Have you also noticed that when you were younger, you could eat all you wanted and not gain weight?  But now, not so much. It’s not you. It’s your hormones. More specifically, it’s the rollercoaster ride of your blood sugar during perimenopause. Let’s take a look at menopause and blood sugar.

Perimenopause is marked by significant hormonal fluctuations. During this time, estrogen, progesterone, and testosterone levels undergo major changes, leading to a range of physical and emotional symptoms. By understanding the impact of these hormonal changes on blood sugar levels, you can take proactive steps to manage your health and feel your best during perimenopause and beyond.

In this blog post, we will explore estrogen and blood sugar; progesterone and blood sugar; the menstrual cycle and blood sugar and how menopause can increase blood sugar. By the end of this article, you will have a better understanding of how you can regulate blood sugar during menopause.

What Is Blood Sugar?

Blood sugar (glucose) is the fuel your cells use for energy and comes mostly from carbohydrates found in food. When you eat carbohydrates, your digestive system breaks them down into glucose that enters your bloodstream so it can then be transported into cells and provide energy.

The hormone, insulin, is released by your pancreas and plays the role of transporting glucose into cells and thus controlling how much glucose is in circulation at any given time. If glucose is not needed in the cells, the excess is stored in the liver as glycogen.

When you consume too much sugar, glucose builds up in the bloodstream and this is known as a blood sugar spike.  The body moves quickly to remove the excess sugar from the bloodstream by producing more insulin.  This can oftentimes cause a dramatic drop in blood sugar levels that leave you craving more sugar to bring glucose levels back up.  The pancreas then releases another hormone called glucagon that signals the cells to stop storing glucose.

Over time, you are left with too much sugar which results in the pancreas producing more insulin.

This excess insulin can lead to intense cravings for sugary foods as the body struggles to keep up with its sudden demand for glucose.

Eventually, this leads to high levels of glucose and insulin in the blood and an inability to move glucose into the cells for energy.  This condition where the body no longer responds effectively enough to the insulin produced is known as insulin resistance.

Without the ability to move glucose into the cells effectively, your cells are left starving of glucose (energy) and you are left feeling tired, hungry, foggy, and craving more sugar.

Estrogen and Blood Sugar

Estrogen is an essential hormone for female health, playing a vital role in reproductive function, bone, and brain health.

Possibly less well-known is the relationship between estrogen and blood sugar.  Estrogen helps the body to respond more effectively to insulin.  Estrogen also plays an important role in regulating the hormones that control hunger and satiety, helping to keep hunger pangs under control throughout the day.

In addition, estrogen helps to reduce levels of cortisol, a stress hormone that increases cravings for carbohydrates and other sugary foods. This makes it easier to resist unhealthy foods, allowing individuals to maintain a healthy diet and keep their weight under control.

Furthermore, estrogen has been linked to increased energy production in fatty tissue, allowing it to be used more efficiently as fuel during exercise or other physical activities.

Progesterone and Blood Sugar

Progesterone plays an important role in regulating menstrual cycles, preparing the uterus for and promoting the implantation and growth of a fertilized egg, and supporting normal pregnancy development. Dubbed “the feel-good hormone,” progesterone releases happy hormones such as serotonin, which helps regulate mood and emotions, making you more relaxed, content, and even motivated.

Progesterone also has a role in metabolism, acting again as a counterbalance to estrogen. It stimulates appetite and has a negative impact on insulin sensitivity. High levels of progesterone can lead to an increased release of insulin in response to glucose. This can make it more difficult for cells to take up glucose from the bloodstream, leading to elevated blood sugar levels.

Testosterone and Blood Sugar

Testosterone is often associated with male hormones, but it has an essential role in women’s health as well. It is produced in the ovaries and helps regulate reproductive functions such as menstruation, egg production, and fertility. In addition, testosterone is crucial for developing strong bones as well as maintaining muscle mass and strength.

Testosterone also helps regulate insulin sensitivity, which means that it helps your body process glucose better. It also encourages your cells to take up more glucose from the bloodstream and use it as energy. As a result, your blood sugar levels remain stable regardless of what foods you eat or how active you are. (This is why your husband can eat carbs and not gain weight.) 

Menstrual Cycle and Blood Sugar

Let’s take a look at how all this ties in with the menstrual cycle phases.

The follicular phase begins on the first day of menstruation and lasts until ovulation. During this phase, estrogen levels rise, promoting the growth and thickening of the uterine lining. Progesterone levels remain relatively low during this time.  Testosterone levels see a small surge around ovulation.

The surge in estrogen causes an increase in insulin sensitivity.  That means, you need less insulin to control your blood sugar and so you are better equipped to handle more sugar.

As ovulation approaches, estrogen levels begin to decline, progesterone levels start to rise and you enter the luteal phase.

menstrual cycle and blood sugar during perimenopause

The luteal phase begins after ovulation and lasts until the start of the next menstrual period. During this phase, progesterone levels increase to prepare the uterus for pregnancy. If pregnancy does not occur, progesterone levels drop, leading to the shedding of the uterine lining and the start of menstruation. 

This shift to low estrogen and higher progesterone levels causes a decrease in insulin sensitivity, leading to higher blood sugar levels.  The decrease in insulin sensitivity helps explain the increased cravings for sugary foods right before your period!

To mitigate these effects, it’s best to reduce carbohydrate consumption during your luteal phase to keep your blood sugars within healthy ranges and focus more on protein, healthy fats, and low-glycemic non-starchy vegetables.

Menopause and blood sugar

Does menopause affect blood sugar levels?

In perimenopause, insulin resistance is more common because of the effects of declining estrogen and progesterone production. 

The benefits of peak estrogen levels start to wane in perimenopause as estrogen levels start to decline.  There will be cycles when estrogen does not peak and ovulation does not occur.  The lower estrogen levels result in a decrease in your body’s ability to handle the carbs/sugar that you once were able to eat without problems.

Additionally, the lower progesterone can result in sleep issues which adds stress to your body and can raise cortisol levels. Cortisol elevates blood sugar.

Together these changes leave your body less able to respond efficiently to higher blood sugar. And you can see how eating the same as you were eating can result in blood sugar woes and weight gain.

Too Much Sugar and Menopause

So what happens when you give in to your cravings and eat more sugary foods than normal?

As noted above, high levels of glucose can cause high levels of insulin production.  This excess insulin raises the level of LH production during the first half of your cycle, which results in increased male hormones (androgens ) instead of estrogen. This exacerbates the decline of estrogen levels.

If estrogen levels don’t reach peak levels, ovulation does not occur and you will experience absent or irregular periods. This results in longer than normal periods or increased bleeding per cycle (menorrhagia).

The decreased levels of estrogen can also result in hot flashes and night sweats.

Additionally, you may have an increase in estrogen because of the influence that insulin resistance has on aromatase activity. Aromatase is an enzyme that converts testosterone to estrogens, which can lead to estrogen dominance. Estrogen dominance can lead to painful, heavy, and long periods.

The presence of this excess estrogen disrupts ovulation. The higher estrogen levels signal the body to slow down the production of FSH, which is needed for the growth of the follicles into an egg. If the egg never reaches maturity, it can result in ovarian cysts.

Menopause and Insulin Resistance

To make things worse, the excess insulin results in the liver decreasing the sex-hormone -binding-globulin (SHBG) which binds to testosterone, leading to more androgens that can cause abnormal hair growth (on the face or body), irregular weight gain/loss, fatigue, and mood swings.  SHBG is already declining as a result of perimenopause and high blood sugar and insulin resistance worsen the impact.

Common symptoms of menopause blood sugar fluctuations include fatigue, mood swings, headaches, and difficulty concentrating. These symptoms can have a significant impact on your daily life, making it difficult to focus on work or enjoy your social activities. It is important to be aware of these symptoms and take steps to manage blood sugar levels during the menstrual cycle.

How do you regulate blood sugar during menopause?

  1. Keep Track of Your Cycle: Knowing when your period is expected can help you prepare for potential changes in your blood sugar levels. You can track your cycle using a period tracking app or a calendar. This can also help you identify patterns in your cycle and anticipate any changes that might occur.
  2. Eat for Your cycle: Eating a balanced diet that includes protein, healthy fats, and low-glycemic non-starchy vegetables can help regulate your blood sugar levels throughout your cycle. Avoid/limit your intake of high glycemic carbohydrates (sugars) during your luteal phase to help minimize blood sugar swings and weight gain.
  3. Stay Active: Regular exercise can help improve insulin sensitivity and promote healthy blood sugar levels. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
  4. Manage Stress: Stress can increase levels of cortisol, which can lead to increased cravings for carbohydrates and sugary foods. Find ways to manage stress, such as practicing yoga, meditation, or deep breathing exercises.
  5. Stay hydrated.  Staying hydrated will help curb your hunger.  Often thirst is mistaken for hunger.

By following these tips, you can better navigate your menstrual cycle and maintain healthy blood sugar levels. Remember, every woman’s cycle is unique, so it’s important to listen to your body and make adjustments as needed.


The menstrual cycle can have a significant impact on blood sugar regulation, which can lead to sugar cravings and difficulty in maintaining a healthy diet. However, by understanding the role of estrogen, progesterone, and testosterone, and how they fluctuate throughout the menstrual cycle, individuals can make informed choices to keep their blood sugar levels in check. It’s important to reduce carbohydrate consumption, and focus on protein, healthy fats, and low-glycemic non-starchy vegetables to mitigate the effects of hormone fluctuations.

If you’re looking to kickstart your journey toward better health, I invite you to join my 5-day Peri- & Post- Menopuase Detox program. It’s a great way to get on the right track and establish healthy habits that will benefit you throughout your menstrual cycle and beyond.

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