The menstrual period is more complex than you think. It is not just a monthly occurrence in a woman’s body; that is because it can also affect other body functions. Although we know it is a series of physical and emotional changes caused by hormonal shifts, it is still difficult to understand them.
Some effects that could happen during a menstrual cycle are increased heart rate, brain chemistry, memory, cognition, and blood sugar levels. The magnitude of these changes can vary depending on the person’s lifestyle. Some women would not feel these, and some would feel severe symptoms, especially women with diabetes.
For example, this study by Schweiger et al. (2011) [1] said that teenagers with type 1 diabetes are predisposed to irregular periods. That is why it is necessary that diabetic women must be knowledgeable about their health, especially during their menstrual cycle, when hormones can fluctuate and impact their homeostatic functions.
So, please continue reading this article because it will cover how the menstrual cycle can affect our blood sugar levels and what happens during menstruation, diabetes management, and medical care.
Menstrual cycle
During a monthly menstrual cycle, the period begins on the first day of the cycle and ends on the first day of the next cycle. It varies from woman to woman, but according to the American College of Obstetricians and Gynecologists (ACOG), [2] the typical cycle length is 21 to 35 days.
The menstrual cycle has two phases: the follicular and luteal phases. The follicular phase begins on the first day of the last period until ovulation. During this phase, the pituitary gland in the brain releases the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). The hormone FSH stimulates the growth and development of follicles in the ovary, each containing an immature egg.
Growth of the follicles produces estrogen hormone, which makes the uterine lining (endometrium) thicken in preparation for pregnancy. Then around the 14th day of the menstrual cycle, the surge of LH triggers ovulation. The mature egg will be released from the ovary to the fallopian tube in the hopes that the sperm will fertilize it.
Furthermore, the luteal phase begins on the last day of ovulation until the next period begins. In this phase, the empty follicle evolves into a corpus luteum which secretes the hormone progesterone. This progesterone helps the body by preparing it for pregnancy. It thickens the uterus lining, called the endometrium, to make it more suitable for a fertilized egg.
However, if the egg is not fertilized, this corpus luteum degrades, and the progesterone will drop. This process triggers the shedding of the endometrial lining, resulting in menstruation.
How Hormones Affect My Blood Sugar Level?
Hormones during a menstrual cycle fluctuate. Moreover, this study by Barata et al. (2013) [3] showed that hormonal shifts could increase or decrease insulin sensitivity. The study concluded that blood sugar levels were significantly lower during the follicular phase and higher during the luteal phase.
The estrogen hormone dominates the follicular phase, the first part of the menstrual cycle. Moreover, that is beneficial to know since, in this study by De Paoli et al. (2021), [4] estrogen improves glucose tolerance and insulin responsiveness.
However, insulin sensitivity is lower in the second phase, which is the luteal phase. In this part, progesterone decreases insulin sensitivity, so the body will have difficulty regulating blood sugar levels. For example, in this study, by Wada et al.(2010), [5] progesterone increases insulin resistance. Moreover, if this insulin resistance is prolonged, it will result in further complications such as coronary artery disease and hypertension. [6]
That is why it is imperative to know these processes to be aware of what steps to take. Monitoring your menstrual cycle and what phases you are currently in is detrimental to your health. Additionally, eating a healthy and low-sugar diet could help maintain sugar levels, especially in the luteal phase.
Self-Management Tips with Diabetes
These are a few tips for controlling the effects of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases: [7]
Stick to a healthy diet
Even if you do not have diabetes, eating a nutritious and balanced diet is critical to optimizing one’s life. As we all know, carbohydrates impact blood sugar levels the most. So managing your diet, like portion-control food containing carbohydrates, is a must to prevent elevated blood sugar levels. Also, avoid processed sugar like coffee, sodas, and powdered juices in your diet. Get your sweet tooth fixed on fruits and vegetables as much as possible. Lastly, portion your food and coordinate it according to your medications. You can use a weighing scale or measuring cups so the amount of food matches your health care professional plans. Moreover, create good meal timing with your medications because if not, too few carbohydrates could cause low blood sugar (hypoglycemia). And too many carbohydrates could lead to high blood sugar (hyperglycemia).
Exercise
Ask a medical doctor for clearance before engaging in physical activity. In this way, the schedule will coordinate with your medications. The study by Colberg et al. (2010) [8] exercises help control blood sugar levels. It could prevent and delay type 2 diabetes, so exercise or working out should be concluded to your changed lifestyle. You must check your blood sugar levels before, during, and after exercise to prevent cases of hypoglycemia. Moreover, drinking enough water can also prevent dehydration, as this can alter your sugar levels.
Medications
Diabetic medications like insulin will typically lower your blood sugar levels. And taking this medication with physical activity can rapidly decrease your blood sugar levels. So consult first with a medical professional before planning these types of activities. Furthermore, contact a doctor immediately if you experience inconsistent symptoms after taking your medications. Additionally, securing insulin at room temperature and checking the expiration date from time to time can prevent any medical complications.
Monitor hormone changes
You must track your monthly hormonal fluctuations to prevent imbalances in blood sugar levels. Check your blood sugar frequently, especially during the luteal phase, where blood sugar levels are generally high. Menstrual symptoms and blood glucose tend to get exacerbated by stress. So practice stress management techniques because stress-reduction techniques could prevent elevated blood sugar levels and severe menstrual symptoms.
FAQ
Can Insulin Stop My Period?
No, insulin will not stop the menstrual cycle, as this study by Toth et al. (1987) [9] suggested. However, insulin will indirectly influence women’s hormones if the body cannot properly regulate the effects of insulin. This process could produce androgen hormones, disrupting the body’s balance between estrogen and progesterone. And this disruption could cause irregular periods and menstrual problems.
Food Suggestions For Diabetic Women
A high-protein diet: Eating carbohydrates with protein can slow down glucose absorption into the bloodstream. So the rise of blood glucose levels will be slow and not abrupt.
Examples: Seafood, lean meats like chicken, eggs, and beans
Non-starchy vegetables: These our low-calorie types of vegetables. And they properly regulate blood sugar levels since they contain low carbohydrates and are high in fiber.
Examples: Asparagus, green beans, carrots, broccoli, mushrooms
Carbohydrates: It is essential to note that this type of food will have the most significant impact on blood glucose levels. So it is essential to choose unprocessed food with no added sugar or sodium and follow the recommended portion from your medical doctor.
Examples: Whole wheat bread, peas, lentils, fruits
Fats: Unsaturated fats that are portion-controlled can also promote longer satiety.
Examples: Olive oil, avocado, sunflower seeds, nuts
Dairy: Although dairy contains calcium and protein, it could raise blood sugar levels. However, you can still consume by opting for low-fat alternatives.
Examples: Low-calorie greek yoghurt, low-fat milk
The following diet recommendations come from American Diabetes Association. [10]
Can Period Raise My Blood Pressure?
Blood pressure is higher during the first few days of the menstrual period than the latter days of the cycle, according to Dunne et al. (1991). [11] However, the slight increase in blood pressure is minimal. Further studies should be conducted to link periods and blood pressure changes.
When to See the Doctor?
If you are diagnosed with diabetes, seeing your doctor every 3-6 months [12] is recommended. And especially for women with diabetes, monitoring blood glucose levels and your changing hormone levels is crucial. Therefore, if you feel any of the symptoms below, it is best to contact your medical doctor immediately.
- High or low blood sugar
- Excessive thirst
- Blurry vision
- Fatigue or weakness
- Wounds that heal very slowly
- Recurrent infection
- Numbness and tingling of the feet and hands
Final Thoughts
All in all, hormonal fluctuations can affect blood sugar levels. And mainly, it depends on the menstrual phases—specifically, the luteal stage, where there is a decreased response of the body to insulin. As a result, the body will have difficulty processing glucose within our bloodstream, increasing blood sugar levels.
However, seeking medical opinion immediately, changing lifestyle, and closely monitoring our overall health could prevent complications and optimize the lifestyle of a woman affected by diabetes.
References:
- Schweiger, B.M., Snell-Bergeon, J.K., Roman, R. et al. Menarche delay and menstrual irregularities persist in adolescents with type 1 diabetes. Reprod Biol Endocrinol 9, 61 (2011). https://doi.org/10.1186/1477-7827-9-61
- American Academy of Pediatrics Committee on Adolescence, American College of Obstetricians and Gynecologists Committee on Adolescent Health Care, Diaz, A., Laufer, M. R., & Breech, L. L. (2006). Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics, 118(5), 2245–2250. https://doi.org/10.1542/peds.2006-2481
- Denise S. Barata, Luís F. Adan, Eduardo M. Netto, Ana Claudia Ramalho; The Effect of the Menstrual Cycle on Glucose Control in Women With Type 1 Diabetes Evaluated Using a Continuous Glucose Monitoring System. Diabetes Care 1 May 2013; 36 (5): e70. https://doi.org/10.2337/dc12-2248
- De Paoli, M., Zakharia, A., & Werstuck, G. H. (2021). The Role of Estrogen in Insulin Resistance: A Review of Clinical and Preclinical Data. The American journal of pathology, 191(9), 1490–1498. https://doi.org/10.1016/j.ajpath.2021.05.011
- Wada, T., Hori, S., Sugiyama, M., Fujisawa, E., Nakano, T., Tsuneki, H., Nagira, K., Saito, S., & Sasaoka, T. (2010). Progesterone inhibits glucose uptake by affecting diverse steps of insulin signaling in 3T3-L1 adipocytes. American journal of physiology. Endocrinology and metabolism, 298(4), E881–E888. https://doi.org/10.1152/ajpendo.00649.2009
- Reaven G. M. (1995). Pathophysiology of insulin resistance in human disease. Physiological reviews, 75(3), 473–486. https://doi.org/10.1152/physrev.1995.75.3.473
- (n.d.). 4 Steps to Manage Your Diabetes for Life. NIH. https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/4-steps
- Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., Braun, B., American College of Sports Medicine, & American Diabetes Association (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes care, 33(12), e147–e167. https://doi.org/10.2337/dc10-9990
- E. L. TOTH, A. SUTHIJUMROON, P. M. CROCKFORD, E. A. RYAN, Insulin Action Does Not Change During the Menstrual Cycle in Normal Women, The Journal of Clinical Endocrinology & Metabolism, Volume 64, Issue 1, 1 January 1987, Pages 74–80, https://doi.org/10.1210/jcem-64-1-74
- (n.d.). Food Groups and Portion Sizes. ADA. https://professional.diabetes.org/pel/food-groups-and-portion-sizes%E2%80%AF-english
- Dunne, F. P., Barry, D. G., Ferriss, J. B., Grealy, G., & Murphy, D. (1991). Changes in blood pressure during the normal menstrual cycle. Clinical science (London, England : 1979), 81(4), 515–518. https://doi.org/10.1042/cs0810515
- (n.d.). Your Diabetes Care Team. WebMD. https://www.webmd.com/diabetes/diabetes-health-care-team