Does Menopause Affect Blood Sugar?

Dr Jedha, Host

Hello wonderful people, Dr Jedha here and thanks for joining me for episode 99.

During my twenties, I always remember my mom and aunties saying, look after yourself because it gets much harder to lose weight as you get older. They all knew this to be true but back in those times, discussions about why, about menopause were taboo. In fact, my mom probably never knew why the belly fat kept getting worse over the years. Many women put it down to age, just getting older, that was the common narrative. I remember my dad even asking me once, why has your mom put a lot of weight on around the middle? Menopause and the changes that occur, it wasn’t a subject anyone really spoke about openly. But women knew. Among other things, they noticed their energy wasn’t the same and the weight seemed harder to manage. No, these changes were not in their head, or yours if you’re experiencing this now. And no, these changes were not just because of age. Of course our bodies can change with age, but it’s not just age. Menopause can have a real impact on our entire metabolism and life. 

On Oct 18th 2025, it’s World Menopause Day, so being that’s later this week and close to the time of releasing this podcast, it seems like a fitting topic to cover. Being educated about the changes that occur in menopause is important, so we can combat the effects. In particular we’ll be exploring a commonly asked question: Does menopause affect blood sugar? The short answer is absolutely yes, it does. But let’s not stop there, let’s explore why and what happens in our bodies that sparks these changes. 

Let’s start by looking at what menopause actually is. Well, firstly, rather than it being one event, it’s better to think of it as a transition in life, similar to when we went through puberty and our ovaries became active with more hormones, we go through a menopause transition where hormones decline and shift. So when have you actually entered the menopause transition? Well, you’ve officially entered the early menopause transition when you have equal to or more than 7 days difference in cycle length of consecutive menstrual cycles. When you have equal to or more than 60 days between periods, you’re in the late menopausal transition. You’ve reached menopause when you stop having a period for 12 months, then you’re in post-menopause. These are the official criteria, but many women and researchers would agree that the effects of the menopause transition can hit women, well before they ever see a 7 day difference in their period cycle. Throughout this process, hormones like estrogen and progesterone can fluctuate unpredictably, creating a rollercoaster effect that disrupts women on many levels. It is actually a whole body transition. I guess if you think of it in the context of puberty, think of all the things your body went through and eventually the onset of periods. Now in a sense, it’s in reverse, the body goes through a major transition. 

One of the most significant changes is that estrogen levels get lower and our hormones shift. Estrogen has protective and regulatory effects on our metabolism, so these shifts can have significant effects on our metabolism, and in terms of blood sugar this drop in estrogen influences insulin and carbohydrate metabolism, how our bodies process and store glucose.

Studies show conflicting results about beta cells in the pancreas, some studies show they can become affected, slowing down the production of insulin; while others show increased insulin production, either way, this will influence insulin sensitivity and blood sugar control. During this time, our muscles become less responsive to insulin while at the same time we can experience as much as 15% loss in lean muscle mass over this transition, if we do nothing about it. That’s problematic because our muscles are a huge absorber of glucose from the bloodstream, so if we don’t have as much muscle or muscle isn’t absorbing glucose effectively we have more glucose lingering in the bloodstream. As a result, many women can see higher blood sugar levels. 

At the same time, the liver starts producing more glucose than we may need. This happens because insulin isn’t working as efficiently in the liver, so the body keeps making and releasing glucose, even when it’s not necessary. This has a significant effect on fasting blood sugar levels, which research shows are one of the most common areas women experience higher than normal levels. 

Then we have changes in fat storage. With lower estrogen, insulin role in regulating fat metabolism also changes, leading to more fat breakdown and larger fat cells that release inflammatory markers and contribute to insulin resistance. Women’s bodies also change how they store fat, with fat redistribution, so it’s common to start seeing fat storage move to the abdomen area. This fat redistribution is particularly problematic for our entire system. This belly fat, called visceral fat, is highly active in producing inflammatory chemicals that can further worsen insulin resistance and blood sugar control. As a result, many women can see higher blood sugar levels. 

Studies also show women have changes in their gut microbiome during this transition, and we know that gut health has an impact on many aspects of our health, including blood sugar regulation, insulin resistance, inflammation etc. And yes, slowing of our whole metabolism is a very real consequence too. During the menopause transition, the bodies energy expenditure naturally declines. Due to the decline in estrogen, loss of lean muscle mass, the amount of calories burned at rest, our basal energy needs, are lower by 50–100 kcal/day, according to research. While that might not sound like much, it adds up. And there are other factors that influence the bodies cells that result in ess efficient energy metabolism; the reduction in hormones like estrogen and progesterone can also alter appetite-regulating hormones that may lead to overeating – and combined with everything we just talked about, the loss of muscle, the visceral fat, the insulin resistance, this is why many women notice weight gain (especially around the belly) even if they haven’t changed how they eat or move. 

Collectively, all of these changes can lead to higher fasting and postprandial blood glucose, greater blood sugar variability, and a higher risk of developing prediabetes and type 2 diabetes, independent of aging itself, because as we established, it’s certainly not just an age thing, the effects of the menopause transition are a well-established research fact by now. 

Now, why does all of this matter so much, not only for women living with type 2 diabetes and prediabetes, but even for those who may not yet have blood sugar issues? Well, menopause is often a turning point for our metabolic health.

When estrogen declines and insulin resistance starts to rise, our bodies are less able to manage glucose efficiently. For women who already have prediabetes or type 2 diabetes, this can mean blood sugar levels creep higher, A1c rises, medications sometimes need adjusting if you’re taking them, and you’ll need to be even more proactive and committed to quality nutrition and making lifestyle changes.

But even for women who have never been told they have blood sugar problems before, this stage of life can be the very first time those changes start to show up. You can suddenly find out your fasting glucose is edging into the prediabetes range, or notice stubborn weight gain around the middle that just won’t shift even though you’ve made no changes to what you eat. And yes, these changes can put you at risk of developing prediabetes or type 2 diabetes 

According to research, there are several metabolic indicators that many women that get diagnosed with type diabetes commonly show and these are, higher body mass index and higher waist circumference – so essentially we’re talking about a higher body weight; then there is high triglycerides, lower HDL levels and high blood pressure, a family history of diabetes, alcohol consumption of 20g or more per day, and smokers. So these are all potential metabolic risk factors to look out for, because if you don’t yet have type 2 diabetes, these could be early warning signs. 

Let’s face it, there’s a lot of changes that go on for women here. Yes, hormone levels change but this brings with it significant effects on our metabolism. The reason these changes matter so much for us, is they aren’t just a blood sugar metric or number in our labs. They can carry very real consequences. Elevated blood sugar in menopause increases the risk of cardiovascular disease, something women are already more vulnerable to after estrogen declines. It also makes it harder to manage weight, energy, sleep, and mood, creating a cycle that can feel incredibly frustrating. So whether you’re already living with diabetes, or you’re concerned about preventing it, this is a crucial time to be proactive about your health.

I know, all of that sounds quite depressing. Hormones are shifting and it might feel like the odds are stacked against us. Yes, these are very real things so the reality is ladies, during this phase of a woman’s life, we need to prioritize our health and our nutrition more than ever before. With the right steps, we can target weight, visceral fat, improve insulin sensitivity and ensure we maintain good blood sugar balance. So let’s walk through a few steps we can take to combat these effects.

First up is nutrition. What we eat is one of the most powerful tools we have, truly, it is. Nutrition feeds and supports every cell, hormone and function in our body. And, during menopause, our bodies need more support than ever. That means eating an abundance of vegetables for their nutrients and antioxidants, plenty of fiber to nurture our gut health, and making sure every meal has quality protein to help preserve muscle mass. Healthy fats like olive oil, nuts, seeds and avocado, also play a big role in reducing inflammation and supporting insulin sensitivity. 

On the other hand, we really want to steer clear of the processed foods, refined carbs, and added sugars that make blood sugar swings worse. It comes down to nutrition quality, focusing on whole, nourishing foods. We covered nutrition and menopause in more detail in episode 77, so I won’t go into detail, you can go listen to that episode. But, I’ll just give a little teaser here: I’ll be sharing more on something I call ‘nourished intervals’ in an upcoming episode, which is a fantastic strategy to target visceral fat and improve insulin sensitivity and blood sugar control.

Next, let’s talk about movement. We know that muscle acts like a glucose sponge, soaking up sugar from the blood and keeping insulin working properly. And the reality…if we don’t use it, we lose it. Remember what I covered at the beginning of the episode, women can lose up to 15% of muscle mass during this transition, unless we’re actively working on it. Whatever you do, don’t get more sedentary, try to get more active. And in terms of muscle health, that’s why resistance training is so important. Lifting weights, using resistance bands, or even bodyweight exercises like squats and push-ups—resistance training is your friend and you gotta do whatever you can here to preserve muscle and get muscle functioning better. Of course, activities like walking, cycling, or swimming are great too, but if you can only do one thing, make sure strength training is part of your week; and if you’re already doing other activities, add in resistance training. It helps blood sugar, metabolism, bone strength, and even mood.

And finally, we can’t forget the lifestyle pieces that tie it all together, things like sleep, stress, and hydration. Poor sleep and high stress push up cortisol, which directly raises blood sugar. So we want to create calming routines before bed, keep the bedroom cool and dark, and find stress-relief practices that actually work for us, whether that’s yoga, meditation, time in nature, or simply saying no to things that drain us. And don’t underestimate water. Staying hydrated helps with energy, digestion, and even appetite regulation.

So, those are the big three, nutrition, exercise and lifestyle. None of us can control the fact that hormones change, but we can control the way we respond. And when we take small, consistent steps in these areas, the payoff is huge. We can manage weight, support our blood sugar, generate higher energy and feel more like ourselves again. 

So…the whole purpose of today’s episode was to answer the question: Does menopause affect blood sugar? And of course we know it does. This menopause transition, which will affect every woman at some stage, can take several years and there are significant changes that occur in our bodies over this time, metabolic changes that all influence blood sugar. 

But, I want to leave you with this reminder: while menopause absolutely does affect blood sugar, it doesn’t mean we’re powerless. The changes we’ve talked about today are real, and they can feel frustrating, but they also give us the opportunity to take charge of our health in new ways. And for us, that means prioritizing our health and recognizing that nutrition, movement, sleep, and stress management aren’t just nice add-ons, they’re powerful tools to protect our blood sugar, our hearts, our bones, and our overall well-being.

So wherever you are in the menopause transition, peri, post, or even just preparing for what’s to come, know that small, consistent steps can make a big difference, they really can. You can feel stronger, more energetic, and more in control of your health. And that’s something worth celebrating, not just on World Menopause Day, but every single day.

If you’re looking to improve your blood sugar during the menopause transition, visit our website and join us as a member. Whether you’re newly diagnosed, you’ve had diabetes for years, or you’re looking at prevention, our program provides proven guidelines, resources and ongoing support that will help you navigate this transition in the best health possible. And if you’re already one of our members, visit the library for this episode, number 99, where we’ll have additional guides and resources for you to explore. 

Remember, small steps, done consistently, really do lead to big changes.

Dr Jedha, over and out.