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By Sathya Mohan

You might be thinking what is the connection between diabetes and the menopause? Well, for ladies reaching that certain age, it can be very traumatic. Menopause is not necessarily a negative experience. It is sometimes called a “change of life” as there are a lot of changes going on in a woman’s body, both as menopause approaches and afterwards.

The menopause marks an important transition into the last third of a woman’s life. It gives the woman and her health professionals an opportunity to review health risks, plan preventive activities, and establish monitoring strategies. This is especially important in women with diabetes because of the compounding menopausal cardiovascular risk and those associated with diabetes. The importance of the menopause is often not appreciated by women with diabetes, nor by their health professionals, and opportunities to avoid future problems may be missed.

Menopause is a natural process that women go through as the child-bearing years come to an end and the ovaries cease to release eggs every month. Menopause is usually defined as the point when periods stop. Menopause is not an event, but a slow process, often lasting up to 10 years. It starts during the age of 40s (sometime late 30s) and the average age for most women to have their last period is 51, where the female sex hormones hormones, estrogen and progesterone, begin to decline.

How menopause affects diabetes

As you approach menopause, ovaries gradually stop producing the hormone estrogen and progesterone. Both of these hormones affect insulin which is the hormone produced by the pancreas that deliver glucose which is life sustaining to every cell in the body.

Decrease levels of estrogen and progesterone can:

Increase the blood sugar. This will be mostly during perimenopause where the body may become more resistant to insulin and this causes blood sugar level to rise.

Decrease the blood sugar. This will be during the time when you reach menopause. Where the levels of estrogen and progesterone decline permanently. Where the body may regain its sensitivity to insulin, which causes blood sugar levels to fall.

The hormone fluctuations that characterize menopause may wreak havoc on the hard-earned blood glucose control. With less progesterone, there may be greater insulin sensitivity and with less estrogen insulin resistance increases, and the lack of these hormones can also cause other changes which can worsen diabetes complications. For example, lowered estrogen levels increase the risks of cardiovascular disease, which is already higher for people who have diabetes, and osteoporosis.

Many symptoms are attributed to menopause, and the most common are hot flashes, disturbed sleep, night sweats and the decreased ability to think clearly. Both menopause and diabetes produce similar symptoms. Some mistake menopausal symptoms such as hot flashes, moodiness etc as the symptoms of low blood sugar, so that they incorrectly assume these symptoms are a result of low blood sugar and start consuming unnecessary calories which in turn raises the blood sugar and in advertently cause a surge in blood sugar

Because of diabetes women experience stronger and more frequent episodes of low blood sugar especially at night. This may affect their sleep, already interrupted by menopause- associated with hot flashes and night sweats. Such sleep deprivation causes fluctuations in blood sugar.

In order to combat this women choose to take hormone replacement therapy or HRT.

These hormones (estrogen and progesterone) replace the hormones that the body no longer make. But this will not be possible in the case of women if she is a diabetic as these hormones affect the blood sugar. But these doses with HRT are so low and they do not cause much effect. In that case the diabetic medicine needs to be adjusted also .If the woman is exposed to these hormones it has benefits like

Protect the heart

Protect the bones from the loss of calcium which can lead to brittle bones.

Eliminate the symptoms such as hot flashes (which are easy to confuse with hypoglycemia) helps to sleep and think more easily.

Complications of Menopause

Majority of women will experience this complication but the intensity may vary within each women

Irregular bleeding
Hot flushes
Vaginal thinning and dryness
Heart diseases

Menopause is complete when you have not menstruated for 12 months. Women with type 1 diabetes experience menopause earlier than average. Women with type 2 diabetes may go through menopause later than average if they are above a healthy weight, as estrogen levels do not decrease as rapidly in women who are overweight.

This is one of the major problems in many women as they gain weight and become less active during this time, which compounds blood glucose control difficulties. So it is vitally important to plan a nutritious, low fat diet with calcium supplements if needed and physical activity. As these measures will lower the risk of cardiovascular disease by keeping the cholesterol level low and protect the bones against the thinning of osteoporosis.

Regular exercise benefits the heart and bones, help to regulate weight, contributes to a sense of overall well-being and improvement in mood. Sedentary women are far more prone to coronary heart disease, obesity, high blood pressure, diabetes, and osteoporosis. They also suffer from chronic back pain, stiffness, insomnia, and irregularity. Depression is also a problem. Therefore exercise plays an important and beneficial role as it circumvent these problems and also achieve higher HDL cholesterol levels.

The Benefits of regular exercise

  • Increases circulation, and improves the regulation of body temperature.
  • Improves weight control by increasing basal metabolic rate and lean body mass.
  • Reduces the risk of cardiovascular disease by strengthening the circulatory system, lowering blood pressure and maintaining a healthier blood cholesterol level.
  • Increases strength and range of movement.
  • Elevates your mood and controls stress.
  • Reduces the likelihood of osteoporosis.

Some suggestions that may reduce the discomforts of menopause:

  1. Eat well balanced meals that forms the basis for managing the diabetes
  2. Cutting out caffeine which may help to reduce hot flashes.
  3. Consuming more legumes and soy products which decreases the discomforts associated with menopause as these foods contain phytoestrogen (plant estrogen.
  4. Last but not the least being physically active may help to increase energy levels and give you a mental lift.

Therefore menopause is an important phase in women’s life where she undergoes a lot of physical changes. The body goes through changes that can affect her social life, her feelings about herself, and functioning at work. Till recently menopause was often surrounded by misconceptions and myths, but it is a natural; step in the process of aging. So one should accept menopause and age gracefully – for “As a white candle in a holy place so is fine beauty of an aged face.”

The information in this article is for educational purposes only, and is not intended as medical advice.