Common Metformin Side Effects in Women and How to Manage Them Naturally

Interested in an oral alternative to Ozempic injections? You might be considering metformin, an FDA-approved type 2 diabetes medication that also results in weight loss. While a pill is certainly more appealing than an injection, side effects are always a possibility no matter the form. Still, most are bothers you can manage naturally. Here, experts explain common metformin side effects in women and offer helpful remedies. 

What is metformin?

Metformin is a prescription medication most commonly used to treat type 2 diabetes (like Ozempic). It helps control blood sugar levels by lowering the amount of glucose produced by the liver and improving insulin sensitivity, explains Aaron Emmel, PharmD, BCPS, pharmacist and founder at Pharmacy Tech Scholar. 

Your doctor may prescribe the standard immediate-release formulation (metformin IR) or metformin extended release (metformin ER), which is typically taken less frequently since it’s absorbed by the body slowly over time. No matter which version you take, doctors advise using caution when drinking alcohol, which can increase the risk of lactic acidosis. This condition occurs when there’s a dangerously high level of lactic acid in the bloodstream, causing nausea, vomiting and weakness.

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Wellness

How Much Weight Can You Lose on Metformin, the Oral Ozempic Alternative?

The type 2 diabetes medication Ozempic has been hugely popular when prescribed off-label for weight loss, thanks to its ability to regulate your blood sugar and curb your appetite. But between shortages, high out of pocket costs and the need for weekly injections, the medication is not suited for everyone. As an alternative, some doctors […]

Can you lose weight with metformin?

While not FDA-approved for weight loss, metformin may be prescribed off-label for weight management. Many people taking metformin do experience modest weight loss, but it doesn’t compare to Ozempic’s capability when it comes to shedding pounds. You can expect to lose about 15-20 percent of your body weight on a semaglutide like Ozempic or Wegovy compared to about 5 percent on metformin.

How metformin aids weight loss 

There are a few mechanisms believed to contribute to weight loss while taking metformin. This includes improved insulin regulation, a mild appetite-suppressing impact and potential changes in gut bacteria that can influence metabolism, explains Pamela Tambini, MD, Medical Director at Engage Wellness.

Possible metformin side effects in women 

Women should know that the side effects of metformin tend to be most prominent at the beginning of treatment and after increasing the dose. Discomfort should ease over time and can generally be relieved with simple home remedies. Here, three common side effects of metformin:

GI upset 

The most common side effect of metformin is gastrointestinal upset. This includes symptoms like nausea, diarrhea, gas and bloating, which occur because metformin irritates the stomach lining, alters glucose absorption in the intestines and alters gut bacteria which can disrupt digestion, says Dr. Tambini. 

The fix? Taking the medication with food rather than on an empty stomach often helps reduce nausea, she offers. Staying hydrated and eating smaller, more frequent meals can also be helpful, as well as reducing intake of carbonated beverages to avoid exacerbation. 

Also smart: Take a probiotic if GI discomfort persists, suggests Emmel. This can help rebalance the good and bad bacteria in your gut, improving digestion and GI irritation. Just be sure to get your doctor’s guidance first. 

Metallic taste

“Another bothersome side effect is something called dysgeusia, or a disturbance in taste,” says Emmel. “This is typically a metallic or bitter taste.” To combat this, the experts we spoke to recommend drinking plenty of water, chewing sugar-free gum and avoiding overly spicy or acidic foods. 

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Vitamin B12 deficiency 

While less common, metformin could hinder the body’s ability to absorb vitamin B12 when taken for an extended period of time. This could lead to fatigue, weakness or nerve-related symptoms such as tingling in the hands and feet, says Tambini. 

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Women in particular may experience side effects associated with micronutrient deficiencies such as thinning hair or changes in hair texture, which could be a sign that nutrient levels should be checked while taking metformin, adds Emmel. 

This risk is higher for individuals with poor dietary intake or pre-existing conditions affecting nutrient absorption, Tambini notes. Regular blood tests can monitor vitamin B12 levels and supplements or B12-rich foods like fish, dairy and eggs can help prevent deficiencies, she explains. 

Ozempic vs Metformin side effects in women 

In most instances, metformin has been observed to produce milder side effects compared to semaglutide medications like Ozempic. For both medications, if side effects persist, worsen over time or interfere with daily life, you should consult your doctor about options such as adjusting your dosage or exploring alternatives, says Dr. Tambini.