Sometimes called the “change of life,” menopause is the time in a woman’s life when she stops menstruating or having periods. More specifically, a woman is said to have reached menopause when it’s been 12 months after her last period. According to the National Institute on Aging, “The menopausal transition most often begins between ages 45 and 55. It usually lasts about 7 years but can last as long as 14 years.”
A number of physiological changes occur during the transition time leading up to and also after menopause, including a decrease in the production of estrogen and progesterone, a decrease in bone mass, an increased risk of heart disease, and a propensity for weight gain.
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Menopause and diabetes
During perimenopause (the time leading up to menopause), hormone levels can fluctuate widely, and many find that their blood sugar levels do, too. Blood sugars may improve if estrogen levels increase, but if progesterone levels increase, blood sugar levels can, as well. Many menopausal women report frustration in trying to manage their blood sugars, as a result.
Common menopausal symptoms
While not all women experience symptoms of menopause, most women have some symptoms, and the NHS estimates that about 8 in every 10 women will have symptoms both before and after their periods stop. Symptoms include:
• Hot flashes
• Night sweats
• Trouble sleeping
• Vaginal dryness
• Urinary issues, like incontinence and UTIs
• Problems with memory and concentration
• Mood changes
• Joint stiffness and pain
• Thinning hair and skin
• Weight gain
Treatment for menopausal symptoms
There are a number of ways to help treat or manage symptoms associated with menopause, including medications and lifestyle changes.
Medications that may be prescribed include:
• Hormone replacement therapy to replace estrogen and help alleviate hot flashes. Estrogen can also help relieve vaginal dryness and protect against osteoporosis and heart disease.
• Antidepressants and anti-seizure medications to help decrease hot flashes and deal with mood changes.
• Medications to prevent osteoporosis.
Lifestyle approaches to help reduce and alleviate symptoms include:
• Wearing lighter-weight clothing.
• Keeping the bedroom cool at night.
• Avoiding foods that may trigger hot flashes.
• Acupuncture and hypnosis.
• Supplements, such as black cohosh and plant estrogens.
Menopause and nutrition
Good nutrition can play a key role during the time before and after menopause, helping to possibly alleviate some of the more unpleasant symptoms, reduce weight gain, improve bone health, and making it a bit easier to manage diabetes.
Hot flashes can variety in intensity and frequency. Not all women get hot flashes; in women who do, they can have them for 6 months or up to 10 years (or longer), according to the North American Menopause Society. Making a few changes to your diet can help possibly alleviate or at least reduce the frequency and intensity:
• Go easy on the spicy foods. Eating spicy foods that contain hot peppers, chili powder and cayenne pepper can cause your core body temperature to soar and may trigger or worsen hot flashes.
• Limit hot foods. That’s not easy to do, but hot soups or stews and hot beverages can also raise your body temperature. Switch to cooler foods and beverages, like salads, water and unsweetened iced tea.
• Cut back on caffeine. Giving up your morning coffee can be tough, but it might be worth it. Caffeine narrows blood vessels and raises your heart rat,e which may trigger a hot flash. Switch to decaf coffee, herbal tea and non-cola diet sodas — or at the very least, decrease the volume of caffeinated drinks.
• Minimize alcohol. Alcoholic drinks cause your blood vessels to widen (called vasodilation), which can make you feel warm and cause skin flushing. Red wine, in particular, is notable for triggering hot flashes. And, alcohol is a source of calories. If you’re not willing to give up alcohol altogether, try switching to white wine or prosecco, and limit yourself to one serving, which is a 5-ounce glass.
• Fit in foods that contain plant estrogens. Plant estrogens, including isoflavones, may help reduce hot flashes due to their weak estrogen-like effects. Soybeans, chickpeas and lentils are great sources, and ground flaxseed, oats, barley, wheat germ, tofu, tempeh, apples and carrots contain some, as well.
Fatigue, or feeling tired and having low energy, can affect many women in the throes of menopause. A lack of sleep — or a lack of good-quality sleep due to hot flashes and night sweats, mood changes and feeling stressed — can contribute to fatigue associated with the change of life. In addition, fluctuating blood sugars can worsen fatigue. Here’s how nutrition might help:
• Limit caffeine and alcohol. Not only will doing so help with hot flashes, but cutting out or limiting coffee, tea, energy drinks and alcohol can definitely help you sleep better. You may also notice an improvement in your blood sugars, as some women find that caffeinated drinks cause their blood sugars to rise. Switch to decaf coffee or herbal tea (preferably cold, not hot) and other non-caffeinated drinks.
• Eat fewer processed foods. Refined carb foods, like white bread and pasta, potato chips, sugary cereals and pastries, as well as foods high in saturated fats can sap your strength. Focus on choosing whole grains, but limit your portions of all carb foods to help keep your blood sugars within your target range.
• Stay hydrated. Water doesn’t give you energy in the way of calories, but you need water so that your body can use energy from the foods you eat. Make a point to keep water with you during the day — and don’t forget to drink it!
• Get your vitamin D. There’s evidence that a lack of adequate vitamin D can cause fatigue as well as depression. Fortified dairy foods, like milk and soy milk, egg yolks and fatty fish give you some vitamin D, but you may need to take a supplement, especially if you don’t live in a sunny climate.
• Rethink your eating schedule. If three square meals are your thing or you find yourself eating a big meal late at night, you may be more prone to lower energy levels, sleep issues and weight gain. Consider experimenting with eating smaller, more frequent meals during the day, making lunch your biggest meal of the day rather than dinner, and/or avoiding eating several hours before you go to bed. Because changes in your eating schedule and meal size can affect your diabetes, talk with your doctor and dietitian about making this work, as your diabetes medications may need some tweaks.
Bone loss can dramatically increase once you hit menopause, thanks to a drop in estrogen levels. According to the National Osteoporosis Foundation, “The greater your bone density is to begin with, the lower your chance of developing osteoporosis.” Women with type 1 diabetes are also at a higher risk of osteoporosis. Your doctor may advise you to take medication to prevent osteoporosis, but you can also boost bone health by making sure you get the following nutrients in your diet:
• Calcium. Milk, yogurt, cheese, canned salmon and sardines, leafy greens, such as kale and collard greens, and fortified foods, like soy and rice milk.
• Vitamin D. Fortified dairy foods and fatty fish like salmon, mackerel, sardines and tuna.
• Vitamin K. Dark green leafy vegetables, Brussels sprouts, broccoli, cauliflower, fish, eggs and cereal.
• Magnesium. Spinach, sweet potatoes, artichokes, almonds, legumes and pumpkin seeds.
Weight gain is a common but dreaded side effect of perimenopause and menopause, and is attributed to hormone changes as well as a decrease in muscle mass that can lower metabolism, or the rate at which you burn calories. Weight gain has health consequences, too, as it linked with a higher risk of high blood pressure, heart attack, stroke and type 2 diabetes. It can also lead to higher blood sugars in women who have diabetes. Nevertheless, it’s possible to avoid or minimize weight gain at this time.
• Focus on eating “whole” foods rather than processed or fast foods.
• Emphasize lean proteins and vegetables at your meals, and cut back a bit on carb foods.
• Fit in fiber to help with digestion and to keep you feeling full. Beans, whole grains, fruits, vegetables are good sources.
• Limit alcohol, which can add excess calories.
• Aim to sleep between 7 and 8 hours at night.
• Make time to be active and include strength-training exercises at least three times a week.
• Review your medications (including those you take for diabetes) with your doctor, as some can contribute to weight gain.
• Find a way to reduce and manage stress.
• Consider working with a dietitian for more specific guidance around meal planning.