Foods to Avoid When Taking Metformin For PCOS

Metformin is a medication that helps with blood sugar control and increasing sensitivity to insulin.

Because polycystic ovary syndrome (PCOS) is characterized by hormonal imbalances, insulin resistance, weight gain, and other symptoms, doctors commonly prescribe metformin as a treatment.

Read on for a comprehensive look at how metformin helps with PCOS, which foods are best to avoid, and which are healthy alternatives.

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How Does Metformin Help Manage PCOS?

Metformin is a medication doctors typically prescribe for managing type 2 diabetes. However, it has several benefits when taken for PCOS.

PCOS is a condition in which several reproductive hormones are too high and cause irregular menstrual cycles or no cycles. It can also cause acne changes and hair growth, and some people have benign cysts on their ovaries. 

While the exact cause of PCOS is unknown at this time, experts understand that having excess weight and a family history (mother or sister) of PCOS are factors. 

The Centers for Disease Control warns that people with PCOS are at higher risk for:

• Type 2 diabetes.
• Gestational diabetes.
• Heart disease.
• High blood pressure.
• Sleep apnea.
• Stroke. 

Metformin offers significant benefits for individuals with PCOS through addressing insulin resistance and lowering sex hormone production in the ovaries by 20% – 25%.

When taking metformin while following a nutritious diet, you can reduce your risk of type 2 diabetes and may notice improvements in your menstrual cycle, acne, and other PCOS symptoms.

Foods To Avoid When Taking Metformin For PCOS

Metformin works to manage your blood sugar levels by decreasing the amount of glucose (sugar) you absorb from food and how much glucose your liver makes.

It can also help enhance your cells’ sensitivity to insulin (a hormone that helps with blood sugar control). 

While taking metformin, it’s important to eat foods that help enhance its effects rather than working against it. 

Starches

Certain carbohydrates quickly break down into glucose during digestion.

The rapid breakdown of these types of carbohydrates can lead to high blood sugar levels, which counteracts metformin’s effectiveness. 

Starches that contain carbohydrates include:

• White bread.
• White rice.
• Pasta.
• Sweetened breakfast cereals.
• Peas.
• Corn.
• Fruit juice.
• Sweetened yogurt.
• Cookies.
• Candy.
• Soda.

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Processed and Ultra-Processed Foods

Processed foods may be high in sugar, unhealthy fats, and low in nutritional value, which works against the positive benefits of taking metformin for PCOS. 

Some common ingredients in these foods include: 

• Hydrogenated oils.
• Artificial food additives.
• Fructose corn syrup.
• Artificial sweeteners.

The ingredients in some processed or ultra-processed foods can significantly increase blood sugar levels and lead to further insulin resistance.

This is one of the primary issues metformin is working to address to help manage PCOS symptoms. 

Some examples of ultra-processed foods include:

• Hot dogs.
• Frozen meals.
• Packaged soups.
• Crackers and chips.
• Packaged cookies and pastries.
• Dressings and condiments.
• Syrups and jams.
• Ice cream and frozen desserts.

Fried Foods

Fried foods are often coated in breading and cooked in unhealthy oils, which contribute to weight gain and insulin resistance. 

Weight gain and insulin resistance also increase your risk for heart disease. 

Overall, it is best to avoid fried foods, but it’s especially important if you are taking metformin for PCOS. 

Examples of fried foods include:

• Chicken nuggets/strips.
• French fries.
• Fried fish and seafood.
• Fried donuts and pastries.
• Fried onion rings and other vegetables.
• Fried cheese sticks.
• Fried tofu.
• Potato chips.

High-Fat Meats

High-fat red meats and processed meats tend to be high in saturated fats, which may contribute to insulin resistance, inflammation, and weight gain.

Consuming these foods can also put you at higher risk for heart disease.

Because people with PCOS are already at higher risk of type 2 diabetes, heart disease, and stroke, it’s best to reduce or avoid these foods while taking metformin.

High-fat meats include:

• Beef ribeye.
• Beef short rib.
• Prime rib.
• Lamb.
• Pork belly.
• Ground meat with a high-fat percentage.
• Chicken thigh and drumstick with the skin.
• Processed meats like sausage and bacon, deli meats.

Sweetened Beverages

Sweetened beverages are very high in refined sugars and carbohydrates, which can cause your blood sugar to rise. 

Too much sugar also directly counteracts the benefits of metformin and increases your risk of diabetes, heart disease, and obesity. 

Sweetened beverages include:

• Soda.
• Energy drinks.
• Sweetened tea or coffee drinks.
• Fruit juices.
• Sports drinks.

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Alcohol

While there’s no direct contraindication against drinking alcohol with metformin for PCOS, alcohol can interfere with how your body processes sugar, making it difficult for you to manage your blood sugar. 

Drinking alcohol can cause your blood sugar to drop too low (hypoglycemia) or, in some cases, increase too high (hyperglycemia). 

If you are taking metformin for your PCOS, it’s a good idea to avoid or limit the amount of alcohol you drink.

If you do choose to have a drink, consider following these guidelines and having no more than:

• 5 oz of wine.
• 12 oz of beer.
• 1.5 oz of liquor.

Healthy Alternatives

When taking metformin for managing PCOS symptoms, it’s best to adopt a diet rich in nutrition-dense foods that optimize the benefits of the medication and support your overall health. 

Carbohydrates

When it comes to eating carbohydrates, select complex carbohydrates such as whole grains, legumes, and vegetables, which stabilize your blood sugar levels and improve insulin sensitivity. 

These foods also give you the added benefit of being high in necessary vitamins, minerals, and fiber, which promotes healthy digestion.

Whole grains include:

• Barley or oats.
• Wholegrain bread or crackers.
• Whole grain cereal.
• Whole-wheat pasta.
• Brown or wild rice.

Snacks

Rather than eating ultra-processed foods for snacking, try eating whole foods that are high in nutritional value and promote healthy blood sugar.

Some healthy snacks  include:

• Fresh veggie sticks with hummus or guacamole.
• Greek yogurt with fresh berries and lower-sugar granola.
• Apple slices with peanut butter.
• Nuts like cashews, walnuts, and almonds.
• Whole grain crackers with tuna.

Cooking Methods

When preparing your foods, learn to incorporate certain cooking methods to help decrease saturated fats in your diet.

Healthy cooking methods include:

• Baking.
• Grilling.
• Boiling.
• Roasting.

To add flavor to your dishes, try adding a fresh squeeze of lemon or incorporating fresh herbs like basil, rosemary, ginger, and thyme. 

Try experimenting with other low-salt seasonings, and instead of using dressings on your salads, include a little drizzle of olive oil, and vinegar.

Proteins 

Protein is an essential part of a balanced diet, but it’s important to choose lean meats and proteins to reduce saturated fat intake and promote metabolic health.

These include:

• Skinless chicken.
• Lean ground beef.
• Fish.
• Tofu.
• Lentils.
• Beans.
• Nuts and seeds.

Beverages

Nothing can top the benefits of water when it comes to improving your health. 

However, if you like to have some variety, try drinking unsweetened tea and coffee, club soda, or adding a squeeze of lemon or other fruit to your water to add flavor. 

Herbal teas with a dash of honey are also a delicious substitute.  

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Potential Side Effects Of Metformin

Doctors generally consider metformin to be a safe medication. However, it does have several side effects that some people experience.

Common Side Effects

The most common side effects of metformin are with the digestive system and include:

• Diarrhea.
• Nausea.
• Vomiting.

About 30% of people taking metformin experience a side effect from metformin.

Serious Side Effects

Less common, but more severe side effects of metformin can include:

• Chest discomfort.
• Headache.
• Sweating.
• Low blood sugar.
• Weakness.
• Ringing in the ears.
• Decreased vitamin B12 levels.

The most serious side effect is a black box warning for lactic acidosis—a very rare but severe issue when lactate accumulates too quickly in the body, causing difficulty breathing, weakness, and vomiting.

Tips For Managing PCOS Symptoms

While there is currently no cure for PCOS, there are steps you can take to manage your symptoms. 

• Weight loss: Maintaining a healthy weight by eating a balanced diet and getting regular physical activity can help relieve PCOS symptoms. It can also help improve sensitivity to insulin, reduce blood sugar levels, and balance your hormones.
• Remove hair: Over-the-counter treatments like creams and other products are available to remove hair. You can also have procedures like laser hair removal or electrolysis done to remove hair or request a prescription cream that slows hair growth.
• Medicine: Talk with your doctor about other medication options that may help reduce acne or help establish a monthly cycle if you want to get pregnant. 

Takeaway

Metformin is a medication typically prescribed to treat pre-diabetes or type 2 diabetes. However, it also has several benefits for PCOS.

Metformin helps increase insulin sensitivity and manage blood sugar and may help lower sex hormones in people with PCOS.

While taking metformin, following a healthy diet and avoiding foods high in refined carbohydrates or sugar, and unhealthy fats is important. 

Instead, incorporate whole grains, fresh fruits and vegetables, lean proteins, and beverages that don’t contain sugar. Learning to avoid frying foods and instead baking, grilling, and roasting will also benefit your health. 

How A Dietitian Can Help

A dietitian can help you discover what foods you can eat to enhance the benefits of metformin and which foods you want to avoid.

After learning your preferences, they can help design a meal plan to get you started toward better health and management of your PCOS symptoms. 

A PCOS dietitian can also give guidance on ways you can meet your weight management goals and which foods to eat to promote reproductive health.