Menopause and Diabetes: What’s the Link?

Menopause occurs when a woman’s reproductive hormones naturally decline, signaling that she is no longer fertile and unable to naturally reproduce. 

Menopause typically affects women in their late forties to early fifties. 

Once a woman hasn’t had her menstrual cycle for a year, she is said to be in menopause. 

However, women can experience symptoms in the months and years leading up to menopause, which is referred to as perimenopause. 

The production of two key sex hormones in women, estrogen and progesterone, decline sharply once a woman hits menopause, triggering a slew of physical symptoms and changes.

This change in hormones and resulting changes can increase diabetes risk factors. 

Menopause can also cause blood glucose changes in women with existing diabetes, adding a challenge to diabetes management.

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Menopause triggers major hormonal changes, which can make your body more resistant to insulin

Levels of estrogen and progesterone drop steeply once a woman hits menopause, which can make blood glucose (blood sugar) levels increase.

Menopause typically occurs around age 50 for most women. 

Being 45 years or older is a risk factor for developing diabetes by itself, so combining older age and fluctuating hormones can increase the risk of diabetes in menopausal women.

Older age is associated with a natural decrease in metabolism, meaning the body stores more energy and burns less than it used to. 

A slowing metabolism can result in weight gain and increased fat tissue, which can trigger insulin resistance and the progression to type 2 diabetes.

Older women might not be as active as they were in their younger years, which is another risk factor for developing type 2 diabetes. 

Being physically active helps the body respond to insulin more effectively, helping to keep blood sugar levels normal.

Researchers are still on the fence as to how much menopause might cause diabetes or increase the risk of diabetes. 

Instead, studies suggest that aging and a change in sex hormones, regardless of menopausal status, are most likely to blame for any increased diabetes risk. 

However, experiencing early menopause (between age 40-44) has been associated with an increased prevalence of type 2 diabetes.


The changing hormone levels leading up to menopause (perimenopause) are associated with several common symptoms, most notably:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Chills
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

What to expect if you have both

Women with existing diabetes face several challenges once they hit menopause. Some things that might make managing your diabetes more difficult once you hit menopause include:

Weight gain

The changing hormones during menopause might make you more likely to gain weight, especially around your middle. 

Menopause isn’t all to blame, though. 

A lot of the reason women gain weight around menopause is due to natural changes in metabolism with aging, as well as decreased activity level. 

Aging is also associated with a loss of muscle mass and increased fat mass, regardless of menopausal status.

Genetic factors also play a role in menopausal weight gain

If your family tends to carry more weight around their middle, you’ll be more likely to gain weight around your midsection as well.

Changes in blood sugar levels

Fluctuations in hormones during menopause can cause blood sugar changes. 

You might notice your blood sugar levels are harder to control when you go through menopause.

You might also notice your blood sugar levels increasing if you gain weight during menopause. 

Weight gain can make the body more resistant to insulin, the hormone that helps lower blood sugar. 

Increased urinary tract infections

The natural decline in estrogen levels during menopause can lead to vaginal dryness. 

Vaginal dryness makes it easier for bacteria to thrive, which might lead to an increased prevalence of urinary tract infections (UTIs). 

Infections can raise blood sugar levels and should be treated by a healthcare provider.

Women with diabetes are already at greater risk of developing UTIs, so dealing with menopause and diabetes can really increase this risk.

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Sleep disruptions

Menopause can result in hot flashes, making it difficult to get a good night’s sleep. 

Sleep disturbances and poor sleep can worsen insulin resistance, making it more difficult to control blood sugar levels.

Sexual changes

A decrease in estrogen and associated vaginal dryness can make sexual intercourse more painful. 

Diabetes can impact sexual health on its own, which can exacerbate the issue.

What you can do to manage them

Managing menopause and diabetes can be challenging. 

However, there are several things you can do to help manage the potentially negative side effects.

Lifestyle changes

One of the best ways to help promote a healthy weight and healthy blood sugar levels is to focus on sustainable lifestyle changes.


Aim for a balanced diet that includes plenty of fruits, vegetables, whole grains, healthy fats, and lean protein. 

A Mediterranean diet has several health benefits, including a reduced risk of heart disease

Increasing age and diabetes can both increase your heart disease risk.

This is why it’s important to eat a heart-healthy diet.

Cutting back on added sugars is another helpful strategy to manage both menopause and diabetes. 

Added sugars contribute empty calories (calories with minimal nutritional value) and can worsen insulin resistance, as well as contribute to weight gain. 

Aim to keep your added sugar intake below 25 grams per day. Keep your eye out for hidden sugars in foods like soups, condiments, yogurts, and cereals.

Physical activity

Being active helps improve blood sugar levels and can help with weight management. 

Aim to get 30 minutes or moderate intensity exercise most days of the week; walking, swimming, biking, gardening, or anything you enjoy that gets your heart pumping is a great choice!

Check your blood sugar more often

Fluctuating blood sugar levels can make it harder to reach your blood glucose targets. 

Checking your blood sugar upon waking, 1-2 hours after meals, and at bedtime can help you and your healthcare provider identify when blood sugar levels are too high or too low. 

Your medication or other aspects of your diabetes treatment plan might need to be adjusted when you’re managing both menopause and diabetes.

Consider hormone therapy

Some women choose to undergo hormone therapy to help ease some of the menopause symptoms. 

Hormone therapy might help improve blood sugar levels, but whether or not it’s considered safe is dependent on each woman managing menopause and diabetes.

So you should discuss it in-depth with a healthcare provider.

Seek help for other menopausal symptoms

If you’re suffering from vaginal dryness during sex, your healthcare provider may recommend a lubricant to help ease the discomfort. 

If weight gain is your concern, consider consulting with a Registered Dietitian or a fitness trainer to help identify some goals and make a plan to help optimize lifestyle changes.

Whatever the symptom, know that millions of other women experience it too. 

There is help available to make you as comfortable as possible while you undergo the changes during menopause while also managing your diabetes.


Perimenopause is the period of time leading up to menopause, the natural decline in reproductive hormones a woman experiences around age 50. 

Hitting menopause causes many changes in a woman’s body, which can also impact her diabetes risk or blood sugar control if she already has diabetes. 

Aging and going through menopause can increase the risk of developing diabetes.

Lifestyle changes such as eating a healthy diet and being more active, checking blood sugar levels more often, and working closely with your healthcare provider can help you manage menopause and diabetes.

Know that you’re not alone, and there are treatment options available to help as you transition into this new phase of life, which impacts women as they get older.

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  1. Kim C. Does menopause increase diabetes risk? Strategies for diabetes prevention in midlife women. Womens Health (Lond). 2012.
  2. Muka T, Asllanaj E, Avazverdi N, Jaspers L, Stringa N, Milic J, Ligthart S, Ikram MA, Laven JSE, Kavousi M, Dehghan A, Franco OH. Age at natural menopause and risk of type 2 diabetes: a prospective cohort study. Diabetologia. 2017.
  3. Stanhope KL. Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci. 2016.
  4. C. A. Stuenkel (2017) Menopause, hormone therapy and diabetes, Climacteric, 20:1, 11-21, DOI: 10.1080/13697137.2016.1267723

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