Michelle Pugle is an expert health writer with nearly a decade of experience contributing accurate and accessible health information to authority publications.
Peter Weiss, MD, is a board-certified OB/GYN and expert in women's health.
If you take metformin for type 2 diabetes, you may wonder if it’s safe to continue using it while transitioning to menopause. While metformin for type 2 diabetes is safe during this transition, there are some particular benefits and side effects to consider. 
This article will help you determine whether or not taking metformin while transitioning to menopause is right for you. It discusses how metformin can impact your hormones and why this matters during menopause.
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Research suggests that metformin is safe and effective during the transition to menopause. It also benefits overall metabolic health and your body’s ability to process energy.

Metformin has demonstrated therapeutic potential for:

It’s known that taking metformin for type 2 diabetes reduces breast cancer risk and improves breast cancer survival. Research published in 2018 on postmenopausal rodents suggests it may be particularly effective when taken during the menopausal transition. More research may be needed on humans,
The study authors concluded that taking metformin while transitioning to menopause, in particular, may be an effective therapy against breast tumor growth. Menopause is considered a life stage where metabolic syndrome and obesity-related breast cancer risk increase.

Metformin impacts a person's sensitivity to insulin, a hormone essential in metabolic functioning.
Metformin also has the effect of lowering testosterone hormone levels in the blood. Lowering testosterone levels has been shown effective in helping to regulate a person's menstrual cycle in their premenopausal years.
Metformin's effect on different hormones, including testosterone and insulin, has shown protective qualities against obesity, metabolic syndrome, and endometrial cancer cell growth during menopausal years.

Metformin also has been clinically tried over a period of six months in the treatment of polycystic ovarian syndrome (PCOS) during premenopausal years due to its effect on different hormones in the body.

Common side effects of metformin include:

A rare but serious condition called lactic acidosis can occur when taking metformin. Always tell your prescribing healthcare provider about any history of kidney disease, heart attack or stroke, diabetic ketoacidosis (too much acid in the blood), or alcohol use disorder to ensure metformin is safe for you. In such cases, your healthcare provider may suggest safer alternatives.
The symptoms of type 2 diabetes can make the symptoms of menopause worse, and vice-versa. Menopause symptoms caused by estrogen and progesterone level changes can make type 2 diabetes more challenging to manage.
For example, sleep problems caused by menopause symptoms like hot flashes, anxiety, and night sweats negatively impact your ability to regulate insulin levels, which is the cornerstone of diabetes management.
Other symptoms from menopause, including vaginal dryness, can add to the pain experienced by any diabetes-related vaginal nerve pain damage.
Menopause symptoms that can overlap with diabetes symptoms include:

Managing type 2 diabetes during menopause can be done effectively. In addition to taking metformin, you may want to consider the suggestions from the Centers for Disease Control and Prevention (CDC) for people in menopause with type 2 diabetes. These include the following:
Taking metformin for type 2 diabetes during menopause is safe. Taking metformin during this life stage is beneficial due to its impact on hormones, including testosterone and insulin. Metformin use during menopause is associated with better overall metabolic health, including reduced risk of obesity.
Common side effects include digestive upset and a metallic taste in the mouth. Symptoms of menopause and diabetes can make the other worse. Management of type 2 diabetes during menopause includes eating healthy, participating in more physical activity, and getting enough sleep.

Managing type 2 diabetes during menopause differs from managing type 2 diabetes without menopause. The unique challenges can be frustrating and make you wonder what's left to do about feeling well again. If you're feeling this way, consider speaking with your healthcare provider about your symptoms, including physical changes, like hot flashes, and emotional symptoms, such as anxiety or depression. Help is available.
Yes, Metformin is safe to take during menopause. It does impact hormone levels, including testosterone and insulin. There is some benefit to this during menopause.
Other side effects of Metformin include digestive upset like bloating, gas, and diarrhea. People also report a metallic taste in their mouths. Metformin can also lead to vitamin B12 deficiency.
Metformin works by moderating insulin sensitivity in people with type 2 diabetes (i.e., helping them manage insulin and blood sugar levels). This can also help manage menopause fatigue. Proper metabolic functioning is essential in how your body stores and processes energy.
Campagnoli C, Abbà C, Ambroggio S, et al. Life-style and metformin for the prevention of endometrial pathology in postmenopausal women. Gynecol Endocrinol. 2013;29(2):119-124. doi:10.3109/09513590.2012.706671
Giles ED, Jindal S, Wellberg EA, et al. Metformin inhibits stromal aromatase expression and tumor progression in a rodent model of postmenopausal breast cancer. Breast Cancer Research. 2018;20(1):50. doi:10.1186/s13058-018-0974-2
Surakasula A, Nagarjunapu G, Raghavaiah K. A comparative study of pre- and post-menopausal breast cancer: Risk factors, presentation, characteristics and management. J Res Pharm Pract. 2014;3(1):12. doi:10.4103/2279-042X.132704
U.S. National Library of Medicine Clinical Trials. The effect of metformin on different hormones in PCOS patients
Medline Plus. Metformin.
diaTribe. Navigating menopause and perimenopause with diabetes.
The North American Menopause Society. Diabetes hits women hard at menopause: beat it back.
Centers for Disease Control and Prevention.  Diabetes and women
By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind. 

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