Diabetes and Menopause: A Combo Challenge

If you're going through menopause, you're undoubtedly familiar with moodiness, sleep
difficulties, and hot flashes. If you have Type 2 diabetes, you've got a few additional concerns. Here's what you can expect during menopause-and what you can do to stay fit and healthy.

Your blood sugar may begin to fluctuate for no apparent reason. Two hormones—estrogen and progesterone—both have an effect on how your cells react to insulin. After menopause, when the levels of these hormones change, your blood sugars can easily get out of control. Those fluctuating blood sugars are worth paying attention to, says Joy Elwell, DNP, FNP-BC, FAANP, Region 2 director of the American Academy of Nurse Practitioners. You should check your blood sugar a bit more often, and try to keep records of your readings and symptoms of low or high blood sugar. Besides adjusting your medications, your doctor may advise you to get regular hemoglobin A1C tests that will show what your average blood sugar levels were for the last several months.

Weight gain is common during menopause, and it can be frustrating to eat the way you always have and still put on pounds, and to feel that you're depriving yourself to no avail. "Our metabolism slows down and we don't need to eat as much as we once did," Elwell says. "Weight gain can occur if you are eating the same amount of food but getting less exercise." Your doctor may refer you to a dietician who can help develop a weight loss plan that's still diabetes-friendly.

Physical activity can also become more challenging, Elwell says. Some women begin developing osteoarthritis, the normal arthritis of aging, and find themselves reluctant to exercise because of all the new aches and pains. But the best way to keep your weight in check is to eat a healthy diet and get regular physical activity, she says.  Start gradually but keep at it, she advises. "Just losing 7 percent of your body fat and getting 150 minutes of moderate physical activity per week can make a difference," she says.

If you've had diabetes for awhile, you may already have some nerve damage, and this may cause problems with sexual arousal. In addition, vaginal dryness, which is very common in women during menopause, can affect your sex life even more adversely by making sex painful. Talk to your doctor-he may suggest a lubricant to restore moisture to the area or recommend vaginal estrogen therapy that will help with vaginal atrophy, a condition marked by thinning and inflammation of the walls of the vagina.

You are at increased risk for cardiovascular disease because you have diabetes, and that risk goes up when you enter menopause, Elwell explains. But you can cut the
risk by eating well and exercising. If your cholesterol level is high, your doctor may even prescribe a cholesterol-lowering medication.



"Menopause and diabetes: A twin challenge." Mayo Clinic.