How Menopause Affected My Type 2 Diabetes

Just when I thought I had my type 2 diabetes under control, menopause threw me for a loop. Fortunately, I discovered ways to help manage both.

My diabetes has long been tricky to manage. Type 2 diabetes is a progressive disease, and true to form, mine has progressed over the years.

Diagnosed over 17 years ago, I’ve gone from being able to manage it in the beginning with lifestyle alone to currently using three different medications to keep my blood glucose in check.

And sometimes, just when I think I’ve “finally” hit a groove, life throws a curveball. In my case, the biggest of these was hitting perimenopause and then menopause.

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How menopause affected my type 2 diabetes

Often, the drastic decline in estrogen and progesterone that accompanies menopause leads to insulin resistance for many women. That’s because these hormones affect how your body responds to insulin.

In my case, I’d already had preexisting type 2 diabetes, so my first thought when my average blood glucose started rising wasn’t menopause. It was that my diabetes was simply progressing despite all my best efforts, which I wrote about in another Bezzy article.

But then I experienced other symptoms of perimenopause, like daily hot flashes, brain fog, trouble sleeping, and frequent migraines. Unlike menopause, perimenopause can’t be diagnosed with a hormone test. But my symptoms were telling.

I also noticed patterns in my blood glucose readings. At that point, I’d started wearing a continuous glucose monitor, and I’d often go weeks with on-target blood glucose followed by weeks of uncontrollable blood glucose, no matter what I ate or did.

These cycles were indicative of my changing hormone levels.

One of the reasons perimenopause can’t be diagnosed with a blood test is that it comes with hormonal swings. These swings can continue for years, even after menopause, which is diagnosed as going an entire year without a cycle.

I’m currently 2 years into postmenopause and still experiencing these hormonal swings. But now that I know what’s behind the corresponding blood glucose swings, I stress far less about them because I know it’s outside my control.

In other words, understanding that this is menopause has helped me stop blaming myself for my blood glucose, as so many of us with type 2 diabetes are prone to do.

Making lifestyle adjustments for menopause

At first, I responded to menopause with lifestyle adjustments, which I wrote about for Healthline. I slowed down, stopped pulling all-nighters to meet article deadlines, and focused on rest, sleep, and self-care.

All of these moves are also great for diabetes. Stress and lack of sleep both directly affect blood glucose. Rises in cortisol, the stress hormone, signal the release of blood glucose, a necessary biological adaptation to help our ancestors fight or flee imminent danger.

Although sabertooth tigers are no longer hiding around every corner, modern-day life has its own stressors that contribute to high cortisol. While stress can be detrimental to everyone, those of us with type 2 diabetes don’t make enough insulin to counteract the accompanying rise in glucose.

So, stress management can be a crucial aspect of any diabetes program. And though we women are often taught that taking time for ourselves is selfish, one potential positive of having type 2 diabetes is that it gives us the “excuse” of needing to take care of our health.

Medical treatments for menopause

Although stress-reducing lifestyle changes came with positive benefits, they didn’t end many of my symptoms. I continued to experience daily hot flashes, brain fog, and mood swings that were interfering with my quality of life and even affecting the people around me.

So, my primary care doctor put me on a hormone replacement therapy (HRT) pill, which immediately reduced most of my symptoms. I still experience a once-in-a-blue-moon hot flash, but nowhere near the daily occurrences that plagued me before. The HRT also significantly reduced occurrences of brain fog.

Plus, there was an unexpected surprise. The HRT also reduced my A1C. Because the pill contains estrogen and progesterone, it helped increase my insulin sensitivity.

However, it didn’t do much for my mood swings. I’d always been somewhat subject to moods around my cycles. But that usually meant bouts of tears. I was unprepared for menopausal rage, a phenomenon that made me feel out of control when something triggered my anger.

At first, I mostly ignored it, except for suffering the occasional embarrassment after the rage lifted over getting so worked up. But when it started to affect my family, I sought treatment.

My primary care doctor validated my experience of feeling “out of control” when she confirmed that menopause can cause a lack of serotonin. As she explained, low serotonin meant I had lost my ability to self-regulate.

So, she prescribed me a selective serotonin reuptake inhibitor (SSRI). I still get angry on occasion. I’m only human, after all. But after starting the SSRI, my anger is different. I can now experience it without feeling as though I’m taken over by rage and that my sense of “self” has left the building. In other words, I’m still in the driver’s seat.

Another bonus: I experienced some of the best blood glucose levels in years after starting the SSRI. Although I didn’t start the pill for this reason, I learned that a 2019 research review showed serotonin may play a role in glycemic control.

Takeaway

Menopause is an unavoidable life stage for cisgender women that may adversely affect one’s type 2 diabetes. Fortunately, there are a bunch of tools that can help with menopausal symptoms that can also help with managing type 2 diabetes.

So, if you feel your type 2 diabetes is being affected by menopause, see your doctor to discuss treatment options that will work for you.