Can you take metformin after hysterectomy? (+3 reasons)

In this article, we will discuss whether metformin can be taken after hysterectomy. We will also discuss the reasons metformin can be used after hysterectomy and other relevant information. 

Can you take metformin after hysterectomy? 

Yes, you can take metformin after a hysterectomy and should continue it as advised by the healthcare provider. Metformin is primarily used for diabetes and polycystic ovary syndrome (PCOS) both of which are not resolved by hysterectomy. 

Hysterectomy is a process in which the uterus is removed surgically. This procedure can be indicated in the following conditions (1): 

• abnormal uterine bleeding
• uterine fibroids
• endometriosis
• pelvic organ prolapse
• chronic pelvic pain
• pelvic infection

Metformin is a biguanide agent that is used in diabetes due to its ability to reduce blood glucose levels by improving the response of the body to insulin. It decreases glucose production in the liver and decreases insulin resistance (2). 

Metformin is used to manage and prevent diabetes and PCOS. Even f you have had a hysterectomy, you will likely need metformin to manage these conditions. 

Why do you need metformin after hysterectomy?

You need to continue metformin after hysterectomy because this procedure does not cure the conditions metformin is used to treat. You need to continue metformin if you were using it for the following conditions (2):

Type 2 diabetes: 

Metformin is primarily utilized to treat and prevent type 2 diabetes due to its hypoglycemic effects. Hysterectomy does not treat type 2 diabetes as it is caused by insulin resistance or insufficient insulin production in the body. 

Antipsychotic-induced weight gain: 

One of the off-label uses of metformin is to reduce the weight gain that occurs as a side effect of antipsychotics. If you take an antipsychotic and experience this side effect your healthcare provider may prescribe you metformin. 

Polycystic ovary syndrome (PCOS): 

Metformin is used to manage insulin resistance that gives rise to PCOS due to the imbalance of hormones. If you experience insulin resistance, you will need to continue metformin as a hysterectomy does not treat insulin resistance. 

Why metformin is taken for PCOS after a hysterectomy? 

Metformin can be prescribed for PCOS after a hysterectomy because PCOS is a hormonal imbalance disorder and irregular periods are just one of the symptoms of this disorder (3).

Thus, removing the uterus may resolve the issue of irregular periods, however,  hormonal imbalance, insulin resistance, and symptoms of PCOS may remain after hysterectomy depending on the type of hysterectomy. 

Hysterectomy can be of the following types (4): 

In PCOS, ovaries play a central role as they are involved in the overproduction of hormones. Thus, if your hysterectomy did not involve the removal of the ovaries, PCOS will not be cured and will persist after this procedure. 

After the hysterectomy, you will not face the issues of irregular periods. However, you will still need metformin to treat the insulin resistance. Insulin resistance in the body triggers the ovaries to produce excessive hormones leading to PCOS (2). 

How to take metformin after a hysterectomy? 

Before the surgical procedure, you will be asked to discontinue metformin because this drug can increase complications in renal function and the risk of lactic acidosis during the surgery (5). 

After the surgery, your blood glucose levels will be monitored especially if you have diabetes. Your healthcare provider will guide you on when to resume metformin based on your condition. 

Take metformin at the dose prescribed by your healthcare provider. Metformin is prescribed in a dose range of 500 to 2550 mg. It is advised to take metformin with food to reduce the risks of side effects (2). 

If you are taking an immediate-release formulation of metformin, you can cut the tablets for ease of swallowing. However, if you are taking an extended-release (ER) formulation, do not cut or crush the tablets. 

It is recommended to take metformin at the same time every day for a consistent response. It is best to take the ER formulation with a full glass of water with an evening meal (2). 

In my experience: 

In my perspective, you can take metformin after a hysterectomy because this procedure does not treat the conditions metformin is used to treat. Metformin is used to manage type 2 diabetes, PCOS, and antipsychotic-induced weight gain. 

If you are taking metformin for PCOS, you will still need metformin after a hysterectomy if your ovaries are not removed in the procedure. If you have PCOS associated with insulin resistance, you will need metformin after the surgery. 

You will be asked to discontinue metformin before surgery to avoid complications during the procedure. You can continue metformin after the procedure as advised by the healthcare provider. 

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