8 Things to Know About Menopause and Diabetes

Diabetes can have an impact on your menopause experience. Here are some tools for managing this natural part of life.

Menopause can happen earlier if you have diabetes (type 1 or 2). Experts aren’t sure why, but they believe it may be related to the effects of diabetes on the aging and function of your ovaries.

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How does menopause affect type 2 diabetes?

Here’s a little background on menopause to help you make sense of how it can interact with type 2 diabetes.

What is menopause?

Menopause can be confusing to talk about because this transition actually has three separate phases, but people often refer to the whole thing as “menopause.”

1. Perimenopause: This is the time period before and during the early phase of menopause. You might experience symptoms related to menopause that start years before actual menopause. This stage usually lasts between 4 and 8 years.
2. Menopause: Menopause is defined as the point in time when you’ve gone 1 year without having a period. On average, menopause tends to happen after age 45 or at age 51. But it can happen earlier in people with type 2 or type 1 diabetes.
3. Postmenopause: This is the period of life starting from menopause until menopausal symptoms stop.

Symptoms of menopause

If you’re navigating type 2 diabetes around midlife, it can help to be able to identify whether you’re experiencing symptoms of menopause so you can treat them as needed.

The National Institute on Aging includes the following as symptoms of menopause:

• Changes in your period: Your period can become heavier or lighter than it used to be, be shorter or last longer, or stop occurring at the same frequency.
• Hot flashes: You might suddenly feel like you’re too hot. You might also get night sweats.
• Mood changes: You might experience depression, irritability, or other mood changes.
• Urine leaks: Your urge to pee might increase, or you could pee when you cough or laugh.
• Sleep issues: You may have trouble falling asleep, wake up frequently at night, rise early, or all of the above.
• Vaginal dryness: This can also occur with pain during sex.
• Changes in libido: After menopause, you may feel less interested in sex. Alternatively, you might find a renewed interest in sex.
• Changes in body composition: You might notice you have less muscle mass or find your waist size increases after menopause.
• Other physical changes: Thinner skin, aching joints and muscles, and headaches can happen with menopause, among other changes to your body. Many are due to hormonal shifts.

Don’t worry if your symptoms don’t look exactly like these. Symptoms of menopause vary widely from person to person.

Hormone changes with menopause and diabetes

Hormone levels naturally change during menopause, including:

• lower levels of estrogen and progesterone
• greater levels of androgens, like testosterone, compared with estrogens
• higher levels of follicle-stimulating hormone (FSH)

According to 2020 research, these hormonal changes alter how your body metabolizes fats. The changes that happen in these hormones during the menopausal transition can increase your chances of developing metabolic-related conditions, including heart disease and type 2 diabetes.

The effects of hormonal changes are complex, though. For example, research from 2021 suggests that in people after menopause, having higher estrogen levels is associated with an increased risk of heart disease and stroke.

So, your hormone levels alone don’t tell the whole story.

8 tips for managing menopause and type 2 diabetes

Here are some key ways to manage the issues related to menopause and type 2 diabetes.

1. Nutritious diet and exercise are keystones of treatment

It may sound like a broken record at this point, but I’ll say it again. A consistently nutritious diet and regular exercise can help lower your risk of complications and other conditions when you have type 2 diabetes.

The same goes for you when you have menopause with type 2 diabetes. Regular exercise plus a diet full of nutrient-rich foods — low in added sugars and refined carbs — can really help.

2. Monitor your blood sugar levels closely

Fluctuating hormone levels can cause your blood sugar levels to change, too. It can help to check your blood sugar often and manage your levels as needed.

3. Manage your risk of heart disease

Research from 2020 suggests you’ll have a greater risk of heart disease after menopause. The changes in hormone levels can lead to increases in belly fat and changes in the fats in your blood, including cholesterol.

Diabetes also increases your risk of developing heart disease, so knowing you’re in postmenopause may help you be more aware of your risk.

You can take action to reduce your risk of heart disease with a few lifestyle changes, including eating whole, nutrient-dense foods and getting regular exercise.

4. Take care of your bones

Your risk of osteoporosis increases after menopause, too. A 2017 study suggests when you have type 2 diabetes, your risk of fractures increases more.

Diabetes disrupts bone metabolism and formation. Complications of type 2 diabetes, like neuropathy, make fractures more likely due to falls.

Type 2 diabetes medications have different effects on bone health. Some, like metformin, appear to have a beneficial or neutral effect. But some evidence shows others may negatively affect it, including thiazolidinediones (TZDs) and SGLT2 inhibitors.

Many of the lifestyle changes that improve your health with diabetes also help reduce your risk of osteoporosis, including eating a balanced diet, getting enough exercise, limiting alcohol consumption, and quitting smoking.

5. If you have prediabetes, take action

You’re more likely to develop diabetes after menopause than you were before it. This is partly because menopause is associated with insulin secretion and sensitivity changes.

So, if you have prediabetes but not type 2 diabetes, consider taking steps now to reduce your risk.

Reducing added sugars and refined carbs you eat can help, among other lifestyle changes, to help prevent type 2 diabetes.

6. Get help for sexual and urinary issues

High blood sugar that can happen in type 2 diabetes can lead to nerve and blood vessel damage, which can affect sexual and bladder control.

Add this to the sexual and urinary symptoms you can get with menopause, and you may face extra challenges.

Sexual issues you could experience with type 2 diabetes include:

• painful sex
• lack of lubrication
• reduced feeling in the genitals
• reduced ability to have an orgasm
• increased risk of yeast infections
• increased risk of urinary tract infections (UTIs)

If you find you’re experiencing issues related to bladder control or sexual comfort or enjoyment, reach out to a healthcare professional. They can help you find solutions to specific issues you’re having.

7. Talk about menopause with your doctors

Sometimes, doctors don’t focus on menopause during wellness visits, especially if they’re mainly focused on managing your diabetes during your appointments.

But menopause symptoms can be uncomfortable and affect your well-being.

It can help to keep a journal and record your menopause symptoms to share when you speak with a doctor.

If you’re wondering whether the changes you’re experiencing are truly related to menopause, consider asking your doctor for a blood test. They can assess your levels of FSH and estradiol to make sure what you’re experiencing isn’t related to other causes.

The doctor who helps manage your diabetes may also recommend starting or changing your medication if you’re having a harder time managing blood sugar levels after the menopausal transition.

8. Consider hormone therapy if you have menopause symptoms

Research has found that taking hormone therapy (formerly called hormone replacement therapy) for menopause symptoms can help improve blood sugar levels.

It may not be appropriate for some people with menopause and diabetes, but can really help others. Ask your doctor for a personalized recommendation.

Takeaway

The menopausal transition is a natural one and a time of life that brings great freedom and enjoyment to many people.

But symptoms and health changes can come with it that you should be aware of, especially if you have type 2 diabetes or are at a higher risk of developing it.

Make healthy lifestyle changes to support your lifelong health overall and manage your risk of heart disease, bone fractures, and more. And don’t neglect your sexual and urinary health — make sure to seek support if you’re experiencing difficulties.