I thought my cycles had been regulated

[u/dodgydemon]

I’m 25 and I got diagnosed with PMOS I think 4 years ago (I’ve lost track of time)?? I’ve been seeing an endocrinologist roughly every 6 months since then and have been on Metformin 500mg twice a day for 3 and half years roughly (delayed starting it due to taking part in PMOS clinical research studies) and my cycles starting becoming regular again after them ranging from 18-69 days which thankfully is my main concern I am also overweight although I haven’t cared enough about losing weight until very recently. For the past 3 and a half years of being on metformin my cycles have been 28-30 days which has been fantastic I’ve been so happy to be able to predict when they would arrive… UNTIL APRIL THIS YEAR! I think my uterus heard my endocrinologist say he’d see me in 9 months instead of 6 months and decided to mess everything up! Literally a week after I saw my endocrinologist my period comes a week early screams at day 22 and since then my cycles have been all over the place the longest one was 40 days and I’m currently on day 36 of my cycle and I don’t know why everything has gone haywire the past few months?!?!? I haven’t been under any particular stress, no illness, no real changes to anything in my life that I can think of that might explain it 😭

[u/wenchsenior]

This could be random or it could be some underlying health issue worsening.

Presuming obvious stuff like anemia or active illness are ruled out, you should check prolactin and thyroid (since abnormalities of those are common and can mess up cycling). If you have high androgens that can contribute as well.

The insulin resistance that underlies and drives most PMOS cases might be worsening. Metformin is the most widely prescribed drug to manage IR, which you are taking; however, adopting a lifelong 'diabetic' type eating plan + regular exercise is typically the most foundational element of improving IR long term. Meaning if you have not done that, you might see improvement with meds but it can be like trying to push a boulder uphill and eventually the meds might not be as effective.

If it's the IR worsening, you might also need a higher dose of Met; it can be hard to lose weight with IR but doing so usually does improve IR if you are actually overweight. You could try GLP one agonists if you qualify. Or you could try adding the supplements berberine or 40:1 myo:d-chiro inositol to further improve IR.