Diabetes & The Body

Menstrual Cycle And Diabetes

Women with diabetes have to pay closer attention to blood sugar levels and possibly making some adjustments in insulin regimen or meal plan. High levels of the female hormones estrogen and progesterone can interfere with the action of insulin, causing high blood sugar levels just before the start of a woman's period and in some cases during the period.

Blood sugar control

Women with diabetes have a reason to keep track of their menstrual cycles: anticipating and possibly taking steps to prevent higher blood glucose levels during the premenstrual period as well as during the menses.

One study of women with Type 1 diabetes found that 61% had premenstrual rises in blood glucose and that 36% of these women adjusted their insulin doses because of these rises. The study also found that 67% of the women who took constant-dose oral contraceptives had premenstrual blood glucose changes.

The rise in blood glucose is associated with increase in female hormones during this period. Women who do not have diabetes have also been shown to have changes in insulin resistance during the premenstrual and menstrual phases of their cycle, and this supports the idea that changes in hormone levels may affect insulin resistance in women with diabetes.

Other possible reason for changes in blood glucose control is an increase in carbohydrate consumption during the premenstrual phase, especially if they have food cravings associated with PMS. It has also been suggested that a decrease in activity just before and during the menses may affect blood glucose control in some women.

Women with diabetes should be aware of the possible need for changes in their diabetes care plan during certain phases of the menstrual cycle. To determine if changes are necessary, what they might be, and when to make them, it helps to track blood sugar levels, insulin doses (if any), activity level, and diet on a calendar for two to three cycles. This will help make future adjustments.

Severe problems with blood glucose control during the premenstrual and menstrual phases are rare. However, diabetic ketoacidosis may occur in women more often premenstrually. One study of women admitted to hospitals for ketoacidosis showed that 50% were premenstrual or menstruating. If symptoms are severe and recurrent, one can consider medical menopause, in which menopause is induced with drugs. In extreme cases, hysterectomy and removal of the ovaries has been performed to prevent the monthly hormone fluctuations.

Blood sugar control is not the only problem associated with the menstrual cycle. An estimated 85% of the women experience physical and emotional changes during the period between ovulation and the first few days of menstrual flow. These physical and emotional changes, or premenstrual symptoms, are considered both common and normal. However, 5% to 10% of the women experience symptoms severe enough to interfere with their daily activities or personal interactions.

Menstruation is a perfectly normal part of life, but it can be an annoyance. If remedies aren't enough to ease pain or discomfort, ask your gynecologist for help. Likewise, if you're having trouble with blood glucose control around the time of your period and aren't able to resolve it on your own, consult your gynecologist or diabetes team for help.