Common Health Issues

Diabetes Effects on Menstrual Cycle

• By Rich Health Editorial Team
• November 11, 2021

If you are a woman between the ages of 12 and 50 or so, chances are that you are keenly aware of the all-important task your body performs every month—preparing an egg that is ripe for fertilization. And if you have diabetes, you may also feel its effects in more ways than one. Not only are you subject to the changes in mood brought about by fluctuating hormones, but you may find that ovulation wreaks havoc with your efforts at blood glucose control.

 

Ovulation is precisely executed, thanks to the carefully timed release of estrogen, progesterone and other hormones. The follicular phase of your monthly cycle starts the day your period begins. This lasts for 12 to 14 days until ovulation, when you release an egg. During the early part of this phase of the cycle, the female sex hormones estrogen and progesterone are at their lowest levels. Then the follicle-stimulating hormone (FSH) is released and this turns on the production of estrogen. This causes your ovaries to release an egg midway through your cycle. 

 

Once the egg is released, you enter the luteal phase of your cycle. A second hormone, luteinizing hormone (LH), causes the secretion of estrogen and progesterone. These hormones thicken the lining of the uterus in anticipation of egg fertilization. If the egg is fertilized and implants, pregnancy proceeds. But if the egg is not fertilized, the ovary stops making estrogen and progesterone. This causes the uterus to shed its lining, and you have your period.

 

If you are like many women with diabetes, this high level of estrogen and progesterone about a week before your period can make it difficult to control your blood glucose levels. That may be because too much estrogen can make your cells more resistant to your own insulin or the insulin that you inject. Some doctors think that this change in blood glucose control before your period is just because you tend to eat more during this part of the cycle. But others think that there is a real change in how your body responds to insulin at this time.

 

But what does this mean for you? It means that if you notice that it is more difficult to control your blood glucose levels before your period, it is probably not your imagination. Many women have high early morning blood glucose levels only to have a low mid-morning value. Other women have consistently high blood glucose readings. Some women may not even notice a change. The trick is to recognize how your body’s menstrual cycle affects your blood glucose control.

 

DIABETES EFFECT ON MENSTRUAL CYCLE

 

Diabetes Menstrual Cycle Effect Symptoms

You may notice erratic patterns of blood glucose control during your menstrual cycle. Most commonly, you may notice that your blood glucose levels are higher during the luteal phase, or the week before your period. It is not unusual for your blood glucose levels to be higher than normal for 3 to 5 days and then return to normal when menses begins. This may occur even if you are following the same eating and exercising routines. You may also notice a dip in blood glucose levels in the late morning.

 

 

What You Should Do When Diabetes Affects Your Menstrual Cycle

 

If you are not sure whether your blood glucose levels are affected by your menstrual cycle, you can do a little detective work to find out for sure. If you are already keeping track of your blood glucose levels on a daily basis, take a look at your log book. Mark down the dates at which your menstrual period began each month for the past 6 months, if you can remember. If you don’t know for sure or have not kept good records of your blood glucose levels and dates of menstruation, now is a good time to start.

Start with a calendar or logbook specifically designed for keeping track of blood glucose levels. Write down all your blood glucose readings on a daily basis. Also make note of the day your period starts each month. If possible, jot down any notes about how you feel. If you get any symptoms of premenstrual syndrome (PMS), jot them down. If you notice any sort of moodiness, bloating, fatigue, cramps, food cravings, or weight gain, make a note of it. Also, make notes of how you are feeling on other days in the month. Be honest about how you are feeling, whether you are close to having your period or not.

 

After you do this for a few months, review your records. Do you notice a pattern? Do your blood glucose readings remain more or less stable from day to day throughout the month? Or do you notice a different pattern before your period begins? If you notice any abnormal blood glucose levels—either too high or too low—around the time you get your period, first think about controlling the symptoms of PMS. Maybe you don’t feel moody or irritable before your period and you don’t think you have PMS. However, it could be affecting you in more subtle ways, and this could affect your blood glucose levels.

You can take the following steps at first to try to control the symptoms of PMS during the week before your period begins. Try to change one thing at a time. This will help you figure out which of the following steps is most effective at helping you control the symptoms of PMS and whether any of these measures improves your blood glucose control:

• Follow your meal plan as closely as possible. Too much salt can cause you to retain water and make you feel bloated, so limit your salt intake. If your food is too bland, try using pepper, garlic, cayenne, chopped herbs, onions, or scallions to spice up your meals

 

 

• Eat at regular intervals. Don’t skip meals or put off eating. If you eat erratically, your blood glucose levels could swing too much. These swings in blood glucose levels could worsen some of the emotional and physical symptoms of PMS, which could in turn worsen your blood glucose control

 

• Limit your intake of alcohol, chocolate and caffeine. They can affect both your blood glucose levels and your emotional state.

 

• Try to exercise regularly. You may feel lethargic before your period and this may be the last thing you want to do. But regular exercise can diminish mood swings, prevent weight gain and make it easier to control blood glucose level.

 

 

Controlling the symptoms of PMS may not be enough to avoid swings in blood glucose levels before your period. If your morning blood glucose levels are still higher than normal, take the following steps:

 

• Add some extra exercise to your daily routine. This may help clear some of the extra glucose from your blood. However, be careful you don’t overdo it and trigger an episode of hypoglycemia. Make sure to monitor your blood glucose level after any period of exercise and then again a few hours later.

 

 

• Avoid eating any extra carbohydrates. If you feel the urge to snack, keep a supply of fresh veggies handy. Celery, radishes and cucumbers can be tasty if you dip them in a fat-free dip such as salsa

 

• If you use insulin, ask about gradually increasing your dose during your premenstrual week. This should be done in small increments so that insulin levels are higher the last few days of your cycle, at the same time that your blood glucose levels tend to rise. It may only take 1 or 2 additional units of insulin. As soon as menstruation begins, return to your usual dose of insulin to avoid hypoglycemia

 

While some women may experience high blood glucose levels before menstruation, others may find that blood glucose levels tend to dip. If this is the case for you, try these tips:

 

• If you exercise regularly, try to reduce—but do not eliminate—the amount your exercise

 

• Try to increase your carbohydrate intake modestly. Don’t make the mistake of adding a lot of junk food to your diet. Add healthy, low-fat foods to your diet

 

 

• If you use insulin, ask your doctor about decreasing the amount of insulin you take a few days before your period begins. This should be done in small increments. A decrease of only 1 or 2 units may do the trick.

 

Some women report that their blood glucose levels swing before their periods. Some report a high morning blood glucose level and then a low mid-morning blood glucose level. The mid-morning dip may be a response to the morning hyperglycemia. See if this is a reproducible pattern for you. If so, talk to your doctor about the best way to handle it. You may want to try incrementally increasing your evening dose of insulin or decreasing your bedtime snack to prevent morning hyperglycemia.

 

This may take care of both your morning hyperglycemia and your mid-morning hypoglycemia. You may also have to make some adjustments in your morning routine to prevent the mid-morning hypoglycemia. This could mean decreasing your insulin slightly or increasing your food intake slightly. Talk to your doctor about the best way to approach this problem.

 

If your periods are irregular, you may find it difficult to predict when your period will start. Some women can predict it from the first signs of PMS. Maybe your breasts become a little sore a week before your period starts. For other women, these signs are not so obvious and it may work better to chart your ovulation. Even when your periods are irregular, if you are ovulating, ovulation invariably occurs 14 days before your period. So if you can pinpoint the date of ovulation, you can be on the lookout for symptoms of PMS a week later. 

 

Many women can tell when ovulation occurs by paying attention to vaginal secretions. Your vaginal discharges tend to be thicker and stickier when you ovulate, often taking on the consistency of egg whites. However, for many women with diabetes, this may be more difficult to notice, due to problems with vaginal dryness.

 

Another way to predict ovulation is to measure your temperature the first thing in the morning before you get out of bed. After your period, your temperature should remain the same until just before you ovulate. It will dip about 0.5 degrees then rise a degree or two. It will remain elevated until just before your period, when it returns to normal. 

Your ovulation occurs on the same day you see the rise in temperature, just after a small dip. With training, you can begin to recognize your body’s signals and know when you are ovulating and when you will begin to menstruate. This can provide you with another tool in dealing with changes in your blood glucose control on a daily basis.

 

You can also invest in an ovulation prediction kit, available at most pharmacies. These kits measure the hormones in your morning urine to predict when you are ovulating. However, they are quite expensive.

 

Sources and References

The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

Associations of Menstrual Cycle Characteristics Across the Reproductive Life Span and Lifestyle Factors with Risk of Type 2 Diabetes by An Pan, Stacey Missmer et al

Diabetes: A Metabolic and Reproductive Disorder in Women by Helena Teede, Ethel Codner et al

Premenstrual Syndrome by Kimberly Yonkers, P M O’Brien and Elias Eriksson