All women know about the changes that occur when the levels of our hormones change, whether at menstruation or the transition through menopause.

What you may not realise is that just like with your menstrual cycle, changes in the levels of oestrogen and progesterone will affect how you respond to insulin.

The fluctuation in your hormones is irregular and erratic through menopause and can cause problems with increased diabetes risk, or with diabetes management if already diagnosed.

One thing that is common for most women at menopause is that they put on weight and apart from a genetic predisposition, is one of the biggest risk factors for diabete.

Given that, and for its many other benefits, watching your weight is a sensible precaution at menopause to reduce your risk for many health conditions.

However, don’t think just because you are slim and not overweight that you may not still be vulnerable to diabetes.

Hot flushes are not just a nuisance, they can also affect your sleep, particularly if you also have night sweats. That is stressful and poor sleep can make your blood sugar levels skyrocket, something you really want to avoid to reduce your risk of diabetes.

Signs and symptoms of diabetes

If you have a family predisposition, or have put on a lot of weight, then your doctor will want to test you but it can help to be on the lookout for some of the telltale warning signs like these:

Hunger and fatigue.Your body converts the food you eat into glucose that your cells use for energy. But your cells need insulin to bring the glucose in so if your body doesn’t make enough or if your cells resist the insulin your body makes, the glucose can’t get into them and you have no energy.

This can result in you feeling more hungry and tired than usual.

Peeing more often and being thirstier. The average person usually has to pee between four and seven times in 24 hours, but people with diabetes may go a lot more.

Normally your body reabsorbs glucose as it passes through your kidneys, but diabetes pushes your blood sugar up, and your body will try to get rid of the extra by making more urine.

At menopause women do notice they are generally peeing more, or having bladder control issues, and the more fluid goes out then you have less fluid to make urine.

This is Catch-22 because when your body wants more liquid, you drink more, and you then pee more.

Dry mouth and itchy skin. Loss of moisture is common at menopause often related to lower oestrogen levels, and you are using vital fluids to make pee, there’s less moisture for other what the body considers non-essentials.

This means could get dehydrated, and your mouth may feel dry as well as your skin feeling more dry and itchy.

Blurred vision should always be checked. It may be age is just meaning a change of glasses is needed, but also the changing fluid levels in your body could make the lenses in your eyes swell up.

So what can occur is that they can change shape and lose their ability to focus.

How to minimise your risk

At perimenopause women start noticing hormonal changes, some related to diabetes but others just part of the normal cycle. Other than a genetic disposition – family history – the greatest risk factor is happily also the one you can most easily control.

Women do naturally put on weight as the decline of oestrogen begins and so the body shifts production into the fat cells. Unfortunately it tends to settle around the abdomen, stomach and thighs where we really don’t want it.

The more weight you put on the more your risk, not just of diabetes as it is is directly related to increased weight, but also of oestrogen dominance.

One of the symptoms of oestrogen dominance is increased body fat which increases the diabetes risk. As if diabetes wasn’t uncomfortable enough, now you can add hot flushes and night sweats to the hormonal mix.

These can cause big problems with sleeping soundly, which in turn can make your blood sugar levels skyrocket, especially if stress affects your diabetes.

Three simple tips to reduce your risk

Diabetes is often, but not always, related to weight increase so if you can take these self-help measures you will do a lot to minimise your risk.

Deal with oestrogen dominance by rebalancing your hormones with bioidentical progesterone. Although oestrogen levels decline at menopause they do continue in a reduced form, but the progesterone that is the body’s natural balancer to excess oestrogen ceases almost entirely.

This was not a problem in the past as women did not have artificially increased levels of oestrogen through synthetic hormones such as HRT and also in the food chain through the increased use of growth promotors in meat and the xenoestrogens present in the environment.

Keep your weight at the right balance for your age and body type and find a diet that you will stick to. Extreme diets are not helpful, but a natural one based on sound nutrition, and that you can easily incorporate into your daily routine is the best.

Exercise has so many health benefits, particularly at menopause, to help with heart disease and diabetes. Exercise does not have to be hot and sweaty and that’s the last thing you need if you are flushing!

Little and often works well, whether that is walking, dancing, tai chi, swimming, yoga, the gym – the choices are endless, so just choose one or two that will help you stay fit, lose weight and have fun.

What if you are already diabetic at menopause?

Unfortunately the many symptoms that start around perimenopause can make it harder to control your diabetes.

You may have hormonal mood swings and ‘brain fog’ that can make it harder to maintain your normal dietary routine or medication. Also, you can experience an increase in insulin resistance due to the weight gain related to excess oestrogen.

There is no doubt that for many women menopause can be stressful, and that can cause an increase in blood sugar swings.