Did you know that blood sugar (glucose) levels are directly related to hormones like estrogen and progesterone? While we are in our reproductive years, estrogen and progesterone follow a mostly predictable pattern. As we move into our mid-40s and 50s, these hormones start to shift and swing. Because estrogen and progesterone act on the pancreatic cells that control glucose release in the body, changing hormones can affect blood sugar levels.
When hormones change, it can result in blood sugar dysregulation and various unpleasant symptoms. This post will discuss how hormones affect blood sugar, the symptoms resulting from blood sugar dysregulation, risks for insulin resistance and diabetes, and how to keep it all balanced.
How does glucose regulation work?
The pancreas is the star of this show, secreting insulin from the pancreatic beta cells and glucagon from the alpha cells. After we eat, food is broken down into glucose, which enters the bloodstream. Insulin is secreted in response to glucose in the blood. Insulin is a key that opens up our cells to let glucose in so our cells can use it as fuel. We want glucose to enter the cells instead of hanging out in the bloodstream. High blood glucose can damage blood vessels and lead to conditions like insulin resistance and type 2 diabetes over time.
The alpha cells of the pancreas secrete glucagon. This hormone tells our body to break down our stored glucose when cells need energy. This might occur when we haven’t eaten in a while and are asking our bodies to do something active. This process can also be impacted by changing hormones and dysfunction may result in low blood glucose. (1)
What effect do estrogen and progesterone have on glucose?
Estrogen and progesterone interact with alpha and beta cells and contribute to the efficiency of the glucose regulation process. (2) So it’s not surprising that when those levels fluctuate or we experience a significant reduction in those hormones as in perimenopause and menopause, blood glucose regulation doesn’t work nearly as well as it once did.
What is insulin resistance?
Insulin resistance develops when our cells become unresponsive to the signals of insulin. This can occur with medical conditions such as PCOS or if the influx of dietary glucose over time is consistently more than the cells can take in.
Essentially the insulin ‘key’ no longer works. And glucose stays in the bloodstream instead of being admitted into the cells.
As a result, blood glucose levels can stay high after we have eaten. This is a major cause of type II diabetes.
How does perimenopause affect blood sugar?
Perimenopause is the time leading up to menopause when a woman’s hormone levels start to decline. This can cause a variety of symptoms, including hot flashes, night sweats, mood swings, and difficulty sleeping. It can also lead to changes in blood sugar levels.
Because of the influence of estrogen and progesterone on alpha and beta cells in the pancreas, when these hormones swing up and down in perimenopause the balance of blood glucose can become similarly erratic. As such, we are more at risk for low and/or high blood glucose. (3)
The disruption of sleep is very common during perimenopause due to the changes in progesterone and the prevalence of night sweats. A reduction in the quality of sleep is also known to affect blood glucose levels. According to a study, many factors may be in play here including decreased activity due to fatigue, increased appetite, and changed glucose metabolism (4)
What are the symptoms of blood sugar dysregulation?
There are a variety of symptoms that can be caused by blood glucose dysregulation. These include:
- fatigue
- brain fog
- cravings for sugary or starchy foods
- anxiety
- irritability
- frequent urination
- excessive thirst
- insulin resistance
- shakiness when having gone some time without eating
What can I do to balance my blood sugar?
There are a few things you can do to help balance your glucose levels:
Eat a balanced diet:
Eating meals that contain protein, fat, and fiber help to prevent glucose spikes and keep sugar levels in your blood even. Complex carbohydrates containing these macronutrients digest more slowly and as a result, send glucose into the bloodstream at a more steady and manageable pace.
Exercise regularly:
Exercise helps to increase insulin sensitivity, which can help to regulate blood glucose levels. It also helps to use up any excess glucose that may be in the bloodstream. Current recommendations are for about 30 mins of exercise 5 days a week including a mix of strength training sessions and cardio.
Improve sleep quality:
Practicing good sleep hygiene can help improve sleep. Turning off electronics at least an hour before bed, keeping your room dark and cool, and avoiding alcohol before bed are all effective strategies.
Managing Stress:
Managing stress can be done through a variety of methods such as exercise, yoga, meditation, and spending time in nature.
If you are experiencing any of the symptoms listed above, it is important to speak with your doctor to rule out any underlying health conditions. Once any underlying health conditions have been ruled out, you can work with a nutritionist on balancing your blood sugar levels through diet, lifestyle changes, and supplements.
References
- How Estrogen Therapy Could Prevent Type 2 Diabetes. 6 Apr. 2018, https://www.medicalnewstoday.com/articles/321421.
- Lee, Sang R., et al. “Progesterone Increases Blood Glucose via Hepatic Progesterone Receptor Membrane Component 1 under Limited or Impaired Action of Insulin.” Scientific Reports, vol. 10, no. 1, Oct. 2020, p. 16316. www.nature.com, https://doi.org/10.1038/s41598-020-73330-7.
- Insulin and Glucagon: How They Regulate Blood Sugar Levels. 27 Mar. 2019, https://www.medicalnewstoday.com/articles/316427.
- Knutson, Kristen L. “Impact of Sleep and Sleep Loss on Glucose Homeostasis and Appetite Regulation.” Sleep Medicine Clinics, vol. 2, no. 2, June 2007, pp. 187–97. PubMed Central, https://doi.org/10.1016/j.jsmc.2007.03.004.
