Menstruation and Diabetes

Diabetes can affect a woman’s reproductive health and influence factors contributing to the regulation of the menstrual cycle. This is largely due to the interaction between the hormones that control menstruation estrogen and progesterone and the insulin hormone, which is closely tied to blood glucose levels that are controlled in women with diabetes. So how exactly does diabetes affect menstruation? And what can women who are living with diabetes do to regulate both menstruation and the symptoms of diabetes?

Diabetes and the Menstrual Cycle
A woman’s glucose levels are controlled by certain hormones, just as hormones regulate the menstrual cycle. Indeed, the interaction between certain hormones can lead to irregular bloods sugar levels. For women with both type 1 diabetes as well as those with type 2 diabetes, fluctuations in blood glucose levels that are associated with menstruation can be a cause for concern.

Most commonly, women with diabetes will experience a rise in blood glucose levels the week prior to menstruation, just after ovulation. Once a woman’s period begins, her blood sugar levels will tend to drop. This fluctuation is caused by a rise in estrogen and progesterone levels, which interfere with insulin activity.

Recognizing Your Cycle
Not all women with diabetes experience these corresponding hormonal fluctuations; however, for those who do, recognizing the patterns of glucose and insulin production during your monthly cycle is an important step towards controlling diabetes symptoms.

It is recommended that women with diabetes monitor changes resulting from menstruation the same way they would monitor blood glucose levels. In order to find a correlation between menstruation and diabetes, make a note of the onset of your period in your blood glucose record book, and watch for any emerging patterns between glucose levels and the menstrual cycle over time.

Women with diabetes should already be keeping a record book as part of a standard diabetes management. Women with type 1 diabetes (who should be recording glucose levels at least four times a day) will tend to experience the most fluctuations in the fasting blood glucose measured before breakfast just prior to the onset of menstruation.

Managing Menstruation and Glucose
It is important for any woman who is experiencing glucose fluctuations to speak to an endocrinologist or other health care provider about ways to manage blood sugar, particularly if these are a result of other hormone interactions.

Your doctor may recommend that women with diabetes type 1 increase insulin by adjusting the intermediate acting insulin, NPH, or Lente later in the evenings at different points in your menstrual cycle so as to keep blood glucose levels stable. However, every case is different and only a health care practitioner can advise any adjustments in insulin.

For women with type 2 diabetes, it is recommended that regular exercise be maintained during these times in order to lower blood glucose level if insulin is not taken as part of diabetes management. Regular exercise can also reduce some of the symptoms of premenstrual syndrome such as moodiness, bloating, water retention and food cravings.

Menstruation and the Diabetes Diet
Women with diabetes are well aware that monitoring their diet is an important part of diabetes care. However, some women experience food cravings in correlation with their menstruation and premenstrual cycles. Cravings for carbohydrates and fatty foods can contribute to fluctuations in blood glucose levels.

In order to minimize food cravings and maintain an ideal diabetes diet, it is recommended that women take measures such as avoiding alcohol, caffeine and chocolate, eating regular meals, and eating low-fat snacks that are also low in carbohydrates such as vegetable sticks and unbuttered popcorn.

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