Hot Flashes and Blood Sugar: Dealing with Diabetes in Menopause

Menpause and Sugar
Menopause can increase risk for diabetes. Mache Seibel

Menopause is a time of changing hormone levels. Estrogen and progesterone levels fluctuate up and down and are not synchronized with each other like they used to be. And that can lead to some unpleasant side effects. Most commonly, women complain of hot flashes, night sweats and weight gain; however, there is a bigger problem that may be looming within - diabetes.

Diabetes is a serious medical condition affecting 1 in 10 adult Americans, particularly type 2 disease. Diabetes is especially challenging for women, specifically middle aged women.1 For those ages 45-54, diabetes represents the number 6 cause of death and rises to number 4 in women 55-64.1  Additionally, diabetes does not just affect your blood sugar levels and require cumbersome blood sugar testing; it can increase the risk for developing other conditions such as heart disease, stroke, blindness, kidney and/or nerve disease.1

Having diabetes while transitioning into or during menopause, can cause additional symptoms or make the typical symptoms of menopause even worse.2 In addition, some of the symptoms of menopause and the symptoms of diabetes are similar. For instance, both situations can cause frequent urination, sweats, feeling warm, mood changes, loss of libido and lack of energy.

Fluctuations in estrogen and progesterone levels can cause variations in blood sugar levels, as well as changes in the body’s response to insulin on a cellular level.2 Additionally, the weight gain that most women experience during this time, can require a change in the dosage of diabetes medication in those with pre-existing diabetes.2 Elevated blood sugar levels can also contribute to the risk of developing vaginal and urinary infections, including bacterial and yeast infections.2

Commonly, women experience sleep disturbances during menopause, which can lead to real fatigue; this can have unwanted effects on blood glucose levels, making it difficult to keep blood sugar levels under control.2  Additionally, menopausal women may experience vaginal dryness causing sexual intimacy issues, however, having diabetes can compound the problem.2 Diabetic nerve damage can affect vaginal nerve networks leading to arousal and orgasm dysfunction.2

Risks for developing type 2 diabetes, include age and obesity, family history including diabetes, prediabetes, being of Hispanic, African American, Native American, Asian or Pacific Islander descent, a history of high blood pressure, cardiovascular disease, cholesterol abnormalities and a sedentary lifestyle.1 Women are at even greater risk by a history of preeclampsia, gestational diabetes and polycystic ovarian syndrome (PCOS).1

There are steps you can take to decrease your risk for developing diabetes, as well as, manage diabetes during menopause. These steps include:1,2

  • Undergo testing when recommended. Check for sugar in your urine each year as part of your annual exam. It is currently recommended that testing begin every 3 years at the age of 45, particularly in those who are overweight. For those with an elevation in blood pressure over 135/80, every 3 year screening tests are recommended. More frequent testing may be necessary based on your personal risk factors.
  • Maintain a healthy lifestyle. Making healthy food and exercise choices is essential.Walk 30 minutes daily and don't eat foods in a bag, can or package or drink sweetened drinks. This can be helpful in managing your diabetes treatment, as well as have a positive effect on how you feel overall during this time of menopause transition. Try incorporating weight bearing exercises into your routine, limiting sugar, fat and alcohol consumption and increasing the intake of omega-3 fatty acids.
  • Involve your healthcare provider.  Speak with your healthcare provider on the recommended timing intervals of blood sugar testing and screening, the potential for needing cholesterol-lowering medications and your current menopausal symptoms.
  • As I discuss in my book, The Estrogen Window, estrogen helps sugar enter the cells of your body, which lowers blood sugar. That can be very helpful in controlling blood sugar levels.

Note: It is not recommended to start a hormone replacement regimen specifically to decrease your diabetes risk;  hormone replacement therapy can reduce the risk of developing diabetes.

Speak with your healthcare provider today about your specific risks, symptoms and recommendations. You are not alone in this transition! For a simple explanation of diabetes and how to control it, visit my Diabetes Song.


  1. Diabetes and menopause: A twin challenge. Accessed December 23, 2015

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