Not everything that happens to you when you have diabetes is a complication, but sometimes it sure can make things complicated! For women with diabetes, our monthly menstrual cycle not only brings in waves of heightened emotion, bloating and fatigue, but it can also bring increased resistance to insulin and food cravings (i.e. chocolate). What happens when those visits from Aunt Flo stop, or at least slow down, as menopause starts to set in? What happens to the diabetes as a woman ages?
We're treating this as part of our monthly series on complications. Although not quite as hilarious as the broadway show on this topic, this is OUR salute of sorts to women who are experiencing The Change:
In fact, the changes that menopause brings in your body can have unfortunate effects on diabetes management.
- Just like with your menstrual cycle, changes in the hormones estrogen and progesterone will affect how you respond to insulin. During the transitional years of menopause (when menstrual cycles slow down but haven't stopped), these hormones are unstable, and cause problems with diabetes management. Higher levels of estrogen usually improves insulin sensitivity, while higher levels of progesterone, cause resistance. As those changes happen, you'll notice your diabetes might be more unstable on some days.
- Any time hormones change, weight can change, and weight has a major impact on diabetes. Women who gain weight during and after menopause can see an increased need in insulin or oral meds, so keep on top of trends and don't assume things will "go back to normal." And those with pre-diabetes may find themselves with type 2 diabetes, so if you're at risk, be aware of these changes.
- Oy vey! As if diabetes wasn't uncomfortable enough, now you can add hot flashes and night sweats to the mix. These can cause big problems with sleeping soundly, which in turn can make your blood sugar levels skyrocket, especially if stress affects your diabetes.
- Those menopause symptoms, including hot flashes and moodiness, can sometimes be mistaken for symptoms of high or low blood sugars. It's best to not rely on your "feelings" and actually test your blood sugar, lest you treat a high blood sugar with juice!
- If you have type 2 diabetes, you may notice additional health problems set in at the onset of menopause. Women with type 2 diabetes are at higher risk of atherosclerosis, which is the hardening and thickening of the artery walls that can lead to stroke or heart attack. Menopause and a more sedentary lifestyle also poses a risk for osteoporosis (bone density problems). Although women with type 1 diabetes are at a higher risk overall for osteoporosis, but the risk seems to be even more pronounced for women with type 2.
Menopause is an uncomfortable but unfortunately inevitable part of life for every woman — diabetes or not! Hopefully this provides some insight into what you to look out for going into The Change when you've got diabetes.
Ladies: anyone out there already gone through menopause with diabetes? Or beginning that process now? As usual, we would love to hear your "in-the-trenches" experiences and suggestions.