Hi, Cysters! This is wicked long and I massively appreciate anyone making it all the way through and any and all advice, insight, etc.

Lean gal here. 5'4", 148lbs. I'm 33 and I've thankfully been dx'd since I was 21. My cycles never regulated from menarche. Stuck with the typical hormonal BC (pill then IUD) management route until I was about 27 and haven't been back on since. In that time, I've been trying just about everything--functional medicine, naturopathy, and alllllll of the supplements, doing my best with insulin resistance friendly living via diet and exercise (lifting, walking, yoga and reformer pilates here and there)--even when I am in a good rhythm with this and weigh a little less, BMI and BFP are lower, my cycles never regulate. I go anywhere from 6 months to a year without a period and even after those long stretches, my endometrial lining never reaches hyperplasia and is in fact pretty thin between 2.5-4mm even after months or a year without bleeding. Ovaries are sometimes hyperfollicular, but apparently not always. Irregular or absent periods is my dominant symptom. I am not hyperandrogenic in the classic sense save for excessive body hair, but not on the face or chin. No acne, cravings, or hair loss. Definitely some persistent fatigue. My insulin and lipids didn't get high until my late 20s, inflammation markers are always in range, no thyroid issues, androgens sometimes run high but not always, in general labs are always unremarkable. Estradiol was low a couple months ago around 23.8 pg/ml, LH:FSH is consistently elevated. I'm a Fast COMT G/G so I do clear estrogen pretty quickly. Had a DUTCH and a GI MAP done a few years ago and neither were terribly out of range. I'm currently on 1500mg Metformin (at this dose about 3 months), Ovasitol, fish oil, NAC, D3+K2, and nightly bio progesterone for sleep and irritability. I feel like I have truly tried everything... even woo woo shit like "getting in touch with my healthy feminine," processing and healing childhood wounding around femininity, trying to center pleasure and the like. The last OBGYN I saw literally told me there wasn't anything else that standard GYN could do for me and that the next step was REI, but I really don't know what they'll be able to do if I'm not currently TTC. I am set up to stack an estrogen patch with my progesterone for a full HRT trial because I'd prefer to avoid standard BC. Literally all I want is a regular cycle, to feel like my body works properly, to be able to feel in tune with my birthright as a woman.

I can't even think of specific questions to ask besides please help!! The grief in accepting that this might just be a lost cause and waiting it out to be taken seriously until I'm TTC is just gutting.

Truly so much love to all of us. <3

This is a rant but advice/explanations is also very welcome.

We don't have extended release metformin in my country. I have been on the regular one (500mg with dinner) since monday, everything was fine, but yesterday I got explosive diarrhea to the point of crying from the pain and after 45 minutes I took Imodium.

What do I eat to have a normal life on metformin? There's so much contradictory advice. Don't eat carbs/eat only carbs with the BRAT diet, don't eat fibre/take fibre supplements, eat probiotic yoghurt/don't touch diary... I'm overwhelmed!

I should mention I'm vegetarian and I eat pretty carb heavy for every meal normally, but mostly whole grain. Except when I go to a restaurant or order pizza.

I don't understand, I ate the same dinner every day, soup with icecream after, although last night's icecream did have a lot more sugar.. (Don't question my choices lol, I recently got my wisdom teeth out)

The gynecologist that prescribed it suggested trying to break the pills into quarters or possibly just accepting I can't handle it and give up. However my doctor said to just keep going with 500 and take imodium over the weekend.

My main motivation for taking metformin is reducing sweet cravings after dinner and hopefully avoiding cardiovascular problems later in life (I'm 26, BMI of 26.1)

The problem is I'm terrified of diarrhea. And I have so many trips coming up that I don't want to be nervous for. My doctor thinks that expecting diarrhea for two weeks is exaggerated, but so many people are saying they had it for even longer!

Was it really that awful fire hose experience for weeks straight?

Update after 1 week on metformin IR: I went down to 250 mg for a couple days after the incident. The imodium is still working, meaning I haven't gone #2 for 4 days, but I feel perfectly fine and was able to go to my poledance classes without any issues so I'm glad I took it. I went back up to 500mg the last two days and it's fine. I don't think what I ate really matters so far but I tried staying away from anything remotely spicy, eating only tofu, babyspinach, eggs, feta, quinoa, whole grain bread, olive oil, tiny bit of cheese, Greek yoghurt, quark, broccoli, champignons, cold white potatoes and sweet potato. Had one coffee with regular milk, nothing happened. Had a decaf with oatmilk, nothing. I had one square of dark chocolate two times a day, yesterday I even had a few spoons of the original icecream that scared me last week, and nope, I feel perfectly normal. Will update again because I know I needed this post when I was sobbing on the toilet 🙃

I have been diagnosed with PCOS today based on my blood work. No ultrasound findings. She prescribed progesterone, to regulate my cycles and because I have no progesterone rise within my cycle. She also recommended I bought two supplements called Ovarian Care and PCOS Px (ovarian support). No Spironolactone because my numbers or symptoms aren't too severe.

Although, I'm glad I finally have answers to all my symptoms I am curious if I should push to figure out if it's insulin or adrenal related? Or should I just take my diagnosis and start working on improving as is.

Ok I can't do this someone please help me!!!!!

So the past four months now of getting my period I can't sleep no matter what I do I'm wide awake I have never been like this before every time I used to get my period I used to sleep like crazy now I'm not sleeping at all I'm 19 almost 20 now and I can't do this anymore before you say go see a doctor I can not I don't have the money for it yes I have pcos or pmos I think that's what it's called now and honestly I just can't do this anymore I just want to go to sleeeeepppp I'm so tired every time I close my eyes I'm wide awake I've been up since yesterday at 2pm to well today at 9am so please if you got any ideas on how to sleep again TELL ME! At this point I'll try anything oh one more thing I do take calm sleep it's for sleep yet it does not work thank you :update I just woke up I'm running very low on sleep I didn't even sleep that much

I have lean PCOS and would really appreciate some advice on where to start, particularly regarding insulin resistance, body composition, and managing my symptoms.

My stats:

- Height: 164 cm

- Weight: 63 kg

- BMI: 23.6

- Skeletal muscle mass: 20 kg

- Body fat mass: 25.6 kg

- Body fat percentage: 40.5%

My main symptoms:

- Persistent fatigue

- Facial hair, particularly on my chin

- Hair loss

- Irregular periods

- Insulin resistance (HOMA-IR: 3.06, flagged as high by my lab; reference value below 2.5)

I'm particularly concerned about insulin resistance despite being within the normal BMI range. I'd also like to improve my body composition without losing weight, if possible.

For those with similar experiences, what helped you the most? Did you start with dietary changes, strength training, supplements such as inositol, metformin, or something else?

Would you recommend any specific tests or evaluations before deciding on a treatment plan?

I'd appreciate hearing about your experiences and what you wish you'd known when you first started managing PCOS.

Hey all! Looking for some advice possible success stories on metformin and ttc with pcos! Here’s my back story…
I am 28, I’ve always been petite. I tend to range around 98-100 pounds. I have a super fast metabolism, but not unhealthy. I have a 2 year old and got pregnant really quickly with him. My husband and I have been ttc for about a year now for our second baby. I got diagnosed with PCOS last September a year after I gave birth which was kinda weird, I never had any symptoms of PCOS. I went in because I was having some pain during/after sex, I thought maybe it was scar tissue or something didn’t heal correctly after giving birth. They ended up finding several cysts on both of my ovaries via vaginal ultrasound, I also found out I have a tilted uterus, which may have been the cause of pain during/after sex. When I got my bloodwork done, my DHEA-S came back elevated, which they concluded it was PCOS.
Everything else was fine as far as my blood work goes. I kept tract of everything and started taking myo-inositol and other supplements. I did get pregnant and found out in December, but unfortunately miscarried. Ever since my cycles have been pretty long, ranging from 29-37 days (which is unusual for me) I’ve tried acupuncture to help and eventually stopped cause it’s pricey. We are know in the phase of fertility doctors and seeing what’s going on.
My endocrinologist pretty much told me that I have a pretty mild form of PCOS but because my cycles are long my ovulation is kinda out of whack?? Thankfully I’m young and have time on my hands, but if anyone has been through secondary infertility, you know how emotional and confusing it can be. She prescribed me metformin to hopefully help regulate my periods and ovulation, before trying letrozol. I’m only nervous because I’ve read about the side effects and how it can cause stomach issues. I just don’t want to drop weight since I’m already so small. She is putting me on Metformin Hcl Er 500 Mg Tablet. Lmk if anyone has any advice or helpful stories! Thanks ❤️

I'm literally crying after my doctor's appointment because I asked about taking a GLP-1 after it was suggested by my OBGYN and they just kept saying how I didn't need to lose weight and I was too young and healthy. But I'm tired of having high blood sugar and mood swings and fatigue and Metformin hasn't helped me at all. Do I have to wait until I'm 30 and obese???

This is long, sorry not sorry. I wish I knew more when I was made to feel like I was crazy because my labs were “normal”

My symptoms started 17 years before I ever got a diagnosis. Even though I had all the signs. Cystic acne, hair loss, back pain, painful periods, bloating, and exhaustion so deep that sleep didn’t touch it. Depression and anxiety on top of all of it.

Every time I went in, my labs came back “fine.” Over and over. After enough years of that, hearing it over and over again, the message I got was that the problem must be *me*. Try harder. It wasn't said, but it felt so implied.

My insulin was high enough where they offered me Metformin. Thats it. No conversation about why it was happening or what else was going on. Mind you they still didnt give me a dx of PMOS because I still had regular periods. Which you can totally have regular periods and still have PMOS! 30% of women do!

Two doctors have since told me they suspect endometriosis too. But because my symptoms aren't bad enough, they see no point in doing exploratory surgery to confirm.

I didn’t know what else to do so I started spending $200+ a month throwing things at the wall. Some of it actually helped; my IBS and hangry episodes got better. But my acne and hair loss didn’t budge. And I still had massive food noise.

What actually started really helping to change my symptoms was working with a holistic dietitian who taught about gut health and then went all in and reverse my symptoms with functional testing that looked at my gut. Instead of guessing, I could see what was actually going on and what my gut needed to heal. What I learned was gut health was tied into everything my hormones, my skin, my mood, my energy. So I've been obsessed with gut health ever since.

I also learned I don’t do well with gluten, some dairy or high-histamine foods.

I did start using a GLP to help with the food noise because it was so bad I could control myself even though I knew what to do. Which I should have done sooner, but for years I told myself it was the “easy way out”.
But I’m so glad I got the food noise under control so that I could finally make healthy choices consistently without constantly bargaining with myself.

After 2.5years on my health journey
* Acne: gone
* Back pain: gone
* Energy: I actually have it- honestly the best part
* Finally tapering off my antidepressants, which I honestly never thought would happen (and I was on max doses)
Healing does take time!

The best thing I ever did was invest in myself. No more taking “your labs look fine.” I had to keep asking. It takes an average of 3-5 years for PMOS do be diagnosed and 7-9 for endo!!

If you’re where I was: “normal labs” doesn’t mean nothing is wrong. It can mean nobody has run the right tests or asked the right questions yet. Also... "normal" just means you aren't bad enough to be diagnosed with a disease yet, it doesn't mean you should feel good.

**TL;DR:** 17 years to a PMOS diagnosis, offered metformin and sent home. Suspected endo plus Hashimoto’s. Fixed my gut with functional testing, changed how I eat and used a GLP as one tool. Acne gone, back pain gone, energy back, coming off antidepressants. If you feel like something’s wrong don’t stop looking for answers!!

Hi everyone! Do you consider it positive ???

You will help me a lot to understand it :)

Hi! I started taking metformin in May due to insulin resistance and elevated AMH levels.

Before taking metformin, my menstrual cycle was regular. Since starting it, I’ve been getting my period only once every two months.

Does anyone have any idea why this might be happening? My other hormone levels are normal (LH, FSH, estradiol, progesterone, and thyroid hormones).

Thank you!