Menopause can be an interesting time for women, particularly with regards to the symptoms that accompany it. Things like hot flashes, night sweats, sleep disturbances, and more can all be contributed to hormone alterations, specifically those related to estrogen and progesterone. What many do not know, however, is the potential link between your hormones, blood glucose, and resultant symptoms. This article will explore the associations between blood sugar and menopause, and what this might mean for treatment of vasomotor symptoms.

What is menopause?

There are three stages of menopause: perimenopause, menopause, and postmenopause. These phases are outlined below:

• Perimenopause is the period of time preceding menopause, which can begin as early as 10 years prior. During this time, your ovaries start to create less and less estrogen, a female sex hormone. Estrogen production decreases more rapidly in the final two years of perimenopause, starting the onset of menopause symptoms. However, you can still have your period and get pregnant during this time.
• Menopause is defined as a period of time in which you have not had a menstrual cycle for 12 months. You do not get your period because your ovaries stop releasing eggs and estrogen. You likely will also experience menopausal symptoms.
• Postmenopause is the phase you enter after menopause. Though menopause symptoms may improve, they could still persist for several years afterwards. Your estrogen levels remain low, potentially elevating your risk for certain medical conditions (1).

How does menopause affect my hormones?

Your hormones are important to regulating hundreds of functions throughout the body. With menopause, estrogen levels gradually decrease to very low levels. This manifests as symptoms like hot flashes, heart palpitations, night sweats, insomnia, bone loss, headaches, vaginal dryness, and drowsiness. Additionally, your body stops producing progesterone after your last period, contributing to hot flashes and night sweats (2).

How does menopause affect my health?

With a decrease in female sex hormones comes some changes to your overall health. Menopause is associated with changes to your mood, diet, and sleep. Additionally, you may undergo some metabolic alterations, affecting things such as fat distribution, blood glucose levels, and cholesterol levels. We will focus specifically on the interplay of menopause and blood glucose in the coming sections.

How does menopause affect my blood sugar?

Post-menopausal women typically have higher glucose levels compared with their pre-menopausal counterparts. One study found that those that were post-menopausal had increased glucose levels, HbA1c, and inflammation. Additionally, post-menopause was associated with increased sugar intake and worse sleep (3).

These alterations to blood sugar levels may influence a women’s susceptibility to hot flashes. Hot flashes are an incredibly common symptoms of menopause, occurring in 80 percent of individuals experiencing menopause. Hot flashes are characterized by a sudden onset of heat, sweating, and flushed skin, which can be very uncomfortable and affect one’s quality of life.

One study followed women in their 40s and 50s over the course of eight years. Findings showed that in these 3,000 women, those with higher blood glucose levels experience hot flashes more often than those with normal glucose levels (4). Additionally, women that have symptoms such as hot flashes and night sweats may have a higher risk of diabetes because of abnormal glucose levels. One study found that those with such symptoms, known as vasomotor symptoms (VMS), had an 18 percent increased risk of type 2 diabetes. It followed over 150,000 women post-menopause. Additionally, participants with severe symptoms had almost a 50 percent increased risk of diabetes (5).

How can hormone therapy help?

Almost 60 percent of women in the US seek treatment for menopause-related symptoms. One study found that menopausal hormone therapy (MHT) improved visceral fat and measures related to glucose, cholesterol, and insulin (3).

As Dr. Peter Attia states in Clearing the Air on Hormone Replacement Therapy, there is some hesitancy coming from both women and their providers when it comes to starting hormone therapy for VMS. While hormone therapy traditionally focuses on managing menopausal symptoms like hot flashes and vaginal dryness, research has shown that hormone therapy can also have significant impacts on preventing chronic diseases. One study shows a 44 percent decrease in risk of major coronary disease in women taking estrogen therapy (6). Additionally, estrogen levels contribute to bone density due to its role in bone resorption and creation of bone tissue. With menopause, drops in estrogen levels contribute to bone loss, increasing one’s risk for osteoporosis and fractures. Supplementing with estrogen can delay this decline.

In addition to hormone therapy, lifestyle changes can be integral to regulating glucose levels and lowering one’s risk for cardiovascular disease. One study supported this hypothesis, showing that amongst 17,000 post-menopausal individuals, a diet rich in fruits, vegetables, and whole grains but low in fat led improved hot flash symptoms. Additionally, weight loss contributed to improved VMS (7). Likewise, incorporating healthy habits may also improve symptoms.

Conclusion

Menopause, though a normal part of life for every woman, can be a finnicky thing to deal with. The hot flashes, night sweats, sleep disturbances, and health conditions associated with menopause can affect your wellbeing, leaving you seeking answers and treatment. Some experts hypothesize that your hormones and blood sugar all contribute to this array of symptoms. Thus, blood sugar management and hormone therapy may be viable options for those hoping to alleviate such symptoms.

References

1. https://my.clevelandclinic.org/health/diseases/21841-menopause#:~:text=During%20menopause%2C%20your%20body%20goes,make%20up%20for%20lost%20hormones.
2. https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-hormone-levels
3. https://sph.washington.edu/news-events/news/night-sweats-and-hot-flashes-tied-diabetes-risk
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462945/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669773/#:~:text=Findings,p%3C0.05%20for%20all).
6. https://www.nejm.org/doi/full/10.1056/nejm199109123251102
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428489/#:~:text=In%20multiple%20observational%20studies%2C%20women,%2C%208%2C%2022%E2%80%9325.

Author

David J. Bauder, PA-C David Bauder, PA-C, is a certified physician assistant and the assistant medical director at Weight Loss and Vitality in Manassas and Alexandria, Virginia, Washington, DC; and Gaithersburg, MD. He enjoys helping patients optimize their physical and mental health to improve their overall well-being. He earned his physician assistant degree from the University of Texas Health Science Center at San Antonio. Afterward, he gained admission into the reputable graduate program for physician assistant studies at the University of Nebraska Health Science Center in Omaha. David has over 26 years of experience working as a physician assistant. He’s practiced in podiatry, family medicine, emergency medicine, general surgery, urgent care, and functional medicine.