>>The mom I am helping has PCOS and did not have sufficient milk for the
last baby.  She has given a dozen references on metformin to her OB/GYN, but
the doc wants to know *why* it has an effect.  If I recall the discussions
here correctly, that is another of the mysteries of PCOS, is it not?<<

Lynn, it is true that we don't have this all figured out yet. But the truth
is that we don't completely understand exactly how metformin is able to help
reverse multiple endocrinopathies in many PCOS women. Yet, we use it because
it *does* help a number of women.  Do we really have to understand the
complete "how" before we use it?  My assumption is that the medication is
obviously helping to correct one or more underlying issues that is
interfering with lactation in some women.  Doesn't improve lactation for
everybody, but then there is no ONE drug that helps PCOS for all women,
either.  

My passion for this goes beyond lactation, however.  If a woman required
metformin to achieve or maintain pregnancy, it is obviously correcting
something that is astray in her hormonal milieu. That "something" is most
likely related to the risk factors for PCOS women of developing more serious
health issues later in life-- diabetes, heart disease, gyn cancers.  It's
not just about making more milk, but about improving long term health for
many women.  When the body is not able to make milk, that is a statement
about the body's overall function and should not be viewed as an isolated,
limited issue.

Lisa Marasco 

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