Diabetes and menopause, a double challenge

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1. What is diabetes?

Diabetes mellitus includes several related problems due to which the body cannot balance the amount of sugar (specifically glucose) in the blood. Blood glucose provides the necessary energy for the body to deal with the daily activities that a person carries.

The liver converts food consumed by a person into glucose, then glucose is released into the bloodstream. In a healthy individual, blood glucose level is regulated by several hormones, primarily insulin. Insulin is produced by the pancreas that produces other important enzymes that are released into the intestine and helps digestion. Insulin is that that stimulates glucose penetration into body’s cells.

People diagnosed with diabetes either do not produce enough insulin (type 1 diabetes) or insulin is not used properly (type 2 diabetes), or both.

In patients with diabetes, blood glucose cannot move into the cells efficiently so that blood glucose levels remain high. This not only affects the cells that need glucose to release energy, but it also affects certain organs and tissues exposed to high glucose levels.


1. What is diabetes?
2. What is menopause?
3. Causes
4. Diabetes and menopause
5. What to do

2. What is menopause?

Menopause is the time in a woman’s life when menstruation and ovulation stop forever. Menopause is considered complete when menstruation has not been shown at all during one year. Although menopause can occur anytime between 40-58 years, the mean age is 51 years.

3. Causes

Natural menopause is a gradual process. The ovaries begin to release smaller amounts of estrogen and other steroid hormones prior to menopause during a phase called perimenopause. When menopause occurs before the age of 40 it is called premature menopause. Premature menopause can settle naturally, but can be influenced by certain factors such as:
- Family history of premature menopause;
- Autoimmune diseases;
- Abnormalities of chromosomes X;
- Medical treatments (pelvic surgery, surgical removal of the ovaries, chemotherapy, pelvic radiotherapy);
- The use of drugs that have low levels of progesterone;
- Smoking.

4. Diabetes and menopause

The menopause can be a challenge for women who suffer from diabetes. Diabetes and menopause can have different effects on the body, including:

- Changes in blood sugar levels. Estrogen and progesterone affect how cells respond to insulin. During menopause, hormonal changes can trigger fluctuations of blood sugar levels. It may be noted that blood sugar levels will be more difficult to control, considering that their variation is less predictable than before menopause.

- Weight gain. Some women gain weight during menopause transition period and after the menopause is already installed. This may increase the need for insulin or medication used to treat diabetes.

- Infections. After menopause, when there is a decrease in estrogen is also easier for bacteria and fungi to multiply in the urinary tract and vagina, increasing the risk of infection.

- Sleep disorders. After menopause, due to hot flashes and night sweats some women deal with sleep disorders. Sleep deprivation and fatigue can make blood sugar levels difficult to manage.

- Sexual problems. Diabetes can affect the nerves of existing cells in the vagina. Following this, arousal and orgasm will be more challenging. In addition, vaginal dryness (a common symptom of menopause) may worsen, causing pain during intercourse.

5. What to do

Menopause can make diabetes increasingly difficult to control, but there are a number of steps that can be taken to manage both diabetes and menopause.

- Healthy choices. Healthy eating and regular exercise are very important in the treatment plan for diabetes and can make a woman feel much better after menopause.

- Frequent blood glucose measurements. Glucose will be measured more frequently during menopause, during the day and occasionally at night. It is advisable to keep a journal that will contain blood glucose levels recorded during a period of time and the manifested symptoms. Based on this information, the doctor will decide a personalized treatment plan. In addition, the specialist may recommend regular testing of glycosylated hemoglobin (A1C) to determine the average blood sugar over a period of time (several months before the test).

- Changing diabetes regimen. If the average blood sugar increases may need to reduce or increase medication dosage for diabetes or be included in a new drug regimen (especially if there is a weight increase or a decrease of the individual frequency of activities).

- Medications to reduce cholesterol levels. People who suffer from diabetes have an increased risk of cardiovascular disease and the risks increase even more after menopause. For this threat to be reduced, it will eat healthy foods and will exercise regularly. The doctor may also recommend including drugs that will keep control of cholesterol.

- Treatment for menopausal symptoms relief. When there are hot flashes, vaginal dryness, decreased sexual response or specific manifestations of menopause, every woman should know that there is treatment to relieve these symptoms. The doctor may recommend the use of vaginal lubricants to restore vaginal moisture or vaginal estrogen therapy for the treatment of inflammation and vaginal wall thinning (vaginal atrophy). For some women, hormone therapy may be an option.



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