Why Insulin Resistance May Be Making Your Menopause Worse
If you are suffering from menopausal symptoms, including hot flushes and night sweats, you may be dealing with insulin resistance. According to one expert, insulin resistance, also called prediabetes, plays a crucial role in perimenopause and menopause.
“If you have insulin resistance, correcting it is going to be one of the best ways to improve symptoms,” says the author of Hormone Repair Manual, Lara Briden. “Losing oestrogen impairs energy metabolism in the brain and creates neurological symptoms such as hot flushes, night sweats, and brain fog.
“To adapt, the brain has to shift from using glucose for energy to using ketones, and that’s harder to do if there’s insulin resistance,” says Briden, a naturopathic doctor.
Insulin resistance occurs when you have chronically elevated levels of insulin, the hormone that stimulates cells to take up glucose. The problem is not with insulin, per se, but with an underlying metabolic dysfunction. The cells have a reduced ability to respond to insulin, leading to a compensatory increase in insulin production.
High insulin reduces metabolic flexibility, which means it’s harder for the cells to switch from using glucose for energy to using ketones (metabolites of fat).
Not only does menopause put you at risk of insulin resistance, “at the same time, having insulin resistance can worsen the symptoms of menopause,” says Briden.
“Normally oestrogen and progesterone somewhat shelter us from insulin resistance,” she says. “Your metabolism liked the insulin-sensitising effects of oestrogen and that’s why losing oestrogen can trigger a shift to insulin resistance and abdominal weight gain.”
“And that metabolic state [insulin resistance] worsens symptoms of perimenopause, particularly brain symptoms such as hot flushes and night sweats.”
““Your metabolism liked the insulin-sensitising effects of oestrogen and that’s why losing oestrogen can trigger a shift to insulin resistance and abdominal weight gain.””
Abdominal weight gain or “apple-shaped” weight gain around the middle or upper body – what many of Briden’s patients call “bra-strap weight gain” – may be a sign of insulin resistance. Other signs include fatigue, sugar cravings, high cholesterol and skin tags.
The best way to check for insulin resistance is with a test. “This is a test for the hormone insulin, not a test for glucose – in other words, insulin resistance cannot not be ruled out by a normal blood sugar or glucose reading.”
“It’s easy to test for – ask your GP.”
Briden adds that even younger women can develop insulin resistance. Two million Australians have prediabetes and one in three will go on to develop type 2 diabetes.
Along with intensifying menopausal symptoms, insulin resistance is linked to many of the long-term health effects associated with menopause. “The shift to cardiovascular [heart disease] risk with menopause is because of insulin resistance,” says Briden. Other associated issues include osteoporosis, dementia and hair loss.
Fortunately, the condition can be easily reversed. “Taking oestrogen via hormone therapy improves insulin sensitivity and corrects underlying energy metabolism problems.
“But women can get a similar benefit by moving the body, eating well by including muscle-building protein and taking magnesium to reverse insulin resistance.”
Lara Briden is the author of Hormone Repair Manual, Pan Macmillan, $34.99. She blogs at larabriden.com
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