re: Insulinoodporność, metformax i ciąża? IP: *.lot.pl 30.08.04, 19:34
      hej,
      ja biorę metformax drugi cykl i do tego encorton. moja gin też twierdzi, że
      poprawia to pracę jajników, a na efekty można czekać do sześćiu miesięcy. ja
      właśnie czekamsmile
      na forum bociana jest cały wątek poświęcony metformaxowi i opinie są dosyć
      obiecujące, może poczytaj tam
      pozdrawiam
    • Gość: masza76 Re: Insulinoodporność, metformax i ciąża? IP: *.lot.pl 30.08.04, 19:35
      nie dopisałam o dawkowaniu,
      ja biorę po jednej tabletce rano i wieczorem. podobno później dawkę się zwiększa
    • Gość: Renata Re: Insulinoodporność, metformax i ciąża? IP: *.pl / *.enterpol.pl 30.08.04, 19:51
      Ja zapodałam sobie metforminę sama. Poczytałam na bocianie /jest tam taki duzu
      wątk/. Podobno bardzo poprawia sie po tym leku praca jajników i ładnie pękają
      pecherzyki / a ja z tym mam właśnie problem/.
      Mój gin podchodzi do tego z rezerwą, ale ja tak do końca nie wierze lekarzom ,
      może to błąd ale leczę się trochę na własną rękę.
      Zarzywam 1X3 dziennie 500 mg. Uaga: na początku można mieć bardzo nieprzyjemne
      dolegliwościnp. mdłości, biegunku, bóle głowy, senność. Ale z czsem to
      przechodzi - im dłużej się bierze tym organizm lepiej się przystosowuje.
      pozdrawiam
      Renata
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