The menopause for women with diabetes

What is the menopause?

The menopause simply means end of menstruation. It is generally defined as not having a menstrual period for 12 months in a row. The menopause may be natural or it may occur after a hysterectomy (surgical removal of the uterus). The usual age for women to stop menstruating is between 45 -55 years.

Signs of Menopause

The first signs can appear six yrs before hand and can be quiet subtle. They include:

  • Mood changes
  • Disturbed sleep
  • Depression and headaches
However, typical symptoms include
  • Irregular periods
  • Hot flushes
  • Night sweats
Other symptoms are vaginal dryness, loss of sex drive, loss of skin sensitivity and bladder problems. These problems will be made worse by high blood sugar levels.

The effect of menopause on the body

Hormonal changes

The menopause and the years leading up to it when your body gradually produces less oestrogen and progesterone. These hormonal changes can affect blood sugar levels differently for each individual. Many women notice their blood sugar levels fluctuate more, and are less predictable than before. The hormonal changes as well as swings in blood sugar levels can contribute to mood changes, fatigue and hot flushes.

Weight watch

Women need to be extra vigilant about their weight during the menopause as the natural tendency during this stage is to store fat for later in life. Any weight gain will increase “insulin resistance” making diabetes control harder to maintain. This may mean increasing your medication.

When women gain weight during or after the menopause the distribution of where it settles changes.

Extra weight gain before the menopause will settle evenly over the hips, bottom and thighs and arms. After the menopause it tends to lie around the middle. Hence the origin of the “middle age spread”.

Ways of decreasing the impact of the menopause

Exercise

Staying active can help with symptoms by improving your mood and overall well-being. Regular exercise, particular weight bearing exercise i.e. walking will help strengthen bones and minimise weight gain.

Diet

Optimal nutrition is important during the menopause. Consuming more vegetables and soy products may also decrease the discomforts associated with the menopause

HRT Treatment

What is it?

Hormone Replacement Therapy (HRT) is designed to increase levels of the female hormone oestrogen which fall as women go through the menopause.

HRT can alleviate the side effects of the menopause while others may find that changing their diet and adopting a complimentary exercise lifestyle works best for them.

What are the health risks?

It is important to understand that HRT is not suitable for everyone and to be aware that there are other treatments available. Women with diabetes should only decide on HRT after discussion with their doctor/nurse taking into account their medical history, family risk factors and personal preferences.

HRT is not suitable for women who:

  • Have or have had breast cancer
  • Experience abnormal vaginal bleeding
  • Have or have had treatment for blood clots
  • Have liver problems
Women who require special requirements are:
  • Mothers or sisters who have had breast cancer or ovarian cancer
  • Cardiovascular risk factors (e.g. high blood pressure, diabetes, high lipids, angina).

APP/KOL/AC 16/03/2007