I am fervently against the long-term use of drugs to control PCOS because I believe the best, safest, long-term way to manage it is through permanent positive lifestyle choices. Drugs work by chemically inducing the body into some semblance of normality, but they do not cure the underlying causes of the hormonal disruptions in the first place and so are not a cure for the condition.
That being said, a lot of women with PCOS need help with ovulation, myself included. I am not a metformin nazi. I am not saying women who take it should be lined up and shot for doing so. Under certain circumstances taking met can improve the chances of successful ovulation. In fact, taking metformin in conjunction with Clomid has been proven to increase the chances of ovulation while undergoing IUI treatment and that's fine with me.
I am already doing a low GI diet, and ever since I started taking Met again, I've had to increase my carbohydrate intake because of the headaches (caused by low blood sugar). My met belly has also been mitigated somewhat by the fact that I forced it upon myself last year but had to stop after a few weeks because of the severe headaches, shakes, fatigue and weight gain.
For the sake of doing everything within my power to conceive, and not having to go through 6 months of IUI in futility, I've decided to foist it upon myself again.
The above flow chart has guided my decisions in my TTC journey. So far I've made the appropriate life style modifications. I may be ovulating but not releasing an egg (shocking contradiction there) because I know every month I get ovulation pains and exactly 14 days later, I get a period. My periods also come like clock work, with not so much as a 2ww delay-scare-fright-joy type glitch. I also know that I have one fully functioning tube. And that for the last two months I've been ovulation on my blocked side, arrrrgh!!!!
I also suspect that I may have mild endometreosis, although this has not been officially diagnosed. I believe it's sabotaging my body's attempts to ovulate. I believe it's what gives me an intense anal pain when I'm ovulating; so much so that I can't sit down and have to lie on my belly until it subsides.
I didn't seriously consider remaining Metformin for ovulation because I was already doing the low GI diet diet/exercise which, for all intent and purpose, is equivalent to Met. In addition, the adverse reactions put me off. I thought to myself; if its about insulin resistance there are pain-free ways to forcing a particular drug on myself. This time around I know what to do while taking Met, how to maintain my blood sugar without any of the intestine-ripping effects. As a result it's so much better this time around. I can tolerate it with just a few extra teaspoons of sugar in my tea, which I'm gradually phasing out.
My aim is to get my body used to it so that when I start my IUI in a couple of months hopefully, together with clomid I can ovulate and hopefully, conceive.