- What is menopause?,
- Impact of menopause on blood glucose,
- Normal blood sugar levels for women aged 50 and above.
Glucose is the fuel that the human body runs on. While glucose metabolism is influenced by a number of genetic and environmental factors, growing evidence suggests that hormonal changes during menopause can throw blood sugar levels out of whack.
But let’s first look at what menopause is and what the body undergoes during menopause before we examine its relationship to blood glucose levels.
What is Menopause?
Menopause marks the end of the menstrual cycle and a woman’s reproductive years. A person officially enters menopause when they’ve not had a menstrual period for a year. The ovaries make the primary female hormones Estrogen and Progesterone, which control menstruation and ovulation (the release of eggs). Ovarian function declines with age, leading to missed or irregular periods, and eventually stops altogether, resulting in menopause.
Five impacts of Menopause on blood glucose
Even before menopause officially kicks in, the ovaries start producing fewer hormones, causing periods to become irregular. This also leads to a decrease in the production of estrogen and progesterone, which plays a major role in blood sugar fluctuations. As these hormonal levels go up and down, blood sugar levels also sway. Menopause occurs in three stages: perimenopause, menopause, and postmenopause.
Spikes in estrogen have been known to make the body more sensitive to insulin (which may lead to hypoglycemia), while progesterone can increase insulin resistance (which leads to hyperglycemia). This decline in estrogen and progesterone levels is one of the earliest signs of perimenopause or menopause transition which, as the name suggests, prepares the body for menopause.
Women are gifted jugglers. They juggle their time between work, home, kids, family, chores and a million other…
Estradiol is the main form of estrogen found in women prior to menopause. Normal estradiol levels can be anywhere in the range of 30–400 picograms per millilitre (pg/mL). Post-menopause, it falls to below 30 pg/mL, when the ovaries stop producing estrogen, and the same is obtained primarily from body fat. A decrease in estrogen levels gives rise to symptoms including hot flashes, night sweats, and mood swings, which are associated with changes in blood sugar levels including spikes (hyperglycemia) and crashes (hypoglycemia).
Progesterone, on the other hand, is the hormone that helps us sleep. Normal progesterone levels before menopause should be around 1.5 nanograms per millilitre (ng/ml). After menopause, they fall below 0.5 ng/ml. When progesterone levels decrease during perimenopause and after, women have difficulty falling and staying asleep.
Studies suggest that when we don’t get adequate sleep, the body releases cortisol, the stress hormone during the day to trigger wakefulness. It releases glucose in the bloodstream through gluconeogenesis in the liver, elevating blood glucose levels. Sleep deprivation, which leads to a sustained increase in cortisol, is a recipe for high blood sugar. Thus the hormonal imbalance in perimenopause and after spawns a cluster of symptoms that directly impact blood sugar levels.
1. Hormonal Fluctuations
Insulin is a hormone produced by the pancreas that helps the body use glucose for the fuel it needs and stores the rest. Estrogen optimizes insulin activity in the body. Consequently, premenopausal women, as compared to men of the same age, have a natural advantage when it comes to using insulin effectively and also have a lower incidence of type 2 diabetes.
This, however, is not the case after menopause, because the decline of estrogen levels makes way for insulin resistance and spikes blood sugar levels. Studies have also shown that menopause is directly related to high fasting plasma glucose levels.
2. Visceral Fat
During and after menopause, weight gain tends to be focused around the abdominal region. This fat, known as visceral fat, secretes a protein called retinol-binding protein 4, which is associated with insulin resistance. High amounts of visceral fat can also lead to type 2 diabetes.
3. Can Blood Sugar or Diabetes Cause Hot Flashes?
Hot flashes, one of the characteristic symptoms of menopause, is also linked to high blood sugar and is an indicator of insulin resistance, which gradually leads to elevated blood glucose levels. In a study of about 1000 postmenopausal women, high blood sugar levels were connected to more physical and psychological symptoms.
One study, which followed 3000 women in their 40s and 50s over an eight-year period, found that the frequency of hot flashes increased in women with higher blood sugar levels, regardless of their weight or oestrogen levels. Another study found that postmenopausal women with metabolic syndrome, which is a cluster of symptoms that includes high blood sugar, were more likely to experience hot flashes and sweating.
Hot flashes also trigger changes in the autonomic nervous system, which is in charge of regulating bodily functions such as temperature. During a hot flash, the heart races, blood gushes to the skin and the skin temperature shoots up and falls as the body starts to give off heat. The autonomic nervous system is also involved in glucose regulation, so studies suggest that the changes in the autonomic system that occur in hot flashes, are also related to high blood glucose levels and decreased insulin production.
4. Early Menopause
The average age for the onset of menopause is between 45 and 55. When menopause occurs prior to age 45, it is considered early menopause; and if it hits before age 40, it is deemed premature (or primary) ovarian insufficiency. Studies have shown that both early menopause and premature ovarian insufficiency increase the risk of type 2 diabetes.
5. Menopause and Diabetes
Diabetes usually develops after age 45, around the same age that menopause begins. Diabetes is known to amplify some of the symptoms of menopause and vice versa. For example, hot flashes may make it difficult to get adequate sleep, and not getting enough sleep can cause a blood sugar imbalance. The two conditions have a way of exacerbating each other.
Normal blood sugar levels for Women aged 40+
Given the close relationship between menopause and blood sugar, keeping a vigilant eye on blood sugar levels is recommended for those approaching or undergoing menopause. One can use the following tools for blood glucose management or glycemic control:
- The A1C test tracks blood sugar levels over a period of time (usually 2–3 months)
- Continuous glucose monitoring (CGM) tracks blood glucose levels throughout the day
- The finger-prick test allows for self-monitoring of blood glucose
While individual needs may vary based on age and other factors, the following figures could serve as a guide for the ideal blood glucose range in non-diabetic adults:
Pre-meal glucose levels range of 72-90 mg/dL
In a study that investigated continuous glucose profiles in non-diabetic subjects, the average glucose levels before eating were observed. These were in the range of 72-90 mg/dl.
Post-meal glucose levels range of less than 110 mg/dL
The same study that investigated continuous glucose profiles in non-diabetic subjects also observed glucose ranges after eating.
In a well-balanced meal, the peak values observed were 99.2 ± 10.5 and 122.1 ± 20.4 mg/dl, respectively. If you consider the glucose ranges after eating using a standard deviation of these averages, then the max glucose limit of 110 mg/dl is a good goal to observe post your meals.
How to manage blood sugar during/after Menopause?
Now that we’ve examined how intricately connected menopause and blood sugar are and glanced at the complications and risks associated with it,
Seven ways to control blood sugar during period
1.Nutritional: Low-Carb Diet
One of the primary aims of a low-carb diet is to restrict glucose intake and it is therefore highly recommended for women in their menopausal and postmenopausal years. It also helps with weight loss, which in turn helps regulate blood sugar by increasing insulin sensitivity.
One study found that menopausal women on a paleo diet (which includes meat, fish, eggs, vegetables, fruits, seeds, nuts and healthy fats and oils, and restricts processed foods, sugar, dairy, trans fats, vegetable oils and artificial sweeteners) experienced a greater reduction in belly fat and overall weight in two years than women on a low-fat diet.
Low-calorie diets, on the other hand, decrease the metabolic rate, facilitating weight gain, which is linked with insulin resistance. A good balance of fibre and protein is also essential in maintaining hormonal balance.
While fibres (whole grains, fruits and vegetables with the skin on) take longer to digest and can keep cravings at bay, proteins (salmon, chicken, eggs, hummus, beans) keep you feeling full without raising blood sugar.
As we’ve already seen, the decline of oestrogen production in menopause means that the body is not using insulin as efficiently as it once did. This, in addition to lack of exercise and weight gain, can be a lethal combination in sending blood sugar levels through the roof.
Exercising on a regular basis not only helps burn sugar in the body, lowering overall glucose levels, it also teaches the body to use insulin effectively. Even something as simple as a daily 30-minute walk can go a long way in weight and blood sugar management.
3.Addressing Thyroid Dysfunction
We’ve already looked at how hormonal imbalances affect blood-sugar metabolism, and the thyroid is no exception. Hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid, slows down metabolism, which in turn allows glucose to accumulate.
Those with low DHEA levels can increase insulin sensitivity and reduce belly fat by increasing their DHEA (dehydroepiandrosterone, a steroid hormone made in the adrenal glands) levels.
4.Getting a Handle on stress
Finding healthy ways to cope with stress is extremely important if one wants to avoid health issues like blood sugar. When we’re under stress, the body releases hormones such as cortisol, epinephrine and glucagon, which increase insulin resistance. Meditation, relaxation techniques and being well-rested can help manage stress levels.
Cinnamon, one of the most popular aromatic spices in the world, is another gift from nature that helps with blood sugar control.
Cinnamon slows the breakdown of carbohydrates and also increases insulin sensitivity. According to Lauri Wright, a spokeswoman for the Academy of Nutrition and Dietetics, Chicago, cinnamon helps immensely in blood sugar control. It must be remembered, however, that cinnamon must be ingested in small amounts, not more than 0.4 teaspoons per day.
Increasing water intake helps the kidneys flush out excess sugar from the body through urine, which helps control blood sugar and lowers the risk of diabetes. To know how much water you should be drinking per day, take your body weight in pounds and divide it by 2. This is the amount of water (in ounces) that your body needs per day.
7.Prevention of UTIs
High blood sugar is a breeding ground for bacteria that cause urinary tract infections (UTIs). With the sharp decline in estrogen levels, menopausal women are particularly susceptible to these infections. Symptoms such as urgency to pee, burning sensation when you pee or foul-smelling urine must not go unaddressed.
The decline in the production of the primary female hormones estrogen and progesterone, which occurs during menopause, has a considerable impact on blood sugar levels. Since these hormones influence how insulin works in the body, the gradual drop in their levels affect insulin sensitivity and blood sugar. The belly fat or visceral fat that makes an appearance in menopause is also related to insulin resistance, and high amounts of visceral fat can increase the risk of type 2 diabetes. Sleep deprivation, which goes hand in hand with menopause, leads to the production of cortisol, the stress hormone, which creates a spike in blood sugar.
Studies have shown that the frequency of hot flashes, now synonymous with menopause, increases in women with high blood sugar. Early menopause (before the age of 45) also puts women at increased risk for type 2 diabetes, which also tends to develop around age 45. Closely monitoring one’s blood sugar during the menopausal age can help you manage the detrimental effects. A nutritional low-carb diet coupled with cinnamon consumption, exercise, proper hydration and stress control are some things you can incorporate into your lifestyle to help keep blood sugar in check during and after menopause.
Disclaimer: The contents of this article are for general information and educational purposes only. It neither provides any medical advice nor intends to substitute professional medical opinion on the treatment, diagnosis, prevention or alleviation of any disease, disorder or disability. Always consult with your doctor or qualified healthcare professional about your health condition and/or concerns and before undertaking a new healthcare regimen including making any dietary or lifestyle changes.
- Menopause, but not age, is an independent risk factor for fasting plasma glucose levels in nondiabetic women
- Effects of Hormone Replacement Therapy on Insulin Resistance in Postmenopausal Diabetic Women
- Vasomotor Symptoms and Insulin Resistance in the Study of Women’s Health Across the Nation