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Dear Diabetes: Diabetes and Menopause

Managing blood sugar levels and menopause

Menopause, or the ceasing of menstruation, is a normal part of aging in women. It usually occurs in a woman’s 40s or 50s, when levels of estrogen and progesterone, the hormones that control the monthly menstrual cycle, decrease and the ovaries no longer produce an egg each month. Menopause may also occur after surgery to remove the uterus (hysterectomy) or removal of both ovaries (bilateral oophorectomy); this is considered “surgical menopause” and may occur at any age before natural menopause.

Menopause happens over a period of time and has three stages:

  1. Perimenopause: when the body’s production of estrogen rises and falls unevenly, and menstrual cycles are irregular. (This can take place over a number of years.)
  2. Menopause: defined as one year since a woman has last menstruated.
  3. Postmenopause: the years after menopause, and when some health risks associated with estrogen loss begin to rise.

(How is diabetes different for women? Read more here.)

Symptoms of menopause

The symptoms of menopause differ from woman to woman. Some common symptoms, related to estrogen and progesterone levels, may include:

(Read more about how menstruation may affect diabetes.)

Additional symptoms may be attributed to a combination of the hormonal changes of menopause and/or the hormonal changes of the natural process of aging; the contribution of each individual factor is not entirely understood. Those symptoms may include:

(Women who are taking therapeutic insulin and have experienced significant changes to their weight, whether menopause-related or not, should talk to their healthcare professional about these changes, and if any adjustments need to be made to their current diabetes medications.)

Menopause and blood sugar

Some physical symptoms of menopause such as sweating “may feel similar to the symptoms a person with diabetes feels when experiencing high or low blood sugar,” says Dr. Mariela Glandt, an endocrinologist at Bronx-Lebanon Hospital in New York. “A woman with diabetes should not dismiss a sudden unexpected sweat as menopause-related without first checking her blood sugar.

(Read more about the symptoms of high and low blood sugar.)

Hormonal changes may also cause fluctuations in blood glucose levels. “You can expect things to be erratic,” Dr. Glandt says. “Blood sugar may become unpredictable.” Always discuss with your doctor what to do if your blood sugar levels are outside of your recommended target range.

Other symptoms of menopause, such as night sweats, may affect the quality of sleep. This may make it more difficult to manage blood sugar levels, says Dr. Glandt. “You may be experiencing a whole conglomeration of symptoms coming together, which may interfere” with blood glucose levels, explains Dr. Glandt. “However, this varies from person to person.” (Talk to your healthcare professional if you have concerns about your blood sugar levels.)

Dealing with diabetes and menopause: what can you do?

“If you were already working hard to manage your diabetes, just keep doing the same thing,” Dr. Glandt says. And if you’ve been neglecting blood sugar checks or eating poorly, she adds, it’s a great time to get back on track. Continue to have regular visits with your doctor, and check your A1C. If you are gaining weight, talk to your care team about diet modifications. Dr. Glandt also points out that menopause is not a reason to reduce your physical activity. Although the symptoms may be bothersome or unpleasant at times, says Dr. Glandt, “menopause is a normal part of aging.”

Jessica Apple is the co-founder and editor in chief of the online diabetes lifestyle magazine A Sweet Life. Her writing has appeared in many publications, including The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review and Tablet Magazine. Apple is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewees, and not of Sanofi US, its employees, agencies, or affiliates.

© 2016 The DX: The Diabetes Experience

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