Blood-sugar balance is a hot topic when it comes to health and wellness – but how does it actually affect our health, and why is it particularly important to be mindful of this balance during perimenopause and menopause?

What are blood sugar levels?

Sugar is a type of carbohydrate, and when we eat carbohydrates, they are broken down into the simple sugar, glucose by our digestive system. Glucose then enters our blood stream, triggering the release of the hormone insulin, which helps to manage rising blood sugar levels by directing glucose into cells, where it is used for energy. While glucose is an important fuel for the body, if the concentration of glucose is too high in the body, it can be very problematic, leading to complications such as insulin resistance and diabetes.

When we talk about “blood sugar balance” we are referring to maintaining a steady release of energy into the blood stream, as opposed to the rollercoaster of sugar “peaks and crashes” that are hallmarks of an imbalance of blood sugar and can contribute to a number of different health concerns.

Some common signs of blood sugar imbalance often include:

• Fatigue
• Mood swings
• Brain fog and poor concentration
• Weight gain
•  Sugar cravings
• Headaches
• Disturbed sleep

Several of these symptoms are also commonly experienced by women going through menopause transition, so we can see that imbalanced blood glucose levels have the potential to exacerbate these symptoms.

How can hormones affect blood sugar levels?

During a woman’s reproductive years, the level of the sex hormone oestrogen rises and falls fairly predictably throughout the menstrual cycle. In perimenopause, levels of oestrogen and progesterone start to fluctuate greatly before your ovaries stop producing oestrogen altogether at menopause (when you have had an absence of periods for 12 months).

Oestrogen helps to optimise insulin. Typically, premenopausal women have increased insulin sensitivity (meaning their bodies use insulin effectively) and lower levels of diabetes when compared to men of the same age. However, after menopause, this advantage disappears due in part to the reduction of oestrogen in the body. Reduced oestrogen levels can lead to insulin resistance, which is when your body does not respond to insulin as effectively and blood sugar increases.

Can imbalanced blood-glucose levels affect menopause symptoms?

In a word, yes. Fluctuations in blood sugar levels are known to affect a number of symptoms associated with menopause. For example, high bloods sugar levels can contribute to fatigue and lethargy, whilst low blood sugar promotes mood imbalances and can disrupt sleep.

Hot flushes

Hot flushes and night sweats, known as vasomotor symptoms, are two of the most characteristic symptoms of menopause, affecting up to 80% of women. Oestrogen plays an important part in glucose transport to the brain, but during menopause, the decrease in oestrogen can inhibit this process. This triggers an overexaggerated neurovascular response, causing blood vessels to expand as the body tries to increase the flow of blood containing glucose and oxygen to the brain, which can also cause uncomfortable feelings of heat.

Low blood sugar can amplify this cascade of events, where dips in glucose between meals can trigger hot flashes. High blood glucose levels and accompanying insulin resistance have also been linked to more frequent and severe hot flushes, so we can see that maintaining balanced blood-glucose levels is key in the management of hot flushes in menopause.

Weight gain

Fluctuations in levels of hormones during perimenopause can impact hunger, weight gain and fat distribution. In a woman’s menstrual years, she will often gain weight around the thighs and buttocks in the form of subcutaneous fat, but during and following menopause women tend to gain weight around the middle. In a vicious cycle, this fat, known as visceral fat, has been shown to negatively affect insulin sensitivity – but the good news is that regular exercise and dietary changes (as below) are effective strategies to reduce visceral fat.

How to support balanced blood sugar through menopause

Diet

It is important that most of the carbohydrate sources we choose result in a slow rise of blood sugar levels to give us energy over a longer period of time. Consuming a healthy diet with low levels of sugar and refined carbohydrates, along with plenty of fibre, protein and healthy fats will help to balance blood sugar levels and maintain a healthy body weight.

Exercise

Moderate daily exercise brings a plethora of benefits to both body and mind. In terms of helping to balance blood sugar levels, regular exercise helps your muscles burn glucose and fat thus lowering blood glucose levels, may help in maintaining a healthy body weight, and can make your body more sensitive to insulin. Exercising regularly can also release endorphins, the happy hormones, which can help to alleviate mood imbalances in menopause.

Weight bearing and resistance training exercises are particularly supportive in menopause to support musculoskeletal health. Even going for short walks after a meal can reduce postprandial glycaemic response, as well as supporting digestion and giving mood-boosting benefits.

Manage stress levels

When we experience stress, the body releases the hormone cortisol which can increase glucose levels in the blood stream. Prolonged and unresolved stress can increase insulin resistance and contribute to weight gain, as well as exacerbate menopausal symptoms such as hot flushes.

Learning to relax through meditation, deep breathing, regular exercise and mindfulness techniques are extremely important to help manage and control stress for women transitioning through menopause.

Support healthy sleep

As with chronic stress, disrupted sleep can increase levels of cortisol, and have knock-on effects to our blood sugar balance. Insomnia and disturbed sleep patterns are extremely common in menopause and links have been reported between later bedtime routines and poor quality of sleep with higher blood glucose levels and poorer blood sugar control.

Please see our recent “ask the expert” for tips to support a healthy night’s sleep.

Nutrients

• Herbs and minerals such as cinnamon and chromium can help to support healthy blood glucose levels
• Vitamin D deficiency is considered a risk factor for type II diabetes, and ensuring a healthy vitamin D level can improve the body’s responsiveness to insulin
• Gymnema Sylvestre is a herb used to support blood sugar balance in the Ayurvedic medicine tradition of India.
• Magnesium can help to promote healthy insulin production and improved insulin sensitivity, as well as having a supportive role in many of areas of health associated with menopause such as bone health, mood balance and sleep.