Menopause is the natural process of a woman’s menstrual cycle stopping permanently, which is considered to have occurred one year after their last period. The years leading up to menopause are called the menopausal transition or perimenopause. This time of bodily change and unpleasant symptoms can be difficult, and it can make diabetes management challenging. Read on to learn more about how to manage Type 1 diabetes and menopause, as well as the connection between menopause and diabetes Type 2 – a relationship that has been shown to work both ways.
How Does Menopause Affect Type 1 Diabetes?
The menopause transition comes with its own set of challenges as the body adjusts to hormonal changes. In addition to the troublesome symptoms of menopause that women experience in common, these changes may complicate diabetes management for women with Type 1 or Type 2 diabetes.
Changes In Hormone Levels
During perimenopause, the body’s natural estrogen and progesterone levels, both responsible for the menstrual cycle (which includes both ovulation and menstruation), fluctuate far more than they have previously. The ovaries produce less and less estrogen as the body slowly prepares to stop releasing eggs permanently. This in turn impacts the body’s levels of progesterone.
Blood Sugar Fluctuations
Changes in hormone levels can lead to blood sugar fluctuations during perimenopause (low, high blood sugar), and women with diabetes can see their glucose sugar levels begin to change more than they used to.
This can result in an elevated risk of high blood sugar, a.k.a. hyperglycemia, which can make it harder to anticipate.
Perimenopause symptoms often include disturbed sleep, mainly because of night sweats, hot flashes, or chills. After a while, these altered sleep habits can also make it harder for women with diabetes to manage their blood sugar levels.
Because of hormone and blood glucose fluctuations, it is quite common for women to gain weight during the menopausal transition. If this occurs, women living with diabetes may need to make adjustments to their treatment.
Women going through menopause are generally prone to higher health risks. The challenges to an efficient Type 1 diabetes management during menopause or perimenopause can also increase these risks, which include possible complications to bone and eye health, renal and nerve function, the cardiovascular system, etc.
Similarly, blood glucose fluctuations caused by both diabetes and hormonal changes can make health problems worse during this period. For instance, there is a higher risk of urinary tract and vaginal infections because of the decline in estrogen levels, which makes it easier for bacteria to grow in the urinary tract and vagina.1 For women with diabetes, these kinds of symptoms might in turn affect their sex life.
Menopause And Diabetes: Planning Ahead And Preventing Health Risks
Because of the impact of menopause on diabetes management, women living with Type 1 or Type 2 diabetes should try to anticipate these changes and challenges.
Watch for signs of perimenopause: one reason this is particularly important for women with diabetes is because it may be hard to distinguish these signs from diabetes symptoms. Therefore, it can be a good idea to write them down and look for patterns. Symptoms that can be related to both menopause and diabetes include:
- Hot flashes
- Night sweats
- Lower energy
- Trouble focusing
- Mood swings
- Trouble sleeping
- Vaginal dryness
Consult your doctor or healthcare team: get recommendations from health specialists on how best to manage Type 1 diabetes and menopause in order to prevent any complications.
Tips: Controlling Diabetes During Menopause
When experiencing diabetes and menopause at the same time, a healthy lifestyle is essential to ensure good diabetes management and avoid health complications. Here are a few tips or lifestyle changes than can help:
- Healthy diet: to manage blood glucose levels, focusing on healthy eating habits is essential. Here are a few recommendations in terms of intake:
- Increase: fiber, calcium, vitamin D, omega-3 fatty acids
- Limit: added sugar, caffeine, alcohol
- Exercising: exercising regularly (2–3 times a week) is key for a healthy lifestyle. Including weight training in your workout routine will help maintain muscle mass and prevent weight gain.
- Regular monitoring of blood sugar levels: even if this is something you are used to, you might want to start taking note of your blood sugar level at the time of a specific symptom, to help you determine trends and adjust your insulin dosage when necessary.
- Relaxation: practicing activities such as yoga, meditation, sophrology, or even journaling can be helpful for managing stress.
- Hormone therapy (HT)2: this treatment for women in perimenopause/menopause replaces the body’s declining hormone levels and relieves symptoms. As HT helps to lower glucose levels and reduce insulin resistance, it can make diabetes management easier.
- Asking for support: whenever you feel the need, do not hesitate to seek support, whether psychological or medical. This also helps prevent depression, which tends to be more common during menopause.
Early Menopause And Diabetes
A study3 carried out by the North American Menopause Society (NAMS) found a relationship between the age of diabetes diagnosis and the age of menopause.
During perimenopause, women’s bodies experience multiple hormonal changes. According to Dr. Stephanie Faubion, NAMS medical director, women who develop Type 1 or Type 2 diabetes at a younger age – before 30 years old for T1D and between 30 and 39 years old for T2D – are more likely to enter menopause earlier than other women. This is because of longer exposure to inflammation and higher glucose levels, which are likely to lead to accelerated ovarian aging.4
Menopause and Type 2 diabetes
Research has not shown a direct cause-and-effect relationship between menopause and Type 2 diabetes – in other words, menopause (and perimenopause) in and of itself does not cause T2D. However, studies have shown that both conditions share a connection.
A Dutch study5 found that women who experience early or premature menopause (mostly before the age of 40) have a higher risk of developing Type 2 diabetes than women who enter menopause after 55 years of age.
The changes caused by menopause and the menopausal transition – namely, the decrease in estrogen levels and insulin sensitivity, blood glucose fluctuations, and possible weight gain – may increase the risk of developing Type 2 diabetes.6 This risk seems to be higher among women over the age of 45, and particularly among those who are overweight or obese.
1 Mayo Clinic: Consumer Health: Diabetes and menopause https://newsnetwork.mayoclinic.org/discussion/consumer-health-diabetes-and-menopause/#:~:text=After%20menopause%2C%20changes%20in%20your,higher%20risk%20of%20diabetes%20complications
2 The North American Menopause Society: Hormone Therapy: Benefits & Risks https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-therapy-benefits-risks
3 The North American Menopause Society: Women With Diabetes at an Early Age Likely to Enter Menopause https://www.menopause.org/docs/default-source/press-release/diabetes-and-age-at-menopause.pdf
4 Healthline: The Link Between Diabetes and Early Menopause: What Women Can Do https://www.healthline.com/health-news/the-link-between-diabetes-and-early-menopause-what-women-can-do#Living-with-diabetes-and-menopause
5 Age at natural menopause and risk of type 2 diabetes: a prospective cohort study https://link.springer.com/article/10.1007/s00125-017-4346-8
6 Verywell Health: Menopause and Diabetes: What Is the Relationship? https://www.verywellhealth.com/menopause-and-diabetes-6748922
7 National Institute of Diabetes and Digestive and Kidney Diseases https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/menopause-increase-risk-diabetes#transcript
8 Diebetes.org (American Diabetes Association) https://diabetes.org/healthy-living/sexual-health/early-menopause-diabetes
12 The North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/diabetes-hits-women-hard-at-menopause-beat-it-back
13 Age at natural menopause and risk of type 2 diabetes: a prospective cohort study https://link.springer.com/article/10.1007/s00125-017-4346-8