It’s hard for me to wrap my head around the fact that I’m “middle aged.” Somehow, I still think of myself as, I don’t know, maybe 27? Forty-six years old seems so mature, and I don’t feel very mature. I feel unsure about things (work, money, kids, etc.), but I can’t ignore the obvious reminders that I am in middle age.

One of those reminders is the fact that my oldest son is about to turn 16 and will be driving soon. That freaks me out for a number of reasons. Mostly because when I was 16, I was a terrible driver. Other obvious reminders are the physical changes to my body. The wrinkles and sun spots (ugh!), but also the recent hot flashes[1].

I live in the south, where temperatures run in the 90s from July through early October, so sweating is the norm. People here learn to live with the heat just like people in the north learn to live with the freezing cold. After months of waking up in the middle of the night with sweat-soaked pajamas (and blaming it on our comforter, even though my husband doesn’t wake up sweaty), I gave in and bought a small fan that blows on my face all night. That should fix it! I told myself, ignoring the voice in my head saying: Are these night sweats? Am I having hot flashes? Is this perimenopause?

In my book The Smart Woman’s Guide to Diabetes: Authentic Advice on Everything From Eating to Dating and Motherhood, I concluded with a chapter on “Aging Gracefully.” When I wrote the book, I was 39 years old, and “aging gracefully” seemed really far away. It feels ironic, and a little bit scary, to reference this chapter now.


In “Aging Gracefully” I cited “Menopause: What to Expect and How to Cope,”[2] by Pat Dougherty, CNM, MSN, and Joyce Green Pastors, MS, RD, CDE, who write that menopause can be especially challenging for women with diabetes.

“Both the perimenopausal and postmenopausal periods may present additional challenges for women who have diabetes. For one thing, the hormonal fluctuations that are common to perimenopause can affect blood glucose levels. For another, some symptoms of menopause are the same as or easily confused with the symptoms of high or low blood glucose levels, so the cause must be determined before corrective action can be taken.”

I concluded the chapter by quoting that “Perhaps the most important thing a perimenopausal woman can do is to listen to and respect her body. Just as each person’s diabetes requires an individualized plan for control, so is each woman’s experience with menopause unique.”

It seems that it’s time to take advice from my own book. Instead of fearing this next stage of my life, I need to understand and embrace it. Whether I like it or not, I am in middle age. It may have been the final chapter in my book, but I realize now that there are many more chapters to write.

Want to learn more about diabetes and menstruation? Read “Diabetes and Your Period,”[3] “Menopause”[4] and “Diabetes and Hot Flashes.”[5]

  1. hot flashes:
  2. “Menopause: What to Expect and How to Cope,”:
  3. “Diabetes and Your Period,”:
  4. “Menopause”:
  5. “Diabetes and Hot Flashes.”:

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Amy Mercer: Amy S. Mercer is a freelance writer living in Charleston, SC, with her husband and three sons. She was diagnosed with Type 1 diabetes when she was 14 years old and has written two books about living well with diabetes — The Smart Woman's Guide to Diabetes: Authentic Advice on Everything from Eating to Dating and Motherhood, and The Smart Woman's Guide to Eating Right with Diabetes: What Will Work. (Amy Mercer is not a medical professional.)

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