During the years leading up to menopause — a time known as perimenopause — many women will say they missed some of the signs: slow weight gain, sleepless nights, irregular menstruation, even waking up uncomfortable or in a sweat. Some recall experiencing difficult to manage mood swings; a change in cholesterol levels, or the horrible crashing feeling from blood sugar fluctuation. For women with diabetes, these symptoms can come earlier in life.
Perimenopause usually lasts about four years until menopause begins. Women enter menopause when their ovaries have completely stopped releasing eggs and they have not had a period for 12 months.
How do perimenopause and menopause affect women with diabetes?
When you have your period, your estrogen and progesterone hormones are fluctuating and can affect how your body responds to insulin. During perimenopause, many women experience periods that are heavier or lighter, longer or shorter than usual. This is caused by the imbalance of progesterone and estrogen. For women with diabetes, the higher levels of estrogen can improve insulin sensitivity. However, higher levels of progesterone can cause insulin resistance. When your menstrual cycle is less predictable, you can expect your diabetes to be less stable on some days than others.
It is no surprise to most women that whenever your hormone balance changes, your weight can change as well. So it is especially important to keep track of weight changes during perimenopause and menopause because too much weight gain puts women at a higher risk of developing Type 2 diabetes.
Women who have diabetes who gain weight during perimenopause and menopause may need to work with their doctor to manage their diabetes and may need to increase the dosage of insulin or oral meds. Identifying and understanding the body’s signals during perimenopause and menopause and those related to diabetes can be quite challenging. Staying in control of your diabetes is manageable with some focused attention. Maintaining a lifestyle that is active and mindful of choosing healthy meal options is important.
Coping with weight gain
• Eat small meals regularly to reduce the chance of fat storage.
• Choose whole-grain foods, fruits, and vegetables over processed food.
• Read the labels.
• Use healthy oils that are high in omega-3 fats, such as olive oil.
• Choose foods with complex carbohydrates, such as fruit and beans, over simple carbohydrates, such as soda and candy.
• Stay active by doing things like walking, yoga, gardening, swimming and biking.
• Exercise with other people — it keeps you motivated and accountable.
• Use an app like Noom, Weight Watchers, or MyFitnessPal to keep track of your activity.
• Establish small achievable goals. Add or delete one thing at a time.
Another challenge may be that you will need to improve your time-management skills. Women with diabetes who are in perimenopause or menopause will need to adjust their schedules to accommodate things like checking their blood sugar levels more often during the day and occasionally during the night. Or you may need to visit the doctor more often to adjust medications — especially if you are gaining weight. And the sleepless nights experienced by many women during this phase requires making time to rest or fit in a nap as part of your daily routine.
How do you know if menopause or diabetes is causing your symptoms?
It can be confusing to determine whether menopause symptoms or diabetes is causing sweating, dizziness, or mood swings. It is very common to mistake hot flashes for low blood sugar. Not being able to distinguish between the two conditions can be frustrating. but you can take a few actions.
Help for hot flashes
• If your breathing is hurried, slow it down and take deep breaths.
• Use a cold cloth on your face and the back of your neck.
• Drink cold or icy water.
• Wear loose, light clothing and dress in layers so you can remove and add them according to your body temperature.
• Don’t use memory foam mattress and pillows because they have a greater tendency to trap heat.
• Use a bedside fan.
• Turn down the thermostat at night.
Check your blood glucose levels more often, especially while experiencing symptoms.
Be sure to eliminate unhealthy factors that may cause similar symptoms, like caffeine or sleeping in a warm room.
Discuss the changes in your body with your doctor. A doctor can help identify the best treatments for you. For example, if you are experiencing vaginal dryness, decreased sexual response, hot flashes, or other symptoms, the doctor may recommend a vaginal lubricant to restore moisture or vaginal estrogen therapy to correct thinning and inflammation of the vaginal walls.
Be compassionate and gentle with yourself. These are big changes and can be overwhelming. Ask for support from family and friends.
Be kind to yourself
• Splurge on loose fitting stylish clothing that will accommodate weigh fluctuations. Choose neutral colors, like grays and whites that you can mix and match easily.
• Create a routine to give yourself some sense of certainty and that will help you with time management.
• Take a “well day” or “mental health day” to just unwind, rest, and relax.
• Try something new. New experiences will help you learn more about yourself and give you new things to think and talk about.
• Try a meditation app like HeadSpace or Stop, Breathe & Think.
• Choose water over other drinks. Staying hydrated is essential to feeling good.
• Meet up with a friend just to catch up.
• Claim some space. Find a place where you can go to have a quiet moment to read a book, or meditate, or cry — somewhere you can get some peace and privacy.
• Get outside for some fresh air every day — even for a few minutes or a walk around the block. Breathe the fresh air. Stand under a tree.
• Make sleep a priority. Everything is more difficult when you’re tired.
When you are unsure of what is causing your discomfort, be proactive in listening to your body, and seek medical advice. Just as you need an individualized plan for diabetes, you will need one for coping with menopause. With some patience, trial and error, and support from your doctor, family, and friends, you will create a plan that is right for you.
Want to learn more about older women’s health and diabetes? Read “Top 10 Health Tips for Women Over 65,” “Diabetes and Chronic UTIs” Questions and Answers” and “Resolving Diabetes-Related Bladder Problems.”