All women know the jazz around their period. Normally 28 days the wheel is spinning around its radius and the “long-awaited cycle of life” hits you. This period could also be anywhere from 21 up to 35 days. But it comes the time when your hormone levels are being triggered and with that, your blood sugar levels also fluctuate. In moments like these women with diabetes are mostly affected by the unique challenges this additional condition is making them face every month.
In this article, we want to shed more light on the (not so actively talked) theme of the effect of diabetes on women’s reproductive health and all the risks that come with it.
The tight relationship between blood sugar levels and your menstrual cycle
Let’s address the elephants in the room: estrogen and progesterone (2 powerful female hormones) are both not only controlling your menstrual cycle but also your blood sugar levels. Estrogen is at its peak right before ovulation where progesterone starts to rise its wave 20 days before your period and slows down 2 days before. All menstrual hormones are at their lowest point when you have your period. So, the messiest time is the calmest for women with diabetes.
Image credit to HelloClue. Visual interpretation from Diabetes:M
When your glucose levels are being disrupted by your monthly cycle, this inevitably affects insulin (which btw is also a hormone). Your body may become more resistant to insulin during this timeframe, although your blood sugar has already risen significantly. As seen in the graphic above, during the following days you might need slight changes in your insulin intake:
- Day 01 – (beginning of the period) high blood sugar and insulin resistance;
- Day 11 – 14 (ovulation) – high blood sugar and insulin resistance;
- Day 15 – 20 – normal levels of blood sugar and insulin;
- Day 21 – 28 (mid-luteal phase) – significant insulin resistance and high blood sugar.
Having cleared out the basics about how menstruation affects blood sugar and insulin intake, let’s find out if people with different types of diabetes are experiencing any additional changes or fluctuations.
Diabetes type 1 and menstruation
The most common insulin fluctuation for women with type 1 diabetes that they experience right before their period comes (3-5 days) is in the morning. The time before breakfast when measuring the fasting blood glucose – can show increased value. This is why a regular adjustment of insulin is often the key to helping you feel better. Not to mention that this part of the whole cycle is the toughest in general with cramps and mood swings. When you add all other sorts of life duties like being a wife, mother, employee, and citizen, you realize how vital it is to have a digital helper as Diabetes: M on your side doing the calculations instead of you.
Some studies have also shown that women with type 1 diabetes are more likely to experience long-lasting periods or even heavy ones. This will contribute to more cravings and eating of so-called comfort foods that are not recommended during the period. Not to mention that the blood sugar around this time is high, so keep a closer eye on what you eat; when you eat it, and how it affects you.
Menopause can come sooner for women with type 1 diabetes which narrows the window for conception. This type of diabetes causes the premature aging of blood vessels which reflects in the premature aging of the ovaries that produce eggs (read the study here). Combined with the fact that the first occurrence of menstruation in some women with type 1 diabetes can be at a later age – a pregnancy has to be planned during a shorter timeframe.
Diabetes type 2 and menstruation
Women with type 2 diabetes can have irregular or missed periods. It happens because higher insulin levels (caused by insulin resistance) often found in this group of women affect menstruation hormones. Another scenario could be that you have your period without ovulation which is called anovulation. Whatever the case is – it will be way harder for women with type 2 diabetes to get pregnant when not having a regular cycle.
If you struggle with type 2 diabetes you are at an increased risk of endometrial cancer not only because of your insulin resistance but also if you are overweight or obese. Having a significantly higher body mass index (BMI) can cause an imbalance between the 2 main female hormones estrogen and progesterone, which may lead to an overgrown lining of the uterus and will inevitably cause endometriosis.
Birth control pills and diabetes
Birth control pills are the most popular contraceptive methods, so we wanted to include them as a synthetic trigger for your blood glucose levels. Pills of this sort are available in different combinations of estrogen and progestin or only progestin.
Please note that hormonal birth control methods such as the pill are not recommended for women with diabetes who have any kind of heart disease or high blood pressure in general as well as blood clots. Ladies who are over the age of 35 or smoke cigarettes also belong to the same restricted group.
If you think that this is the best way to control your menstruation cycle and prevent yourself from conception – you need to consult with your doctor so they can monitor your blood sugar levels over a few months (usually 2-3). They have to assess your hemoglobin A1C, total cholesterol, LDL & HDL triglyceride levels, and blood pressure. In this time frame, side effects could occur such as breast pain, break-through bleeding, irritability, weight gain, high blood pressure, and other symptoms that can increase the risk of diabetes complications (insulin resistance, eye or kidney problems).
Tips on what to do and eat around THAT time of the month
Besides cramps, bloating and mood swings – food cravings are the premenstrual syndrome that women with diabetes need to be careful with around their period. Be more mindful around that time of the month and follow these recommendations:
- Limit high-carb & high-sugar foods like chocolate, sweets, alcohol, and caffeine;
- Avoid snacking at all costs;
- If it is so bad that you need a snack – try reaching for low-carb & low-fat options;
- Set regular meal times;
- Move your body! Not only right before your period but all month long.
Catching the wave and riding with it
So, you happen to be a woman with diabetes. Managing your menstrual cycle might be a little bit challenging but once you understand the pace at which your wheel is rolling – then tweaking the dosage of your insulin will be a breeze. As long as you manage your diabetes daily, maintain a healthy diet, and exercise regularly – you will have stable blood sugar levels. In case of any additional concerns – make sure to contact your doctor and consult with them on how to manage your glucose levels the best way possible.
Disclaimer: This article is for informative purposes only. Always contact your health care provider before taking any measures regarding your health.
More Resources on the topic:
5 Things Women Need to Know About Diabetes and Their Period
Researchers find diabetes risk with some birth control pills
Estrogen And Progestin Oral Contraceptives (Oral Route)
Ask D’Mine: The Best Birth Control for FWDs is…
Contraceptive Pill and Diabetes
Reproductive and Sexual Health
