Contributed by Judith Jones-Ambrosini

I clearly remember waking up in the middle of the night drenched with sweat.  Yikes! I thought "What’s going on here?"  In a misty midnight daze of alarm and confusion, I reached for the bg meter on my nightstand to check my blood sugar.  It was 111.  Fine.  I didn’t feel any symtoms of a hypoglycemic episode, so where were these awful sweats coming from?  Perhaps I was coming down with a cold or flu.  Next day I was a little crabby from lack of a good night’s sleep. And then, next night the same thing happened - more ringing wet sweats.  What was going on with me?  I  upped my bg checks from the usual six times a day and noticed unexplainable rocky road patterns in blood glucose levels.  Really now, WHAT WAS GOING ON HERE? 

I called my endocrinologist and explained these odd occurrences.  He asked several pointed questions and in a snap came back with a one word answer: MENOPAUSE.      

After a few months of living with the menopause invasion into my life I renamed it “NUCLEAR MELTDOWN”.

Menopause and Diabetes

Menopause is a time in the lives of women with diabetes that certainly presents some unique challenges. But once you come to terms with the fact that it has arrived  and will be around for a (hopefully short) period of time, the next step is to learn what to expect and then consider options of how to handle it.

The word Menopause has been around since the mid-1800’s.  It’s etomology comes from the Greek “menos” meaning month or moon and the French word “pausis” meaning pause or cessation. For many years if was commonly referred to as “change of life”. It is a phase that occurrs after menstral periods have stopped and the ability to reproduce ceases, usually when a woman is in her mid-foirties or early fifties. The combination of diabetes and menopause can team up to cause a variety of unpleasant hormonal effects on a woman’s body.

The hormones estrogen and progesterone affect how cells respond to insulin and can trigger fluctuations in blood sugar levels.  Bg swings can be variable and unpredictable.  Some women gain weight during the menopausal transition and post-menopause. If this occurs one must be diligent about the need for adjustments in insulin or oral medication, exercise and diet.

Some other  not so lovely happenstancres of menopause are the possibilities of bone loss, depression, moodiness, urinary and vaginal infections due to fluctuations in blood glucose levels and sleepless nights. Those hot flashes or nuclear meltdowns during the night that I mentioned before, are what causes restlessness and interupted sleep. Without porper rest it can be tougher to manage blood sugars.  Last but certainly not least, the diabetes/menopause duo  can damage the nerves of the cells that line the vagina, interfering with arousal and orgasm sensations and vaginal dryness which may cause pain during sex.  However...

Help Is On The Way!

Menopause or no menopause, healthy lifestyle choices —  eating fresh, balanced nutrient packed foods, exercising regularly and keeping a positive attitude  — are the hallmarks of wise DiabetesSisters. But a  few specific tips to consider during your journey through menopause are:

1.  Check your blood sugar frequently. This means keeping a meter close to your bedside to test during the night as well as checking more often than usual during the day. Do this even if you use a Dexcom or other CGM.
2. Be sure to speak with your endocrinologist about insulin or medication adjustments during menopause especially if you  have gained weight or reduced your level of physical activity. On the other hand if your average blood sugar level decreases, you may need to reduce dosages.
3. If you're struggling with the symtoms of menopause there are treatments available such as vaginal lubricants to restore vaginal moisture. Vaginal estrogen therapy may correct thinning and inflammation of the vaginal walls. Other options are speaking with a registered dietitian to help with how to eat healthily and not gain weight. Another available posssibility is hormone therapy. Work closely with your endocrinologist and gynochologist  to determine what is best for you during this challenging time of transition in your life with diabetes. And most of all, remember it is your body andadecisions on treatment are up to you.
4. Weight-bearing exercises and increased  exercise in general help relieve some of the stress of menopausal symptoms.  I remember running two miles every morning during menopause and it really helped calm fluctuating mood swings as well as helping with blood sugars.
5. Limit your alcohol intake.
6. Increase sources of omega-3 fatty acids in your diet. Salmon and sardines are good examples as are soy, canola oil, flax seeds, and walnuts.

The menopausal "Change of Life” manifests itself differently in each one of us.  It is something Mother Nature has set up especially for us because she knows we can handle it as strong, smart DiabetesSisters.

About Judith Jones-Ambrosini
Judith has lived with diabetes for over fifty years and has been recognized by Lilly with a Lilly for Life award for journalism and by Medtronic as a Helping Hands calendar recipient. Her diabetes columns, Judith’s Cyber Kitchen and MoTo Move can be found onwww.diabetesnet.com.  She has written diabetes publications Diabetes Positive, Diabetes Interview (now Diabetes Health) and Diabetes Self-Management. She is a dedicated proponent and practitioner of daily exercise including dance, tai chi, and cycling.  She is a distance walker having completed several half and full marathons.  Every spring she walks the 32-mile loop around Manhattan Island.

Her first book The Sisterhood of Diabetes: Facing Challenges & Living Dreams is available on Amazon and B&N as well as on www.thesisterhoodofdiabetes.com websiteand in local bookstores. The book tells the stories of 48 strong and determined female athletes, ages 8-95,  who redefine past attitudes toward diabetes as they motivate and inspire all of us.Contact Judith at: diabetesmotivation@gmail.com