Menopause and Diabetes
By: Ramona Hrysikos, MSN Ed, FNP-C, FNP-BC, CDCES, BC-ADM
Menopause marks a significant transition in a woman’s life. It can bring a variety of physical and emotional changes. For women already managing diabetes, the onset of menopause can add a layer of complexity to an already demanding health routine and overall health.
The hormonal changes during menopause and the significant decline in estrogen and progesterone levels can impact insulin sensitivity. Glucose regulation and metabolism are affected by Estrogen levels. Estrogen has a role in regulating glucose metabolism, and when its levels drop, insulin resistance can increase. Insulin resistance is linked to change in fat distribution in the post menopausal woman. The fat distribution tends to settle more in the abdomen and can make it difficult for controlling blood sugar. Women are at greater risk of developing T2DM during menopause and at even greater risk if they have a predisposition with family history of T2DM or obesity.
Women who live with diabetes and are peri menopausal, or are in the throws of menopause, are susceptible to the impact that diabetes can have on a woman’s health during this time in her life. Cardiovascular disease risk is one of them. Both menopause and diabetes can independently increase the risk of CVD and together the risk is compounded. Cardiac risk assessment and health should therefore be monitored closely.
Symptoms of menopause, such as hot flashes, sleep disturbances, and mood swings are typically more severe in women living with diabetes as high blood sugar levels can exacerbate these symptoms. Hormonal changes in a females living with diabetes can also affect vaginal health by causing dryness or cause an increase urogenital infections.
Other considerations are with the emotional changes, mood swings, stress management and anxiety during menopause. Fluctuating blood sugars can contribute to or exacerbate mood swings and anxiety. Menopause can cause emotional changes due to hormonal fluctuations. Stress can contribute to elevated blood sugars. Making an effort to incorporate relaxation techniques like meditation, yoga, or deep breathing exercises can help both emotional symptoms of menopause and diabetes. Dealing with both diabetes and menopause can be challenging and can seem overwhelming. Support groups and therapy are a consideration to help manage the emotional side of menopause. Regular check-ups, personalized advice, and adjustments to your treatment plan can help you manage your symptoms.
Managing both diabetes and menopause requires a healthy balanced approach that is inclusive of diet, exercise, weight management, medications, and or HRT therapy.
Eating a healthy diet rich in fiber, low in refined sugars, and a focus on whole foods can help manage both blood sugar and menopausal symptoms. Eating foods made with soy, which are rich in phytoestrogens, may help with estrogen imbalances while avoiding concentrated sweets can help with glucose stabilization.
Exercise can improve insulin sensitivity, help with weight management, and with managing aggravating menopausal symptoms like hot flashes and mood swings.
Medications may need to be adjusted accordingly as insulin resistance, insulin requirements, and glucose fluctuations may be required to maintain balance. Some women benefit from HRT or hormone replacement therapy for management of menopausal symptoms and can help with vaginal dryness and the impact on urogenital health. History of heart disease or blood clots may eliminate candidacy for this type of therapy.
Talking with your physician or healthcare provider to see if this is an appropriate therapy is important. Working with an endocrinologist, gynecologist, and a dietitian to create a personalized plan that addresses both conditions would be beneficial.
In conclusion, navigating through the journey of diabetes and menopause can feel daunting, it is possible to maintain a healthy and balanced life with the right approach. By focusing on diet, exercise, stress management, and regular monitoring of blood sugar has been shown to help. Women can and have success in managing both conditions and can feel empowered through this stage of their life. Menopause doesn’t have to be a barrier to maintaining positive health, emotional health, and diabetes can be controlled effectively with a proactive approach and the right support.
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