Explore the intricate relationship between menopause, insulin resistance, and blood sugar control. Understand the impact of declining hormones on women's metabolic health and the latest research-driven strategies to manage these changes.

Key takeaways

• Menopause signifies a pivotal shift in a woman's hormonal balance, affecting metabolic health, including insulin resistance and blood sugar control.
• Declining levels of oestrogen, progesterone, and testosterone during menopause can lead to metabolic dysregulation, increasing the risk of type 2 diabetes and cardiovascular disease.
• An understanding of the changes in body fat distribution, particularly central adiposity, is critical due to its association with metabolic dysfunction and chronic inflammation.
• The gut microbiome is significantly impacted by excessive abdominal fat, altering nutrient metabolism and promoting inflammation.
• Lifestyle modifications, such as dietary changes and increased strength training, can help manage these menopausal changes and maintain metabolic health.

Menopause signifies a crucial biological transition in a woman's life, bringing her reproductive years to a close. This period is characterised by notable hormonal shifts, including the reduction in oestrogen, progesterone, and testosterone production. These changes carry significant implications for a woman's metabolic health.

What is metabolic health?

Metabolic health refers to the proper functioning of your body's metabolic processes. Your metabolic processes include a range of biochemical reactions that your body uses to convert food into energy. These processes are crucial for maintaining your body's basic functions, such as cell repair and growth, body temperature maintenance, digestion and the immune response.

Metabolic health encompasses factors such as:

• Blood sugar levels: your body's ability to efficiently manage blood sugar levels is a key aspect of metabolic health. Dysregulated blood sugar levels can lead to conditions like insulin resistance, prediabetes, or type 2 diabetes, especially in menopausal women.
• Blood pressure: high blood pressure can stress your heart and blood vessels, leading to cardiovascular diseases.
• Cholesterol levels: this includes the lipid levels in your blood.
• Waist circumference: excessive abdominal fat is linked to an increased risk of metabolic syndrome.
• Body mass index (BMI): obesity can contribute to poor metabolic health and related conditions.

Menopause, hormones and metabolic health

The hormonal changes women experience during menopause are closely linked with changes in metabolic health.

Oestrogen

Oestrogen, a primary female sex hormone, plays a pivotal part in maintaining metabolic stability by managing insulin sensitivity, glucose metabolism, lipid metabolism, and body fat distribution.

As women transition through peri-menopause and oestrogen levels decline, they may become more vulnerable to metabolic dysregulation. This can lead to insulin resistance, glucose intolerance, and lipid dysregulation (dyslipidaemia). This may increase the risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. Therefore, menopause and blood sugar fluctuations is a very common experience.

Progesterone

Progesterone, though often overlooked, also contributes to metabolic changes during menopause. Progesterone, a key smooth muscle relaxant with receptors throughout the body, helps to balance cortisol, a stress hormone. Elevated cortisol levels can promote central fat deposition, contributing to visceral fat load and impacting glucose regulation in the liver. These changes can affect a woman's metabolism and her ability to maintain a healthy weight.

Testosterone

The decline in testosterone levels during menopause can impact women's metabolic health. Although commonly associated with men, women also produce significant amounts of testosterone. As an anabolic hormone, testosterone aids in muscle and bone strength. A decrease in testosterone levels during menopause can lead to a drop in muscle mass, an increase in fat mass, and a shift in fat distribution.

Weight gain and metabolic dysfunction

The term central adiposity refers to the accumulation of fat around the abdomen. As muscle is more metabolically active than fat, this shift in body composition can contribute to metabolic dysfunction, cardiovascular disease, type 2 diabetes, and chronic inflammation.

Central adiposity or belly fat is also linked with higher amounts of visceral fat — a type of fat that releases inflammatory cytokines and hormones, leading to metabolic dysfunction. This type of body fat can also increase fatty liver disease risk, exacerbating metabolic challenges.

Gut microbiome and metabolic health

Modern research is highlighting the profound impact of excess abdominal fat on the gut microbiome. This is associated with a decrease in beneficial bacteria and an increase in harmful bacteria. These alterations in the gut microbiome can further contribute to metabolic dysfunction, promoting inflammation and disrupting nutrient metabolism.

Improving your lifestyle during menopause

Menopause is a significant life transition that carries profound implications for a woman's metabolic health. It's essential to understand the impact of hormonal changes on insulin resistance, blood sugar, and overall metabolic health. Healthy lifestyle habits are key to supporting metabolic health and improving menopausal symptoms.

Some general ways to improve your lifestyle during menopause include:

• Increasing dietary fibre and protein intake
• Reducing overall calorie consumption if excessive
• Incorporating strength training into your routine
• Managing your stress

Talking to your doctor and other health professionals is important to get lifestyle support that suits you.

How to track your metabolic health

The key to managing menopause and insulin resistance lies in understanding your unique metabolic health profile. Continuous glucose monitors (CGMs) are devices that provide real-time measurements of blood glucose levels, a valuable tool for tracking metabolic health during menopause. They work by using a small sensor inserted under the skin to measure glucose in the interstitial fluid (the fluid between cells).

The Vively app helps you better understand how your body is responding to the hormonal imbalances and adjust your lifestyle accordingly. This is particularly beneficial in addressing the effects of menopause on insulin resistance, blood sugar control, and overall metabolic health. This empowerment can help women navigate the menopausal transition with confidence, maintaining their health and wellbeing during this pivotal time.