The Challenges Of Menopause For Women With Diabetes

In 1900, when a woman’s life expectancy was 40 years, menopause was a sign of inevitable decline for anyone who lived long enough to experience it.

Now, many women live into their eighties and menopause has become a right of passage into a new, often vibrant and fulfilling phase of life.

“After working with thousands of women who have gone through this process, as well as experiencing it myself, I can say with great assurance that menopause is an exciting developmental stage—one that, when participated in consciously, holds enormous promise for transforming and healing our bodies, minds, and spirits, at the deepest levels,” writes Christiane Northrup, M.D. in The Wisdom of Menopause.

The Challenges

While menopause is no longer a transition to dread, it may present special challenges for women with type 1 or 2 diabetes. Anticipating possible problems and addressing those that arise will help maintain overall well-being.

The challenges to watch for are:

• Glucose Variability. Unexpected blood sugar fluctuations may occur since changes in estrogen and progesterone levels alter the way cells react to insulin.
• Weighty Issues. During and after menopause some women tend to put on weight. The added pounds can lead to increased insulin resistance and possibly the need for stricter monitoring or diabetes medication. Additional weight also increases the risk of elevated blood pressure and heart disease.
• Infection Risk. Diabetes puts women at increased risk of vaginal and urinary infections. The risk of infection is significantly higher during menopause since having less estrogen in the body makes it easier for yeast and bacteria to multiply in the urinary tract and vaginal areas.
• Pleasure Problems. High blood sugar can damage nerve cells, including those in the vagina. Thinning and inflammation of the vaginal wall may occur because of this nerve damage, making arousal and orgasm achievement more difficult. These issues can be exacerbated by the vaginal dryness that sometimes accompanies menopause.
• Nocturnal Annoyances. Menopausal women may have their sleep interrupted by night sweats or hot flashes, and poor sleep can impact blood sugar management.

Meeting the Challenges

As usual with diabetes, the primary way to meet its challenges is making healthy lifestyle choices such as eating well, staying active, and limiting alcohol consumption. These same wise choices will also help minimize any discomfort owed to menopause. Women should also:

• Consider monitoring glucose levels more often and keep a log that includes both diabetes and menopausal symptoms (e.g., hot flashes, mood changes, fatigue). This will help you, and your doctor determine how your blood sugar reacts to the hormonal changes occurring, and what treatment adjustments to implement.
• Get help for uncomfortable menopause symptoms such as insomnia, vaginal dryness, or hot flashes. A doctor might recommend vaginal lubricants, for instance, or discuss the pros and cons of hormone replacement therapy. Other options are herbs such as maca, Pueraria mirifica, and black cohosh that help some women navigate through menopause with greater ease.
• Get plenty of vitamin D to maintain bone density, since bone thinning may increase during menopause. If you do not acquire enough from sunshine and milk products, a quality vitamin D supplement may be in order.
• Ask your doctor about the advisability of increased A1C, blood pressure, cholesterol, and bone density screenings.

With good self care, women with diabetes can traverse menopause knowing that the best adventure of their life may lie ahead.

“According to Chinese and ancient Ayurvedic medicine, at age 60, women end their householder life and begin to develop their souls. Our fertility stops being about having children and starts being about what we create for ourselves that benefits us and the people around us.” ~ Christiane Northrup, M.D.

Sources: Diabetes; Dr Northrup; Dr Northrup
Photo credit: Gareth Williams