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Dear Diabetes: Different for Women?

Dear Diabetes: Is diabetes different for women than it is for men?

The answer, it turns out, is yes, in many ways – it comes down to hormones.

For many women with type 1 or type 2 diabetes, managing blood glucose levels may be more difficult in the week or so leading up to menstruation. That’s because the same hormones that are responsible for regulating the menstrual cycle – progesterone and estrogen – may also increase insulin resistance. In the days following ovulation, levels of both hormones usually rise, which may add additional challenges of high blood sugar to whatever other premenstrual symptoms you may be experiencing (I’m looking at you, chocolate bar). Then, once you begin to menstruate and levels of those hormones drop, your blood sugar may drop as well. This may happen quickly, so it’s important to test frequently to avoid potential lows.

In addition, menopause and the years leading up to it – called perimenopause – may also affect your diabetes care. The reasons are similar: as your body transitions to a post-menstrual phase of life, your hormone levels fluctuate, which may cause unpredictable responses to insulin and other medications and, in turn, may lead to high or low blood sugar. Menopause also brings additional challenges, like weight gain – which may alter your medication requirements – and greater susceptibility to urinary tract and yeast infections. Also, some of the symptoms of menopause, like night sweats, short term memory lapses, and mood swings can be confused with those of low blood sugar, making it especially important to test your blood glucose frequently.

Diabetes can affect your sex life, too. Chronic high glucose levels can damage cells and nerves that line your vagina, causing difficulties with arousal and orgasm – which can be especially problematic if combined with a diabetes – or menopause-induced lack of lubrication. And stress of any kind, including the daily stress of managing your blood sugar, may also interfere with your sex drive.

There are things women can do to understand the effect of sex hormones, such as keeping track of blood sugar in relation to your menstrual cycle for several months and paying special attention to the time between ovulation (which usually occurs from between 11 to 21 days after the beginning of your period) and the beginning of menstruation, since that’s when the most insulin resistance from hormone fluctuations may occur. Once you have a sense of your body’s patterns, you can talk with your doctor about ways to adjust your medications, diet, and exercise habits to help keep your blood sugar in balance, no matter what the time of the month it may be.

For more stories in the Dear Diabetes series, visit The DX archive.

© 2012 The DX: The Diabetes Experience

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