Menopause and Blood Sugar: What Women Need to Know

When navigating perimenopause or menopause with type 2 diabetes or prediabetes, it can contribute additional challenges that you need to think about.

Or if you’re a woman going through perimenopause or menopause and wondering how it influences blood sugar, you’re in the right place.

This time of life can bring unique challenges, especially when it comes to balancing blood sugar.

But there is good news: understanding the connection between menopause and blood sugar can empower you to take meaningful steps toward better health.

Let’s explore how menopause affects blood sugar, why these changes occur, and—most importantly—what you can do about it.

How Menopause Affects Blood Sugar

During menopause, your hormone levels—particularly estrogen and progesterone—fluctuate and eventually decline.

These hormones don’t just regulate your menstrual cycle; they also play a critical role in how your body processes glucose.

Insulin Sensitivity

Insulin is a key hormone that helps regulate blood sugar levels. We want to keep our insulin sensitivity high, so that insulin can perform it’s job properly.

Estrogen has a protective effect on insulin sensitivity. When estrogen levels drop, your body may become less responsive to insulin, making it harder for glucose to move out of your bloodstream and into your cells.

This is known as insulin resistance, which can result in higher blood sugar levels.

Fat Distribution and Weight Gain

Menopause often brings a shift in fat storage, with more fat accumulating around the abdomen.

This type of fat, called visceral fat, is metabolically active and can increase insulin resistance, further driving up blood sugar levels.

Sleep Disruptions

Menopausal night sweats and hot flashes can make restful sleep feel like a distant dream. During perimenopause, you may also notice sleep disruptions due to fluctuating hormone levels.

Poor sleep is linked to insulin resistance, weight gain and higher fasting blood sugar levels, making it harder to stabilize your glucose levels during this transitional phase.

Stress and Cortisol

Hormonal changes during menopause—and even earlier, in perimenopause—can heighten stress levels and increase production of cortisol, a stress hormone.

Elevated cortisol not only raises blood sugar but can also exacerbate insulin resistance, creating a cycle that impacts energy levels and mood.

Learning to manage stress during this period is a crucial part of balancing blood sugar.

Perimenopause and Blood Sugar: Early Changes to Watch For

Before menopause, most women go through perimenopause, the transitional phase where hormone levels fluctuate unpredictably.

These fluctuations can start as early as your late 30s or 40s and can last several years. They also impact blood sugar regulation in several ways:

• Estrogen Fluctuations: When estrogen dips, insulin sensitivity drops.
• Progesterone Spikes: Higher progesterone levels can temporarily worsen insulin resistance, leading to blood sugar spikes.
• Increased Cravings: Many women report cravings for sugary or starchy foods during this time, which can affect blood sugar control.

Addressing blood sugar imbalances early during perimenopause can help ease the transition into menopause and reduce your risk of long-term complications.

Common Blood Sugar-Related Symptoms During Perimenopause

You might notice subtle changes in your blood sugar control during perimenopause, such as:

• More frequent blood sugar spikes or crashes, especially after high-carb meals.
• Increased sugar cravings or cravings for starchy foods.
• Difficulty losing weight or unexplained weight gain, particularly around your midsection.
• Greater fatigue or brain fog after meals, linked to unstable blood sugar.

Why Menopausal and Perimenopausal Changes Matter

The shifts in blood sugar control during menopause and perimenopause can increase your risk of complications if left unaddressed.

These include:

• Higher blood sugar and A1c levels
• Difficulty managing weight
• Increased risk of cardiovascular issues

But here’s the key takeaway: these changes are not inevitable.

By understanding how perimenopause and menopause affect your blood sugar and taking proactive steps, you can improve your health and well-being during this time of life.

Why It’s Important to Act During Perimenopause

If you can, addressing blood sugar imbalances during perimenopause can set the foundation for better health as you transition into menopause.

Proactively managing your blood sugar now can reduce the risk of developing type 2 diabetes, heart disease, or other metabolic issues later.

Steps to Balance Your Blood Sugar During Menopause and Perimenopause

Whether you’re currently living prediabetes or type 2 diabetes, or you’re a woman concerned about how perimenopause or menopause may affect your blood sugar, the good news is there are proven strategies to help you take control.

1. Optimize Your Nutrition

What you eat plays a pivotal role in managing both menopause symptoms and blood sugar levels.

Focusing on a quality nutrition plan is going to be the most important thing for balancing blood sugar, keeping the weight off and staying in optimal health.

Prioritize Protein

Protein helps stabilize blood sugar by slowing the absorption of carbohydrates and keeping you feeling fuller longer.

Aim to include high-quality protein sources like eggs, chicken, fish, and plant-based options such as soybeans, tofu or lentils with each meal.

Eat Tons of Vegetables

Vegetables are the best type of carbohydrate to eat, as they are lower in overall carbs, contain fiber and powerful antioxidants and polyphenols that can help reduce inflammation and balance blood sugar.

Incorporate Healthy Fats

Healthy fats from sources like avocados, nuts, seeds and olive oil can reduce inflammation and support insulin sensitivity.

Overall, you really need to have a clean diet, a quality nutrition plan that will help you address the issues that come with perimenopause or menopause.

Your nutrition plan is going to be one of the most important things to focus on.

2. Move Your Body Regularly

Exercise is one of the most effective tools for improving insulin sensitivity and reducing blood sugar levels. It’s really important to move your body more. But exercising smart is key.

Strength Training

During perimenopause and menopause women lose muscle mass, so including strength training can lead to better results.

Building muscle can help you lose weight, plus, it enhances your body’s ability to use insulin effectively.

Aim for strength exercises 2-3 times a week.

Aerobic Exercise

Alongside strength training, try to include regular aerobic exercise.

Activities like walking, cycling, or swimming help improve glucose uptake by your muscles. Even a brisk 10-minute walk after meals can make a difference.

Tip: Consistency matters more than intensity. Start with activities you enjoy and gradually build from there.

3. Prioritize Sleep

Prioritizing sleep can’t be emphasized enough: You absolutely need quality sleep during perimenopause and menopause.

While we know sleep can be disrupting at this time, do the best you can to get better sleep, as this will lead to better blood sugar control.

Here’s a few tips:

• Establish a Routine: Go to bed and wake up at the same time each day, even on weekends.
• Create a Cool, Dark Sleep Environment: Lowering the temperature and using blackout curtains can help combat night sweats.
• Limit Caffeine and Screens: Avoid both at least two hours before bed to promote restful sleep.

4. Manage Stress

As mentioned above, chronic stress raises cortisol, which can disrupt blood sugar levels.

• Mindfulness Practices: Deep breathing, meditation and yoga can reduce cortisol levels and improve insulin sensitivity.
• Time in Nature: A simple walk in a green space can lower stress and blood sugar levels.
• Support Network: Don’t hesitate to reach out to friends, family or a counselor when you need support.

Tip: Experiment with stress-relief techniques to find what works best for you.

5. Monitor Your Blood Sugar

Monitoring blood sugar can help you understand how your body responds to different foods, activities and stressors.

• Use a Glucometer: Check your blood sugar before and after meals to see how your choices impact your levels.
• Consider a Continuous Glucose Monitor (CGM): A CGM provides real-time insights into your blood sugar trends.

6. Incorporate Adaptogenic Herbs

Adaptogenic herbs, such as ashwagandha, maca root, and rhodiola can provide perimenopause and menopause support.

For example, ashwagandha has been shown to reduce stress and lower cortisol levels, potentially improving insulin sensitivity.

Maca root may support energy and mood during perimenopause and menopause, helping you stay motivated for healthy lifestyle changes.

Rhodiola, on the other hand, is known for its ability to reduce fatigue and improve resilience to stress, both of which can help with overall blood sugar management.

Post-Menopause and Blood Sugar: What to Expect

After menopause, once your hormone levels have stabilized at lower levels, blood sugar regulation remains a critical focus.

The absence of estrogen’s protective effects can make it more challenging to maintain insulin sensitivity and manage your blood sugar effectively.

Here’s what you need to know about the post-menopausal phase.

Why Post-Menopause Matters for Blood Sugar

During post-menopause, women often face compounded metabolic challenges due to:

Persistently Low Estrogen Levels

Estrogen plays a key role in supporting insulin sensitivity and keeping glucose levels stable.

Without estrogen, the risk of developing insulin resistance increases, potentially leading to higher blood sugar and A1c levels.

Body Composition Changes

The accumulation of visceral fat around the belly—common in post-menopause—can worsen insulin resistance, inflammation and overall metabolic health.

Even if your weight doesn’t change, shifts in fat distribution may increase blood sugar instability.

Higher Cardiovascular Risk

The metabolic shifts during post-menopause can elevate your risk of heart disease, especially when paired with poor blood sugar control.

Keeping blood sugar stable becomes even more crucial for protecting your heart health.

Bone and Muscle Health

Declining estrogen can also lead to reduced bone density and muscle mass.

Since muscle is one of the body’s main sites for glucose uptake, maintaining strength is vital for managing blood sugar.

Proactive Strategies for Post-Menopause

The good news is that with the right approach, you can still support healthy blood sugar levels and reduce risks of complications in the post-menopausal years:

1. Strengthen Your Muscles

• Prioritize resistance training to maintain muscle mass and improve insulin sensitivity. This is especially important as muscle naturally declines with age.
• Incorporate weight-bearing exercises like walking or yoga to support both blood sugar and bone health.

2. Focus on Anti-Inflammatory Foods

Post-menopause often brings more systemic inflammation, which can worsen insulin resistance.

Combat this with anti-inflammatory foods, such as:

• Fatty fish (salmon, mackerel, sardines) for omega-3s.
• Berries, leafy greens, and cruciferous vegetables like broccoli and cauliflower for antioxidants.
• Healthy fats like olive oil, nuts and seeds.

3. Address Fat Redistribution

If abdominal fat is becoming a concern, focus on reducing visceral fat through:

• Intermittent Fasting: Focusing on meal timing, such as eating breakfast later, can improve insulin sensitivity and help with fat loss.
• Portion Awareness: Avoid overeating even healthy carbs like whole grains or starchy vegetables.
• HITT: Incorporate High Intensity Interval Training, which includes short bursts of intense activity followed by recovery periods—can help women at all stages of menopause manage body composition, particularly abdominal and visceral fat, while improving overall metabolic health.
• Afternoon Exercise to Increase Fat Burning: Research indicates that training in the afternoon can help burn more fat, so workout in the afternoons to maximize your exercise outcomes.

Menopause: Moving Forward With Confidence

Perimenopause and menopause bring changes that can make managing blood sugar more challenging, but they also offer an opportunity to take charge of your health.

While post-menopause brings lasting hormonal changes, it also offers an opportunity to build a long-term plan for optimizing your health.

By focusing on optimizing your nutrition, regular exercise, stress management and good quality sleep, you can significantly improve your blood sugar control during this transitional time.

With the right strategies, you can navigate this phase of life with confidence and enjoy improved health and well-being well into your later years.