Menopause: The change that can add challenges to diabetes management

Menopause and the years before it, or perimenopause, may add some challenges for women who have diabetes.

The hormones estrogen and progesterone affect how your cells respond to insulin. After menopause, changes in your hormone levels can trigger fluctuations in your blood sugar level. You may notice that your blood sugar level changes more than before, and that it goes up and down. If your blood sugar gets out of control, you have a higher risk of diabetes complications.

Also, you might gain weight during the menopausal transition and after menopause. As a result, weight gain may require you to adjust your diabetes medication.

Even before menopause, high blood sugar levels can contribute to urinary tract and vaginal infections. After menopause, the risk is higher because a drop in estrogen makes it easier for bacteria and yeast to thrive in the urinary tract and vagina.

Sleep can also be an issue. After menopause, hot flashes and night sweats can keep you up at night. In turn, the sleep deprivation can make it tougher to manage your blood sugar level.

In addition, diabetes can damage the nerves of the cells that line the vagina. This can interfere with arousal and orgasm. Vaginal dryness, a common symptom of menopause, may worsen the issue by causing pain during sex.

What you can do

Healthy lifestyle choices are important aspects of your diabetes treatment plan, and healthy foods and regular physical activity can help you feel your best after menopause. Eat a variety of fruits and vegetables, whole grains and lean poultry. Aim for about 30 minutes of physical activity — such as brisk walking — a day. And if you smoke, quit.

It may also be important to measure your blood sugar frequently and keep a log of your blood sugar readings and symptoms. You doctor may use the information to adjust your diabetes treatment plan as needed. If your average blood sugar level increases, you may need to increase the dosage of your diabetes medications or begin taking a new medication — especially if you gain weight or reduce your level of physical activity. Likewise, if your average blood sugar level decreases, you may need to reduce the dosage of your diabetes medications.

Also, measure your blood pressure often and take medication if it’s high. Because diabetes increases risk of cardiovascular disease — and that risk increases even more when you reach menopause — be sure your cholesterol levels are in healthy ranges. Eating a healthy diet and exercising regularly can help, but you may need cholesterol-lowering medication.

In the meantime, remember that treatments for menopause symptoms are available if you need them. Talk to your health care team if you experience hot flashes, vaginal dryness, sexual dysfunction or other menopause symptoms.

Connect with other women talking about menopause and diabetes in the Women’s Health support group on Mayo Clinic Connect, an online patient community moderated by Mayo Clinic.

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