Managing Diabetes Through Menopause Part 1

What is menopause?

Managing diabetes through menopause can be challenging. But first, it's important to understand exactly what menopause is. Menopause happens when a woman's reproductive hormones, estrogen and progesterone, decline naturally with age. Menopause is achieved when a woman has gone for twelve consecutive months without a menstrual period. Prior to this, women go through ‘perimenopause’ which is the years leading up to menopause.

During perimenopause, hormone levels decrease which can cause irregular periods and symptoms like hot flushes, insomnia, mood changes, night sweats, breast tenderness, fatigue and vaginal dryness.

When does menopause happen?

Menopause typically occurs around age 51-52 in Australia, and women can spend about half their lives in this stage. This prolonged period makes it crucial for women to be informed and supported. Medical treatments are available to manage symptoms.

What changes in the body during menopause?

Besides hormonal changes, menopause brings other physical changes that can impact glucose levels. These include:

• Loss of bone density increasing the risk of fractures.
• Decreased muscle mass which can slow metabolism and weaken joints.
• Weight gain, especially around the abdomen, which can worsen insulin resistance.
• Hot flushes and night sweats which can disrupt sleep, raising glucose levels.
• Increased risk of heart disease due to changes in cholesterol and blood pressure.
• Higher susceptibility to urinary and vaginal infections due to vaginal dryness and altered bacteria.

People with diabetes taking SGLT2-inhibitor medications such as empagliflozin (Jardiance) and dapagliflozin (Forxiga) are at even higher risk of urinary and vaginal infections due to these medications causing more glucose to be flushed out in the urinary tract.

It's common to experience mood disorders like depression and anxiety during menopause. These issues can stem from hormonal changes affecting mood or from dealing with the uncomfortable and unpredictable symptoms of menopause. For instance, the Australian Menopause Society found that women experiencing moderate-to-severe hot flushes and night sweats were three times more likely to have moderate-to-severe depressive symptoms compared to others.

Read more about your mental health and wellbeing.

With all the physical changes that occur after menopause, it is not surprising that a woman may first be diagnosed with type 2 diabetes during or after menopause. Research indicates that going through menopause at a younger age increases this risk. These findings highlight the importance of managing both physical and emotional health during menopause and staying informed about potential health risks.

While some of these physical changes are a natural part of aging and unavoidable, there are actions you can take to reduce the impact on your health. Stay tuned for part 2 of this feature to learn some practical tips for managing diabetes through menopause.

Remember to reach out to your diabetes team if you need support. You can find support, understanding and expert knowledge through making an appointment with our diabetes health professionals through the Diabetes Victoria Clinic.