PCOS, Mirena, Keto and Stopped Metformin

I suggest going to your endocrinologist. Most PCPs will end up referring you to one anyway. I don't know how things are in your city, but finding an endocrinologist that also treats PCOS is rare here and I had a heck of a time finding one. It is important to get blood work to see if some of your hormone levels are off. Hormone levels can change from one month to the next, especially when you tamper with your diet or your weight. If you were prescribed Metformin, it was for good reason and you should not have quit taking it without consulting with your doctor. The Metformin will help control your insulin levels, which in turn controls the way your body processes sugars from food, and weight.

Perhaps you need to go back to the Metformin and modify your diet. Modification of lifestyle (exercise and diet) could help you enough to not need the Metformin anymore, or to reduce your prescribed dosage. If Metformin and exercising helped you lose weight, why not continue with that? According to Google "Hormonal IUDs also list weight gain as a possible side effect. However, according to the Mirena website, fewer than 5 percent of women using it experience weight gain." I don't know if you could be in that 5%, but does not seem that likely.
Not exercising, eating anything you want, and not taking your medication WILL make you gain weight though.

MilitaryMom 6. has the right idea. You need to consume small portions of lean proteins and vegetables. Simply cutting down on portion sizes will make a big difference. I had no idea how large portions were until my endocrinologist explained it to me. Now I understand why there's such an obesity epidemic -- restaurant portions are HUGE! They also sneak things in like sugars and fats into the sauces and condiments, so you're consuming food that isn't exactly healthy, and large portions of it. Stay away from starches and stick to a low glycemic index diet, which is best for those with PCOS and diabetes. Again, your endocrinologist can provide you with a brochure as to what types of foods these are. Do some walking, eat at a decent time, and get a good amount of sleep as well, I'm sure you'll start seeing results!

I can't speak to most of your issues other than I did start a keto diet a few months ago. It didn't work for me at all. I lost 1 lb in 30 days, never cheated once, and was miserable the entire diet.

Maybe look at a different type of dieting? Keto doesn't work for everyone. I did lose 15 lbs after going back to my regular "diet" that I do when I need to lose weight (had a girlfriend who was doing keto that is why I ended up trying it). For me, my diet consists of as many fruits and vegies as I want and only lean meats/lean proteins. No soda. No dairy. Lots of water. Daily exercise (even if it is just walking). No starches/breads/potatoes/rice/tortillas/chips/etc. All fruits and vegies are fresh or frozen (if frozen, no sauces or butters or rices added), never canned. All meats are lean and nitrate free and do not exceed 3 oz per meal. I have no problem sticking to this diet and really never hungry since I can eat as many fruits and vegies as I want. My favorite is guacamole with either carrots or celery (instead of chips).

Good luck!

Could be a lot of things, which makes it so hard. Looking back, I did gain weight on Mirena. I didn't really make the connection at the time because I had the Mirena put in within a year of having a baby and I typically gained weight post--pregnancy but this was after my normal post-pregnancy weight gain and then went 10 lb above and beyond that.

I was recently diagnosed with celiac disease and didn't have typical symptoms. I've been seeing that there are a lot of women with both PCOS and celiac and that treating the celiac helps with the PCOS symptoms. You may want to get tested for this to make sure that you aren't ignoring an auto-immune disease that can be the root of other problems.

Dr. Sara Gottfriend has a great series of book. I really like The Hormone Cure and the accompanying Hormone Cure Diet. She has a wealth of knowledge regarding hormones, health, and diet. Of course work with your endocrinologist and/or OB GYN but look into her work and see if there is anything that speaks to you.

I think you should consult your Endocrinologist about the diet and metformin, and get her opinion on your best strategy for weight loss.

I think you should bring up the cramps and migraine with your OB at your annual appointment. Neither are unusual - I also get both during my period. I got them both with my period before I was on Mirena also. So I know they aren't caused by the Mirena, it's just what my body does when my hormone levels change. and the cramps are definitely less painful with Mirena than they were before. Nonetheless, while I wouldn't make an extra appointment for this, it's worth mentioning to your OB at a routine appointment.