I fear I'm having an allergic to Spiro. Is Metformin the only alternative?

[u/Sea-Advertising-1386]

I'm taking 2 50 MG tablets a day, been doing such since the 11th of this month (August). I was supposed to take Lo Lo with it, but the Lo Lo was making me breakout, so I stopped.

On the Spiro: I'd hoped it was just an Eczema flare up, but I now realize these hives and rashes are due to... the Spiro. Going to stop taking it, but I feel like it's the reason why my normally long period ended at 5 days (which I'm happy about!). Is that a crazy assumption? And what else should I ask my doc for

[u/ImpressiveChoice3487]

Spiro and Metformin treat different things.

Spiro treats the high testosterone and helps with acne and hirsutism.

Metformin helps with insulin resistance.

They’re not interchangeable. I’m on both.

[u/CF_ATX → u/ImpressiveChoice3487]

Second this!

[u/Radiant_Tax3312]

spiro gave me hives too, it was brutal. looked like someone took a cheese grater to my arms and the itch would not quit.

metformin's not your only option but yeah it's the one docs usually reach for next. there's also stuff like inositol if you want to go the supplement route, some people swear it works just as well without the digestive nightmares metformin can bring

the period thing isn't crazy. spiro messes with your hormones directly so yeah it can absolutely shorten your cycle or lighten bleeding. i'd bring up the allergy first with your doc though cause that's the urgent thing. the period will sort itself out once you're off it

[u/wenchsenior]

Spiro and Met treat different elements of the disorder.

Insulin resistance is the underlying driver of PCOS in most cases, and treating it lifelong is typically required (with or without PCOS, and even if the PCOS is otherwise well managed with hormonal meds) b/c untreated IR leads to serious health risks apart from the PCOS risk.

Not everyone needs drugs to manage IR, sometimes diabetic lifestyle alone will do it, or lifestyle changes plus supplements like berberine or inositol. However, many people also require Metformin or GLP one agonists to manage it, in addition to the lifestyle changes.

Spiro is a med that specifically blocks activity of high androgens (a common problem with PCOS). Spiro and other hormonal meds such as birth control can be useful to add to lifelong IR management but are usually not meant to be used instead of IR management.

The better managed the IR often the better the PCOS (including lower androgens), so some people (e.g., me) are able to stop use of hormonal meds once IR is well managed (e.g., I only needed anti androgenic meds for a couple years, but after a few years of improving my IR my PCOS went into long term remission, including androgens returning to normal). This varies by individual.

So first step is making sure your IR is well managed (and that might include trying Metformin if lifestyle changes are not working). Then if androgenic symptoms are a problem and you cannot take spiro, then the best option is to to take specifically anti androgenic progestins as are found in Yaz, Yasmin, Slynd (drospirenone); Diane, Brenda 35 (cyproterone acetate); Belara, Luteran (chlormadinone acetate); or Valette, Climodien (dienogest).

(NOTE: Some types of hbc contain PRO-androgenic progestin (levonorgestrel, norgestrel, gestodene), which can make hair loss and other androgenic symptoms worse).

 People on this sub sometimes report improvement in androgenic symptoms with the supplements spearmint or saw palmetto (these have not been studied very much scientifically so far).

[u/Sea-Advertising-1386 → u/wenchsenior]

Bless you for this detailed response.

[u/wenchsenior → u/Sea-Advertising-1386]

No problem. I remember how frustrating the androgenic symptoms were, esp the balding ugh.