Menopause Survival Guide
Raging hormones? They’re not just for teenagers. Women going through menopause also deal with hormonal shifts, mood swings, and the like. This life stage might be even more trying for women with diabetes.
Menopause marks the end of a woman’s reproductive years and occurs naturally after menstruation stops completely, usually when a woman has gone 12 months without a period. The average age that women reach menopause is 51.
But it doesn’t occur overnight. Perimenopause, the years leading up to menopause, often starts when a woman is in her early to mid-40s. Some women deal with hot flashes, irritability, sleep disturbances, brain fog, and related issues, while others have very few symptoms.
Whether you’re sweating through your first hot flash or preparing for this transition, we’ve got you covered. Here are some common concerns and tips for thriving during a phase of life that can be both challenging and liberating.
My blood glucose levels are wacky.
As if going through menopause wasn’t taxing enough, women with diabetes might also have to deal with less-predictable blood glucose levels, thanks to a decline in estrogen that seems to cause cells to become more insulin resistant.
Cynthia Stuenkel, MD, an internist, endocrinologist, and clinical professor of medicine at the University of California–San Diego, says that during menopause, hormone fluctuations are no longer on a schedule associated with menstruation.
“For women with diabetes, this can really wreak havoc with [their] blood sugar control,” Stuenkel says.
What you can do: Monitor your blood glucose carefully, as directed by your doctor. If you use oral and/or injectable medications to control your blood glucose, be diligent about taking them as prescribed. Make lifestyle choices that support healthy blood glucose levels, such as exercising, practicing stress management, and eating healthfully. If you’re still getting your period, track its onset to see if there are correlations with your blood glucose levels. Naturally, talk with your doctor about any changes that concern you.
I’m all hot and bothered.
Perhaps the most common complaint from menopausal women is about hot flashes—those moments of intense heat, sweating, and (in some cases) rapid heartbeats, often followed by a clammy chill. Hot flashes are thought to be caused by changes in the hypothalamus, the part of the brain that regulates body temperature. Some women experience them several times or more a day or just a few times a week. And some women experience them as night sweats. The good news: Hot flashes are usually over quickly, lasting from a few seconds to a few minutes.
What you can do: Many women with diabetes say hot flashes feel similar to a bout of hypoglycemia, or low blood glucose, when sweating and even dizziness take hold. But don’t automatically blame menopause when you feel those symptoms coming on. Check your blood glucose to make sure you’re riding out a hot flash, not having a blood glucose low. To keep comfortable, consider dressing in layers so that clothes can be removed when a hot flash occurs. A portable fan may provide a little relief, too. For another way to control hot flashes, see “Hormone Replacement Therapy: Is It for You?”.
I have vaginal dryness and/or pain with sex.
As the body reduces the amount of estrogen it makes, natural vaginal lubrication can dry up—and that dryness can make women more prone to vaginal or urinary tract infection, says Evelina Sterling, PhD, MPH, MCHES, a public health consultant at Southern Research and Evaluation Institute in Roswell, Georgia. Women with diabetes may have nerve damage in their genitals, which can lead to pain, tingling, and burning sensations. And that pain can dampen the desire for sex.
What you can do: Over-the-counter lubricants can help, especially to make sex more enjoyable and to avoid vaginal tearing. If those aren’t enough, your doctor may prescribe a topical estrogen to use. Sterling says it’s important to talk with your doctor promptly about discomfort or pain with sex—it may be a sign of nerve damage.
I can’t sleep.
Night sweats are just one symptom of menopause keeping women up at all hours. Another is an increase in the need to go to the bathroom, which could be a sign of high blood glucose. Some women also experience insomnia in perimenopause and menopause. And as people who’ve been living with diabetes for a while know, disruptions in the sleep cycle can cause changes in blood glucose levels. (For more on that, click HERE.)
What you can do: If you’re experiencing these symptoms, test your blood glucose levels regularly, as directed by your doctor, says Sterling. Experts recommend keeping a regular sleep routine and a cool bedroom to fend off night sweats. Spicy food, caffeine, and alcohol can also keep you awake, so it may be best to limit those for now. Regular exercise can make for a better sleep schedule—and it can also fight the creeping weight gain linked to menopause.
Mood swings? What mood swings?!
If you’ve dealt with the mood swings and irritability that can come with menstruation and with low or high blood glucose levels, then you know that your hormones can affect your emotions. The same is true for women in perimenopause and menopause, when shifts in hormone levels cause shifts in how you feel physically and emotionally. Women who have had postpartum depression or another major depression at some point in their lives are more likely to face mood swings or depression during this transition, says Stuenkel.
What you can do: Talking with a therapist can help you deal with emotional and mental changes. Some women find that antidepressants or other prescription drugs may be necessary. Either way, it’s important to reach out, says Nancy Kelinson, LISW, a retired clinical social worker in Des Moines, Iowa, who has type 1 and went through menopause.
I need support.
Some of the symptoms of menopause can feel too personal to share. Yet knowing you’re not alone can make a big difference for many women.
What you can do: Don’t suffer in silence, Sterling says. Consider joining a support group. She also recommends that you talk to your health care provider and see what options exist to make this phase easier to manage.
A Word on Heart Disease
Cardiovascular disease is the most common cause of death for people with type 1 and type 2 diabetes. The Endocrine Society recommends that women focus on healthy eating and exercise, both during and after the menopause transition. Controlling weight and reducing high blood glucose, high blood pressure, and abnormal cholesterol can reduce your risk of having a heart attack.
Does Menopause Cause Type 2 Diabetes?
If you’re online long enough, you can find information on just about anything. But it’s challenging to find a definitive answer to the question of whether menopause causes type 2 diabetes.
“If you look at the constellation of women aging and increasing their weight, possibly having more aches and pains, and decreasing their physical activity, it could certainly be a perfect storm for developing type 2 diabetes,” says Cynthia Stuenkel, MD, an internist, endocrinologist, and clinical professor of medicine at the University of California–San Diego. “But we really don’t have large randomized trials specifically looking at women with diabetes [to determine a possible link]. We probably should, considering how many women are being diagnosed.”
To maintain good health, make wise lifestyle choices:
- Eat healthy meals and snacks without more calories than you need for your daily activities.
- Get at least 30 minutes of exercise, five times a week.
- Manage your bloodglucose levels to stay within your safe target range.
Not all women go through perimenopause. Women who have hysterectomies or other medical treatments might be pushed into what is called “induced menopause” and can face many of the same symptoms as women who go through perimenopause naturally.
If you know you’re going to be put into induced menopause, talk to your health care provider about your concerns.
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