It is a fact that in my years of teaching people with diabetes about keeping healthy, many women of menopausal age do not know much about the topic. Menopause will occurs in women and natural menopause is not related to an illness. Women sometimes have fears and anxiety about this subject. My patients tell me that their friends have had hot flashes and perhaps a change in mood but do not know much more. Let’s explore this topic. Feel free, Diabetes Sisters, to comment on this blog. Those that have been through what is called by some “the change of life”, may have real life comments and suggestions on what to do to make the transition easier. Please share your views with all of us.
What is menopause?
Natural menopause is defined as the time that follows 12 continuous months without having a menstrual period or in medical terms, amenorrhea. (1) A women’s ovaries stop making the hormones estrogen and progesterone thus ending a women’s fertile period. The average age of menopause in Caucasian women in the United States is 51.5 years. Women of Hispanic and African-American decent usually go through menopause a little earlier and those of Asian heritage a little later. (2)
Early menopause happens to some woman before the age of 40. When this happens it is called premature menopause. Reasons this may occur include:
Genetics- Ask your mother and sisters at what age they went through menopause. Genetics are a strong indicator of the timing that menopause occurs. (3,4)
Procedures that remove or damage the ovaries can cause menopause. A term used when both ovaries are removed is surgical menopause. (5)
There are many other causes of early menopause, which includes diabetes. For information go to: http://www.34-menopause-symptoms.com/early-menopause-causes.htm
One study in Columbia concluded that menopause does not increase the risk of diabetes, but women with type 2 diabetes do have triple the risk of having an early menopause. (6) It is interesting to note the results of a study of early menopause in type 1 women in Finland. Over 900 women were involved (2011). It was concluded that age at menopause for women with type 1 diabetes was not lower than the general population. Factors that did, however, influence early menopause were microvascular complications (end-stage renal disease and proliferative retinopathy). (7)
What is Perimenopause?
As much as 8-10 years before natural menopause takes place, a woman’s ovaries gradually start to produce less and less estrogen. This loss increases naturally until one to two years before menopause, at which time a women’s ovaries begin ceasing the production of estrogen entirely. A women may exhibit menopausal symptoms which on average lasts for up to four years. With the halt of estrogen, the woman will not release eggs. During perimenopause, it is possible for the woman to become pregnant. A women should be mindful that this can occur and discuss this with their medical team. (8, 9)
Symptoms of Perimenopause
Some woman do not experience any symptoms but many do. You should call your doctor to discuss menopause and the changes that may happen. These are some of the symptoms that sometimes occurs with a drop in estrogen levels:
Changes in body temperature regulation including hot or cold flashes and night sweats
Changes in emotions (moods, depression)
Body change including the need to urinate in a hurry, difficultly with normal sleep habits, dry skin, breast tenderness and headaches
Menstrual cycle changes
Problems with memory (10)
For a more extensive list go to: http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause
Some doctors and dietitians recommend the following to help get through the menopausal period and after to keep healthy.
Maintain a healthy weight and eat a diet that meets your healthcare needs.
Exercise according to your physician’s recommendations
Ask your doctor and dietitian about specific recommendations for you.
Sometimes women ask about medications to help them get through the premenopausal time period. The FDA has released a booklet on medications that can be accessed here: http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118627.htm Ask your doctor what is best for you.
Special Considerations for Women with Diabetes going through Menopause
Before menopause many women have fluctuations in their blood glucose as their hormones change during the month. The fluctuations can continue during perimenopause. It is recommended to test blood glucose levels frequently and ask your physician for help with blood glucose regulation.
Weight gain will affect your blood glucose levels. Work with your dietitian to control your weight and ask your physician about proper exercise.
Ask your doctor how to monitor your blood glucose if you have trouble sleeping. This may affect your blood glucose levels
Low estrogen levels can increase the probability of having yeast and urinary tract infections.
Talk to your doctor about reducing your risk of cardiac problems after menopause. (11)
Talk to your doctor and dietitian about ways to support bone health. Ask your doctor if you need a bone scan if you have not had one yet.
Please do comment on this blog and share your experiences with us. We would love to hear about ways you have coped with going through menopause.