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Changing for the Change of Life By Janis Roszler, RD, CDE, LD/N Let's talk about menopause, the single moment when a woman's menstrual period finally stops, or more specifically, perimenopause, the time that leads up to this moment. Little is written about how this affects a woman's diabetes control, but it can in very significant ways. Here are some of the facts: • Perimenopause happens gradually The perimenopausal period can last from three to six years. During this time, a woman may experience a variety of mild to severe symptoms, including hormone and mood swings, weight changes, headaches, fluid retention, and even memory problems. All of these can affect her diabetes control. She may forget to care for her diabetes at certain times, may experience an increase in insulin resistance from an unwanted weight gain, and have unpredictable hormone and stress-related blood sugar swings. This is a confusing time for a woman's body. Remember, the stroll through puberty was filled with challenges, and the road through menopause can be frustrating as well. If you are perimenopausal, test frequently and be patient with yourself and your glucose control. • Hormonal changes may cause confusing symptoms During perimenopause, hormonal changes may cause symptoms that resemble insulin reactions - hot flashes, rapid heartbeat, and flushed skin. Don't automatically assume that these feelings are caused by a drop in blood sugar. Your level may actually be fine, yet feel as if it were low. Always test before you grab a small glass of juice or several glucose tablets. If you treat a non-existent blood sugar low with a quick snack your glucose level may climb too high. If your physician prescribes hormone treatments, they may cause you to experience some of these symptoms also. • You can still become pregnant According to Dr. Susan Love, the author of Dr. Susan Love's Menopause and Hormone Book, if you've stop menstruating for several months, your period can suddenly reappear. The only way to truly know that you have had your final menstrual cycle is to go for an entire year without menstruating. Until this year has ended, use reliable birth control to avoid an unplanned pregnancy. An accidental pregnancy can be hazardous to your health and to the health of your baby, especially if your blood glucose control is not optimal at the time that you conceive. • Menopause increases diabetes-related health risks When your menstrual period has stopped completely, your risk for heart disease increases, calcium is depleted from your bones, and the change in vaginal secretions heightens your risk for vaginal infections. Meet with both a gynecologist and your diabetes care team to help keep these health risks to a minimum • Be flexible This time of your life can be frustrating, but don't despair. All women will go through it at some point in their lives. Eat well, stay physically active, and adjust your diabetes treatment plan as needed.
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