How Menopause Affects Diabetes and Blood Sugar Levels

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Medical review by Elizabeth Gomez MSN, FNP-BC

Menopause is a completely natural stage of life. This transition involves complex hormonal changes that can have a major impact on blood glucose levels if you have diabetes. Many women with type 1 and type 2 diabetes who experience menopause have found that the condition is more difficult to manage.

The symptoms of menopause can be very severe and can be very confusing. This is a fact that is rarely accepted in our culture. Furthermore, the effects of menopause on diabetes management are not particularly well-received.

In this article, we will explore how menopause and diabetes interact and the practical steps that can be taken to stabilize blood sugar levels and alleviate the transition.

Three stages of menopause

Menopause is the key to a woman’s life that stops her from stopping her menstruation. This change does not occur at once. Instead, experts talk about “menopause transitions,” with beginnings, centers and ends.

• Perimenopause It is the beginning of a transition where hormonal changes begin to take effect, and you may experience classic menopause symptoms, such as hot flashes to menstruation and unpredictable changes. According to the National Institutes of Health, the perimenopausal period usually begins between the ages of 45 and 55, and typically lasts for 4 to 8 years.
• menopause It is the first year of the last period. It is impossible to predict which period will be the last, and therefore can only be recognized retrospectively.
• Postmenopausal It’s the end of the transition – technically, it will last for the rest of your life. You have stopped taking a period, but you may continue to experience prolonged menopause symptoms.

All three stages can significantly affect blood glucose control. The three stages of menopause transition are associated with various changes and symptoms, and various people experience these stages differently.

Menopause and hormones

Variations in hormone levels can have a strong effect on glucose metabolism and insulin sensitivity. The transition to menopause can be particularly difficult times for blood glucose management, such as adolescence and menstrual cycles.

Since puberty, your body has regularly produced the hormones estrogen, progesterone, and testosterone to regulate your birth rate. Menopause represents the end of this stage in your life, and the associated important hormonal changes occur. Your body will slowly (or suddenly) create and use these hormones. They are replaced by higher levels of other hormones, such as luteinizing hormone and follicle stimulating hormone.

However, the transitions are not always smooth. During the menopause, your body may produce even more estrogen than usual, even though your estrogen levels will eventually drop to very low levels by postmenopausal.

The unpredictability of this process can lead to blood sugar surprises.

Menopause and blood glucose control

During the menopause transition, the best advice is to expect something unexpected. It is found that changing hormone levels rapidly fluctuates insulin sensitivity. You may experience more blood sugar and lower levels than usual. During the perimenopausal period, cycles become unpredictable, as are blood glucose results at unstable hormone levels. Heavy cycles with heavy insulin resistance can follow lighter cycles with lighter insulin resistance.

The change may seem confusing. Estrogen lowers blood glucose levels, but progesterone increases it and your body produces less both hormones as you approach menopause. I’m confused!

However, generally speaking, women who use insulin probably expect to see an increase insulin during the menopause and can expect a postmenopausal reduction.

After menopause, it should gradually stabilize blood sugar. Loss of monthly periods should reduce blood glucose fluctuations associated with the menstrual cycle, and may require less insulin to control blood glucose.

Conclusion: Test your blood sugar levels frequently, communicate with your doctor, and prepare to adjust your diabetes management habits, such as diet, exercise, and medication.

Diabetes and menopause symptoms

Everyone experiences menopause differently. Menopause symptoms are very severe and uncomfortable for some, but not very noticeable for others. The incomplete list includes:

• Hot hot
• Night sweats
• Hair removal
• Dry or discomfort in the vagina
• Sleeping hindrance
• Loss of sex drive
• Mood fluctuations
• Weight gain

For more information, we recommend this excellent overview from daily health.

Important to note is that many of these symptoms overlap or interact with symptoms of hypoglycemia or hyperglycemia. If you are experiencing night sweats, mood swings, dry vaginas, or uneven sleep, it can be difficult to know which conditions are causing discomfort at any time, or whether both diabetes and menopause combine to exaggerate the effects. Symptoms of one condition can also worsen other conditions. For example, if menopause causes weight gain or sleep disruption, it can make glycemic control even more difficult.

You need to be prepared unexpectedly and are keen to ask your doctor for help with your symptoms. It is also wise to check your blood sugar levels more frequently. Also, if you don’t already have it, ask your doctor about a continuous glucose monitor.

Diabetes and early menopause

Women with type 1 and type 2 diabetes are more likely to experience early menopause, and a 2022 study (PDF) suggests that early diagnoses are more likely to enter menopause. All types of diabetes can “affect ovarian aging,” leading to early onset of menopause transitions.

The Cleveland Clinic says that “early menopause” occurs before the age of 45, while “early menopause” occurs before the age of 40. Both conditions are associated with more severe menopause symptoms. Early and early menopause spends such years without the protective benefits of estrogen, and therefore also increases the long-term risk of conditions such as osteoporosis and heart disease.

If you are experiencing early or early menopause, there is nothing you can do to reverse the transition, but healthy diet, exercise and glucose management habits can help ease the transition and improve your long-term health. Some experts also advise more aggressive treatments with hormone therapy.

Menopause and long-term health risks

Menopause creates new health challenges for women. According to daily health, postmenopausal women face high risks of several health issues.

• Heart disease
• Osteoporosis (weak, brittle bones)
• Weight gain (especially around the abdomen and internal organs)
• Urinary tract infection
• Urinary incontinence

All of these conditions are increasingly associated with people with diabetes. Cardiovascular disease is already the biggest cause of death in diabetic patients, and diabetic women have also experienced a high incidence of osteoporosis. Of course, weight gain is significantly associated with progression of type 2 diabetes and dissatisfaction with glucose management in type 1 diabetes. Even urinary tract infections and incontinence can lead to increased risk given the trend of diabetes that slows the body’s ability to combat infections.

There is also a complex relationship between menopause and diabetes itself. Menopause increases the risk of type 2 diabetes as well as related metabolic conditions such as high blood pressure and high cholesterol.

All healthy postmenopausal adults are advised to make healthy diet and exercise decisions to reduce the risk of conditions such as heart disease and osteoporosis. That advice could double for diabetic women. The transition to menopause is a great time to seriously work on losing weight and improving fitness.

Hormonal therapy

There is one treatment that provides general relief for the symptoms of menopause transition and reduces the risk of long-term outcomes, such as osteoporosis: hormone therapy. There are many forms of hormone therapy in menopause – pills, patches, creams, sprays, injections, etc. – but they all aim to supplement the hormones that women are trying to create, especially estrogen.

Before the generation, hormone therapy was widely prescribed, but its use declined dramatically after a 2002 study suggested it created a major long-term risk such as breast cancer. As explained in the 2023 article of The New York Times MagazineHowever, many recent studies have tested treatment as a safe option for many women. The North American Menopause Society states that “for women who start hormone therapy near menopause (ages 50-59, normal), the benefit risk ratio is preferred, but is more risky over time since the advancement of menopause and age.” However, many doctors are reluctant to prescribe treatment to one of their patients.

In women with existing type 2 diabetes, there is evidence that hormone therapy improves glycemic control. In a 2001 study, 7.9% of women using the treatment, while similar women who did not use it had A1c in 8.5%. Hormonal therapy is also reported to reduce the risk of diabetes.

However, blood glucose levels from hormone therapy are considered secondary. Hormonal therapy is not approved for glycemic control only, and your doctor may consider prescribing it only if you are experiencing serious symptoms such as hot flashes.