Originally published in EverydayHealth.com, written by Marijke Vroomen-Durning, RN. Medically reviewed by Lindsey Marcellin, Md, MPH.
How does menopause affect women with type 2 diabetes? Find out about the extra care needed to help you sail through this transition.
Menopause is a topic that often generates a lot of opinions from women — those who welcome it and those who dread it. There’s also a lot of discussion about whether it’s something that should be “treated” or left to occur naturally, without any medications.
For some women, menopause is more than just the end of their child-bearing years. It can have a profound effect on chronic illnesses such as type 2 diabetes. Women with diabetes often have to be more aware of the changes than most other women.
Changes Within “the Change”
If you usually ovulate every 28 days or so, you may have wide variations as you approach menopause. You may have cycles that go 40 days or longer between periods and at other times find that your periods come only a couple of weeks apart. While this is happening, the levels of your hormones, estrogen and progesterone, are changing quite a bit, too. These hormonal changes can affect your blood glucose levels, which for women with type 2 diabetes could cause problems.
To avoid complications from type 2 diabetes, it’s essential to keep your blood glucose levels as even as possible — something that can be tricky during menopause.
Recognizing Menopause Symptoms
Some symptoms of menopause could be confused with signs of too high or too low blood glucose, including dizziness, sweating, and irritability. With symptoms being so similar, it may be hard for a woman to tell which is which. Rather than guessing, you should check your blood glucose levels when you’re experiencing these signs. If the symptoms persist or get more uncomfortable, try talking to your doctor about treatment options.
Women with type 2 diabetes who are overweight may undergo menopause later than their type 1 diabetes peers. It’s been found that estrogen levels in women who are overweight drop more slowly than those who are underweight or of normal weight.
At the Onset
Menopause is also a time when women who didn’t know they had type 2 diabetes may first be diagnosed with it. Brian Tulloch, MD, an endocrinologist at Park Plaza Hospital and Medical Center and clinical associate professor at the University of Texas Medical School in Houston, explains, “The biggest issue here is with certain minorities who have a three- to five-fold higher chances of having type 2 diabetes.” Hispanics, for example, have a higher rate of diabetes than whites, he says. Add to this higher genetic risk the frequency of obesity and the decline of physical activity, and you see why so many women are diagnosed with type 2 diabetes as they begin the onset of menopause.
Health Complications
Women with type 2 diabetes who have gone through menopause may no longer have wild hormonal swings affecting blood glucose levels, but they do have other health issues to keep in mind. They are at higher risk of developing atherosclerosis, the hardening and thickening of the artery walls that can lead to stroke or heart attack. Weight gain after menopause isn’t unusual, but it seems to be more common among women with type 2 diabetes. This adds to the risk of heart disease.
With menopause and a more sedentary lifestyle comes another risk: osteoporosis, the bone-thinning disease. While women with type 2 diabetes aren’t at as high a risk of osteoporosis as those with type 1 diabetes, they do have a higher risk of breaking bones than a menopausal woman who does not have diabetes.
Hormone Replacement Therapy
Hormone replacement therapy (HRT), or hormone therapy, after menopause remains a controversial topic, but could be an option for women with type 2 diabetes who are experiencing difficult menopause signs and having trouble keeping their blood glucose under control.
Studies on HRT safety after menopause have conflicting results, but some doctors seem to be coming around to favoring hormone use again, albeit in a more careful manner. Says Dr. Tulloch, “There’s now a tendency to go against what was believed five years ago, when [the Women’s Health Initiative study of post-menopausal hormone use] suggested post-menopausal estrogen wasn’t such a good idea. I think the pendulum has swung back the other way.”
However, not all doctors agree with this. The general consensus is that a woman should begin HRT only if her symptoms, such as hot flashes, are severe and can’t be managed any other way. If a woman chooses not to go on HRT, she should discuss her diabetes medication with her doctor, as she may need a lower dose than she was on before menopause. Be sure to discuss your individual situation with your own doctor to come to the best course for your well-being.
Menopause involves change for every woman; working with your medical team at this important life passage will help you make the healthiest transition.
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