{"id":49790,"date":"2018-10-30T10:55:57","date_gmt":"2018-10-30T14:55:57","guid":{"rendered":"https:\/\/asweetlife.org\/?p=49790"},"modified":"2018-10-30T10:55:57","modified_gmt":"2018-10-30T14:55:57","slug":"does-your-period-affect-your-diabetes","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=49790","title":{"rendered":"Does Your Period Affect Your Diabetes?"},"content":{"rendered":"

Each month, the average woman\u2019s body prepares for pregnancy.\u00a0 Ovaries release an egg, if pregnancy doesn\u2019t occur, the lining of the uterus sheds, and hormone levels rise and fall.\u00a0 The average menstrual cycle is 28 days long, but anything between 21 and 45 days is considered normal.\u00a0 Bleeding for 2 \u2013 8 days is average and normal.<\/p>\n

\u2026 \u00a0typing the words \u201caverage\u201d and \u201cnormal\u201d over and over again feels weird, because women with diabetes know we\u2019re coming into this whole arrangement outside the range of \u201caverage\u201d or \u201cnormal\u201d when it comes to pancreatic function.<\/p>\n

Admittedly, I didn\u2019t know a lot about the phases of the menstrual cycle until I was trying to get pregnant with my second child.\u00a0 I understood the basic mechanics, but it wasn\u2019t until I was tracking ovulation and fertility potential on a spreadsheet that I saw data on how my period influenced my blood sugar control.\u00a0 Essentially, I saw that my blood sugars had predictable and irritating fluctuations around certain points in the menstrual cycle, adding a new variable to diabetes management.\u00a0<\/p>\n

The two main hormones that regulate the menstrual cycle are estrogen and progesterone.\u00a0 Estrogen causes the lining of the uterus to thicken in preparation for a potential pregnancy, in addition to helping regulate bone and vaginal health.\u00a0 Progesterone helps maintain the lining of the uterus during pregnancy, and both of these hormones affect insulin resistance and\/or sensitivity, contributing to the roller coaster of blood sugars that many women experience during their cycle.\u00a0 Add these hormonal influences to the long list of things that can influence blood sugars!<\/p>\n

Endocrinologist Jennifer Shine Dyer offered some clinician perspective: \u201cBoth highs or lows can be seen 1 week before the menstrual cycle, depends on the woman. This is due to increased or decreased insulin sensitivity and progesterone seems to be the main player here. Very few studies have been done to really look into the causes but H.I. Cramer was the first researcher to notice fluctuations in blood sugar due to menstruation. His findings were published in the Canadian Medical Association Journal in 1942<\/a>. He found that 38% of the women reported that menstruation had changed their diabetes control. 70% of those women reported deterioration of control by experiencing hyperglycemia. 30% experienced hypoglycemia and improved control. Studies also show increased insulin sensitivity or no effect in women as well.\u201d<\/p>\n

And after talking with several women about how their periods affect diabetes, I saw some themes in these anecdotal experiences:<\/p>\n

\u201cThis [the menstrual cycle] is a HUGE and under-examined area of influence on BG patterns. My own BG starts going up a few days before my period, and I literally start craving chocolate.\u201d<\/p>\n

\u201cI definitely go high consistently\/have insulin resistance the week before [my period]. Once it starts, everything levels out.\u201d<\/p>\n

\u201cI can predict the start of my period from the terrifying low that always happens the night before. Lows so severe that my husband has had to call the paramedics three times, even though I cut my nighttime insulin in half the week before, trying to catch them. And then highs for the 3rd, 4th and 5th days. Really huge blood glucose swings.\u201d<\/p>\n

\u201cI am very insulin resistant the week before. I am so not insulin resistant during. Makes me nuts.\u201d<\/p>\n

Researcher Sheri Colberg-Ochs<\/a> had perspectives as researcher and a woman with type 1 diabetes to share.\u00a0 \u201cin the research world, it\u2019s pretty well established that if you\u2019re studying insulin action as an outcome in women subjects, you have to try to study them at the same time of their cycle. Hormonal elevations from ovulation until the period starts raise insulin resistance. There\u2019s lots of variations in hormone levels from one woman to the next, though. Being perimenopausal is also very challenging as levels of some hormones are higher and others lower. My control was easiest during my three pregnancies, even though my total insulin needs were higher. They didn\u2019t fluctuate by the month, more by the trimester as they rose over time.\u201d<\/p>\n

Looking to make your period less of a diabetes hassle?\u00a0 There are some things that might help:<\/p>\n

Track your cycle every month.<\/strong>\u00a0 This will help you identify monthly trends, giving you some data to take proactive moves (like setting a basal rate profile on your insulin pump for the week of your cycle, etc.)\u00a0 Be patient in pursuit of patterns, as it may take a few months to see them emerge.\u00a0 There are a lot of period tracking apps available.<\/p>\n

Consider using a continuous glucose monitor to help track your monthly trends<\/strong>.\u00a0 This data, mapped against the data from your monthly cycles, can help drill down on blood sugar trends and give you the information you need to make medication changes, etc.\u00a0 (Definitely talk to your clinician before making any changes, though!)<\/p>\n

Talk with your clinician about your options.<\/strong>\u00a0 Some women with diabetes opt to employ hormonal birth control methods<\/a>, like the pill or an IUD, to help regulate their cycle and help predict fluctuations on a monthly basis.<\/p>\n

Practice self-care.<\/strong>\u00a0 Getting enough sleep, eating well, and exercising regularly help in every aspect of your physical and mental health.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

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