What if metformin for PCOS does not relieve irregular periods?

PCOS can affect ovulation, and metformin mainly changes how the body handles insulin; period patterns may therefore remain irregular. Other contributors include pregnancy, thyroid disease, raised prolactin, changes in weight, stress, or medicines. Long gaps between bleeds can allow the womb lining to build up, so the next step is not simply increasing the dose without advice.

Book a review with your gynaecologist or primary-care clinician. Mention the date of the last bleed, pregnancy possibility, missed doses, side effects, and any new symptoms. The clinician may review blood tests, medicines, and the treatment plan, then discuss cycle-regulating or womb-lining protection options. Take metformin as prescribed unless advised otherwise, and do not stop it suddenly without discussing why.

Seek prompt care for very heavy bleeding, dizziness, fainting, severe lower abdominal pain, or a positive pregnancy test with pain or bleeding. Contact a clinician when periods are absent for a prolonged interval or bleeding becomes unpredictable, because the pattern may need assessment and protection of the womb lining.

Ask whether pregnancy and other hormone conditions should be checked, how often you need a bleed, and which options fit your fertility plans. Discuss metformin's purpose, side effects, dose review, and what bleeding symptoms should prompt urgent help.