Menopause—and the years leading up to it—may present unique challenges if you have diabetes. But it’s not necessarily a one-two punch. First, learn what to expect. Then consider what to do about it.

Diabetes and menopause: What to expect

Menopause is the phase of life after your periods have stopped and your estrogen levels decline. In some women, menopause can occur as a result of surgery, when the ovaries are removed for other medical reasons.

Diabetes and menopause may team up for varied effects on your body, including:

Changes in blood sugar level. The hormones estrogen and progesterone affect how your cells respond to insulin. After menopause, changes in your hormone levels can trigger fluctuations in your blood sugar level. You may notice that your blood sugar level is more variable and less predictable than before. If your blood sugar gets out of control, you have a higher risk of diabetes complications.
Weight gain. Some women gain weight during the menopausal transition and after menopause. This can increase the need for insulin or oral diabetes medication.
Infections. Even before menopause, high blood sugar levels can contribute to urinary tract and vaginal infections. After menopause—when a drop in estrogen makes it easier for bacteria and yeast to thrive in the urinary tract and vagina—the risk is even higher.
Sleep problems. After menopause, hot flashes, and night sweats may keep you up at night. In turn, the sleep deprivation can make it tougher to manage your blood sugar level.
Sexual problems. Diabetes can damage the nerves of the cells that line the vagina. This can interfere with arousal and orgasm. Vaginal dryness, a common symptom of menopause, may compound the issue by causing pain during sex.

Diabetes and menopause: What you can do

Menopause can wreak havoc on your diabetes control. But there’s plenty you can do to better manage diabetes and menopause.

Make healthy lifestyle choices. Healthy lifestyle choices—such as eating healthy foods and exercising regularly—are the cornerstone of your diabetes treatment plan. Healthy foods and regular physical activity can help you feel your best after menopause, too.
Measure your blood sugar frequently. You may need to check your blood sugar level more often than usual during the day, and occasionally during the night. Keep a log of your blood sugar readings and symptoms. Your doctor may use the details to adjust your diabetes treatment plan as needed.
Ask your doctor about adjusting your diabetes medications. If your average blood sugar level increases, you may need to increase the dosage of your diabetes medications or begin taking a new medication—especially if you gain weight or reduce your level of physical activity. Likewise, if your average blood sugar level decreases, you may need to reduce the dosage of your diabetes medications.
Ask your doctor about cholesterol-lowering medications. If you have diabetes, you’re at increased risk of cardiovascular disease. The risk increases even more when you reach menopause. To reduce the risk, eat healthy foods and exercise regularly. Your doctor may recommend cholesterol-lowering medication if you’re not already taking it.
Seek help for menopausal symptoms. If you’re struggling with hot flashes, vaginal dryness, decreased sexual response, or other menopausal symptoms, remember that treatment is available. For example, your doctor may recommend a vaginal lubricant to restore vaginal moisture or vaginal estrogen therapy to correct thinning and inflammation of the vaginal walls (vaginal atrophy). Your doctor may also recommend hormone replacement therapy to alleviate the symptoms if you have no contraindications for this therapy.
If weight gain is a problem, a registered dietitian can help you revise your meal plans. For some women, hormone therapy may be a good option.