Diabetes and menopause: A twin challenge

Diabetes and menopause may team up for varied effects on your body. Here's what to expect — and how to stay in control.

By Mayo Clinic Staff

Menopause — and the years before it — may provide some challenges for women who have diabetes. If you have diabetes and you're going through menopause — or soon will be — learn what to expect. Then consider what to do about it.

Diabetes and menopause: What to expect

Menopause is the phase of life after your periods have stopped and your estrogen levels decline. Menopause can also occur as a result of surgery, when the ovaries are removed for other medical reasons.

Diabetes and menopause may team up for varied effects on your body, including:

  • Changes in blood sugar level. 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 goes up and down. If your blood sugar gets out of control, you have a higher risk of diabetes complications.
  • Weight gain. You might gain weight during the menopausal transition and after menopause. Weight gain may require an adjustment in your diabetes medication.
  • Infections. Even before menopause, high blood sugar levels can contribute to urinary tract and vaginal infections. After menopause — when a drop in estrogen makes it easier for bacteria and yeast to thrive in the urinary tract and vagina — the risk is even higher.
  • Sleep problems. After menopause, hot flashes and night sweats may keep you up at night. In turn, the sleep deprivation can make it tougher to manage your blood sugar level.
  • Sexual problems. 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.

Diabetes and menopause: What you can do

Menopause can wreak havoc on your diabetes control. But there's plenty you can do to better manage diabetes and menopause.

  • Make healthy lifestyle choices. Healthy lifestyle choices are important aspects of your diabetes treatment plan. Eat a variety of fruits and vegetables, whole grains, lean poultry and low-fat dairy products. Aim for about 30 minutes of physical activity — such as brisk walking — a day. Healthy foods and regular physical activity can help you feel your best after menopause, too. Also quit smoking if you smoke.
  • Measure your blood pressure often. Make sure your blood pressure levels are within a healthy range. Ask your doctor if you have questions or concerns about your blood pressure. If you take medications for high blood pressure, be sure to take them as prescribed.
  • Measure your blood sugar frequently. You may need to check your blood sugar level more often than usual during the day, and occasionally during the night. Keep a log of your blood sugar readings and symptoms. Your doctor may use the details to adjust your diabetes treatment plan as needed.
  • Ask your doctor about adjusting your diabetes medications. 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.
  • Ask your doctor about cholesterol-lowering medications. If you have diabetes, you're at increased risk of cardiovascular disease. The risk increases even more when you reach menopause. To reduce the risk, eat healthy foods and exercise regularly. Your doctor may recommend cholesterol-lowering medication if you're not already taking it.
  • Seek help for menopausal symptoms. If you're struggling with hot flashes, vaginal dryness, decreased sexual response or other menopausal symptoms, remember that treatment is available.

    For example, your doctor may recommend a vaginal lubricant to restore vaginal moisture or vaginal estrogen therapy to correct thinning and inflammation of the vaginal walls. Your doctor may also recommend hormone replacement therapy to relieve the symptoms if you don't have conditions that could cause a higher risk of complications.

    If weight gain is a problem, a registered dietitian can help you revise your meal plans. Hormone replacement therapy might be a good option, too.

Having diabetes while going through menopause can be a twin challenge. Work closely with your doctor to ease the transition.

Jan. 15, 2020 See more In-depth

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