Perimenopause, or the years leading up to menopause, isn’t just about changes to your menstrual cycle. Behind the scenes, fluctuating estrogen and progesterone levels are influencing your metabolism, energy, mood, and your blood sugar.
For women living with diabetes, prediabetes, or insulin resistance, this period can bring new challenges in keeping glucose levels steady. Even if you’ve had a reliable eating and/or medication routine for years, hormonal ups and downs can throw your blood sugar into unfamiliar territory.
Estrogen plays a key role in helping your body use insulin effectively to lower blood sugar levels. As estrogen levels gradually decline in perimenopause, cells can become less sensitive to insulin, meaning glucose stays in your bloodstream longer. This can lead to:
What you can do: Prioritize strength training and high-fiber foods, which can improve insulin sensitivity naturally.
Progesterone levels don’t drop in a straight line as we age, they rise and fall unpredictably. At higher levels, progesterone can increase blood sugar levels and make it harder for insulin to do its job lowering your blood sugar. This hormonal whiplash can mean:
What you can do: Track symptoms alongside your glucose data to spot patterns. This helps you and your doctor/dietitian make targeted adjustments.
Perimenopause often brings hot flashes, night sweats, and restless nights. Poor sleep raises cortisol (your body’s main stress hormone) and night sweats can lead to dehydration, both of which can drive up blood sugar readings. Add in midlife stressors such as career changes, caregiving, life transitions, etc. and you’ve got a perfect storm for higher readings.
What you can do: Build stress relief into your day, even in small bursts. Deep breathing, gentle stretching, or short walks can lower cortisol and stabilize blood sugar.
Bottom line: Perimenopause is a time of transition, but understanding the specific ways it affects blood sugar puts you back in control. With awareness, tracking, and tailored strategies, you can keep your glucose and your health on track through the midlife years and beyond.
