Menstrual cycles and type 1 diabetes (T1D) have a lot in common: they can be unpredictable, inconsistent from person to person, and physically challenging. For Women’s Health Month, Breakthrough T1D is taking a closer look at how periods and menopause may influence blood sugar.
What happens during the menstrual cycle?
Most girls get their first period around age 12. Then, each month, the ovary releases an egg; if it doesn’t get fertilized, it’s reabsorbed, and the lining of the uterus is shed as a period. This cycle continues unless the egg is fertilized, after which it implants into the uterine lining (and periods stop). At the end of a woman’s reproductive window between ages 45 and 55, known as menopause, periods stop permanently, and pregnancy is no longer possible.
These complex processes are driven by a conversation between a woman’s brain, ovaries, and uterus, which is controlled by different hormones released at different times. These hormones—such as progesterone and estrogen—may significantly impact blood sugar.
Life with T1D and periods
Women with T1D are more likely to experience longer and irregular periods. More than one-third of teenage girls with T1D—especially those diagnosed before their first period—may have abnormal menstrual cycles. Because 50-60% of people are diagnosed before the age of 15, many women and girls will experience this.
The hormonal culprits responsible for these irregularities affect blood sugar differently depending on the menstrual cycle stage. Progesterone, which is elevated leading to the next period, may increase insulin resistance and the risk of hyperglycemia, especially compared to after the period ends.
The role of estrogen is less clear: it may increase insulin sensitivity—especially when levels are rising post-period—or have no effect at all.
Pregnancy Guide
Get guidance and support on all stages of pregnancy, from pre-pregnancy
planning to juggling T1D as a new mom.
What about menopause?
On average, women diagnosed with T1D before their first period may have a three-year reduction in reproductive lifespan compared to women without T1D—meaning earlier menopause.
As if the barrage of symptoms—including mood swings, brain fog, and sleep issues—weren’t enough, women with T1D might encounter unpredictable blood sugar because of decreasing estrogen and progesterone. Even more, menopause and hypoglycemia can have overlapping symptoms, so special attention is needed to prevent dangerous lows.
Putting it all together
While further scientific studies are required to better understand how hormonal changes affect T1D, there are things you can do to manage your blood sugar more easily.
First, work together with your healthcare team to track blood sugar levels during different menstrual cycle phases or menopause to identify patterns and know what to expect. Women with T1D who take hormonal birth control may have different considerations.
Next, the usual: exercise, eat healthy, and get good sleep. Carefully consider your diet right before your period; while you may crave sugar and carbs, you may also be more susceptible to hyperglycemia, so proceed with caution.
Finally, be kind to yourself. Life with T1D can be hard. Periods and menopause can be hard. Just remember—you’re not alone!
