Women's Monthly Cycle Affects Blood Glucose Control, But Not Consistently

Menstruation’s effect on women varies by individuals.

| Aug 15, 2009

Only a handful of studies have examined the relationship of a woman's menstrual cycle to her blood glucose control, but they have one finding in common: menstruation's effect on blood glucose is as varied as each individual's disease. As a result, blood glucose testing remains the only way to know how a woman's monthly cycle affects her diabetes control.

Kimberly Trout, an assistant professor at Villanova University's College of Nursing who led one of the more recent studies, said that her study and others reveal decreased insulin sensitivity during menstruation as the most common issue. According to various studies and published reports, including Trout's, this decreased insulin sensitivity could be related to fluctuations in hormone levels during the different phases of the menstrual cycle, as well as inflammation and premenstrual symptoms such as mood swings.

But studies and anecdotal evidence also show opposite effects for some women, and no effect for others. In Trout's study, published in 2007, three out of five women experienced this phenomenon, but the research didn't pinpoint its etiology. And for one person in the study, insulin sensitivity improved.

"Progesterone is thought to be the main culprit in decreased insulin sensitivity during the luteal, or post-ovulation, phase," Trout said in an interview. "It's not completely understood. I also know so many women whose blood sugar levels drop. Because there are such individual and varied results in studies, everyone needs to really monitor themselves."

In some cases, fluctuations can cause DKA, according to a Review of Endocrinology article published last September. But the same article notes that extreme cases are not common and that even mild fluctuations are not always experienced by menstruating women. Trout suggested that an analogy can be made with the dawn phenomenon, an event clearly identifiable in many individuals with diabetes, but not necessarily experienced by all.

H. I. Cramer was apparently the first researcher to note fluctuations in blood glucose resulting from menstruation. His findings were published in the Canadian Medical Association Journal in 1942. In another early study on the subject, published in the British Medical Journal in 1977, 76 out of 200 women reported that menstruation changed their diabetic control. Specifically, 53 reported that their control deteriorated and their blood glucose increased. Twenty-three, however,  experienced improved control and problems with hypoglycemia.

According to the BMJ article, "Menstruation appears to be an important factor in influencing control of diabetes. The mechanism of the changes observed has not yet been determined, but it seems to be a subject worthy of further investigation." Not much has changed since then. Over the years, changes in insulin sensitivity during menstruation have been noted in anecdotal reports from patients, but these changes have been difficult to document due to the many factors that impact insulin sensitivity. Trout said it's also difficult to recruit women for studies. "Women between 18 and 45 are busy women," she said. "We screened over 100 women, and only six completed our study."

Trout is hopeful that new technologies, in the form of more precise continuous glucose monitoring, will make the phenomenon easier to track in individual women. When that occurs, monthly blood glucose patterns will be easier to identify and remedy. In terms of future study, Trout said, "The effect of premenstrual symptoms and PMS is something to take a look at."

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Categories: Blood Glucose, Blood Sugar, Diabetes, Diabetes, Insulin, Low Blood Sugar, Research, Type 1 Issues, Type 2 Issues, Women's Issues

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Posted by Anonymous on 17 August 2009

What I'm curious about is last year I had 2 surgeries looking for answers to my chronic pelvic pain and the possibly of having endometriosis. both pre-surgery bloodwork showed blood sugar numbers were fine. Surgery found no proof of endometriosis, At this point I had been on lupron for 3 months.

I had my next 3 month lupron injection. Now my body is coming out of the chemical menopause and my eyes went blurry and my blood sugar was 550.

I'm wondering if there is a connection between the re-start of the hormones in my body and the sudden onset of diabetes.

Posted by Anonymous on 21 August 2009

I always had the same symptoms monthly ... high sugars prior to the start of my cycle and low sugars during.

Posted by Anonymous on 21 August 2009

I too have issues with increased insulin sensitivity during menstruation-to the point of daily lows. Interestingly though, this has only be noticeable in the past year or so even though I have been a Type 1 diabetic for 11 years. Again, just another reminder we are not all the same and one size treatment does not fit all.

Posted by rosiolady on 21 August 2009

I am post menopausal now, but have been type 1 for 39 years, so I've had plenty of experience with hormonal changes affecting my BG. Mine always followed a specific pattern, which was helpful once I figured it out. I too always wondered if hormonal concerns were a key in the development of diabetes, considering how strongly they affect BGs. However, I do note from the article that some people notice no changes do to hormonal swings. A very interesting subject and one that needs more investigation in my opinion.

Posted by kdommer on 21 August 2009

I, too, have noticed a pattern based on my monthly cycle. The week before my period starts, I consistently run higher than normal in my glucose readings such that I use a higher basal rate on my pump during this time. However, once it starts, I run much lower for about a week. I tracked this for a couple of years and the data did support it. I agree that more research needs to be done. I would love to participate in such a study!

Posted by uniqueinvite on 22 August 2009

I too am curious as to the effects of menopause and diabetes. I've been curious for quite a while and would love to know your research on that.

Posted by Anonymous on 29 August 2009

I consistently run low the day before menstruation starts (now that I am no longer on oral birth control). Then back to normal during menstruation. It's too short of a time span to change my basal rates. More research should be done for sure. What about how the need for insulin drops temporarily in type 1 females during pregnancy at 8-10 weeks and lasts for about 4 weeks? Any large studies on this?

Posted by mgordon on 7 September 2009

I alway feel sluggish on those days. In addition, my blood sugars stays elevated for three days then it dives to the low 50's.

Posted by Anonymous on 25 January 2010

I can relate to the problem with sluggishness--I always feel like a wrung-out dishrag the first couple days of my period! My BG drops, too, and I always figured it was because of the uterine cramping. After all, if I worked out 24 hours a day like my uterus does during my period, I'd use up a LOT of blood glucose!

Posted by Anonymous on 17 November 2012

I also am having issues. I'm almost insulin resistant a week before my period starts. Seems like major amounts of insulin have little effect. I have had type 2 for 12 years. I noticed the article above talked about progesterone. I had to have progesterone shots when I was pregnant because mine was so low. It would be great to get some feedback!

Posted by Anonymous on 5 August 2014

I have high sugar levels 1 week before my period and the result is then thrush . Lately during my period I feel light headed and find concentration hard

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