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Navigating Perimenopause and Type 1 Diabetes: My Personal Journey

As women managing Type 1 Diabetes (T1D), the journey through perimenopause can feel like a train wreck. The absence of information concerning how perimenopause affects glycemic control poses a significant challenge, impacting our hormonal balance, blood sugar levels, and our mindset about aging with a chronic disease.


In episode 53 of The Type 1 in Midlife podcast, I talk about this crucial yet often overlooked subject, exploring the link between perimenopause and T1D, sharing my own personal journey. Discover strategies to confidently manage diabetes amidst fluctuating hormone levels, navigating through blood sugar swings, bodily changes, and the sense of isolation.



In this study, women shared their experiences during perimenopause:

"The unpredictability definitely makes it harder, because I was so regular, and I was in a system. So, it's… can be unexpected, unpredictable to me is the biggest challenge," (Viviene).
"Unfortunately, it's a juggling game which, if you can say, I've got this piece of food here and I can dose for that, and that's fine, but there's other things that come into the equation that I can't explain. If you're having hot sweats during the night, that kind of masks the symptoms because you're not sure… I mean you can be clammy and be hypo and you can be clammy because of menopause," (Suzanne).
"…because your diabetes is always with you, the menopause is like a visitor; it's the stranger, while diabetes is something familiar," (Rachael).




Understanding Perimenopause's Impact on Blood Sugar

Perimenopause, the transition to menopause, brings hormonal fluctuations that can profoundly affect blood sugar levels, especially for those with T1D. Changes in estrogen and progesterone levels can lead to insulin resistance, making it difficult to maintain stable glucose levels.


Health coach Melissa Slemp

How Do You Know If You're in Perimenopause?


Knowing the true definition can provide clarity:

'Perimenopause refers to the transitional phase before menopause when a woman's body begins to naturally transition toward the end of her reproductive years. During perimenopause, hormone levels, particularly estrogen and progesterone, fluctuate irregularly, leading to various symptoms such as irregular menstrual cycles, hot flashes, mood swings, weight gain, insulin resistance, sleep disturbances, and changes in libido. Perimenopause typically begins in a woman's 40s but can start earlier or later, and it can last for several years before menopause officially occurs.' (Mayo Clinic, May 2023)

Managing Blood Sugar Levels

Navigating perimenopause and T1D necessitates a multifaceted approach to blood sugar management. Monitoring insulin pump reports and understanding increased insulin requirements are essential. Effectively managing menopausal symptoms can reduce anxiety surrounding blood sugar fluctuations.


Women typically don't know how perimenopause will affect blood sugar:

  • Your usual routine may not work anymore.

  • It can be frustrating, stressful, and feel hopeless.

  • Leads to unpredictable levels.

  • Menopausal symptoms can mimic signs of hypoglycemia, especially at night.

  • Menopause can induce anxiety, stress, and fear due to its unfamiliar impact on blood sugar.

  • You need support and resources on what to ask your doctor and how to advocate for your needs.

Personal Experience

At the age of 50, I embarked on a yoga retreat in Costa Rica with friends, unaware that my body was already shifting due to perimenopause. I grappled with feelings of bloating and not recognizing my body anymore and I felt anxious about the unfamiliarity. During the retreat my blood sugar became unpredictable, requiring more insulin. Upon returning home, conversations with friends sparked my curiosity about perimenopause and hormones.


Drawing from my health coaching background, and my study of hormone health, I was looking for clear answers. Reaching out for medical guidance was pivotal and requesting hormone testing to have a better idea of what stage I was in, and if it was linked to my insulin resistance and weight gain.


Reflecting on this experience, it was empowering to have answers and most importantly a clearer direction. I deserved this and recognized perimenopause as a time for growth. Now, I use my experience as a gift to enrich my health coaching to inspire other women facing similar challenges. Get started with my free guide to help you navigate type 1 diabetes through menopause.


Expert Insights

Managing T1D during menopause requires a proactive approach to hormone health. Seeking guidance from healthcare professionals specializing in diabetes and menopause is crucial for personalized recommendations and support. Click here for my free guide to help you manage diabetes during menopause.


In episode 27 of the Type 1 In Midlife Podcast, Dr. Tabitha Barber highlighted the importance of hormone level testing and symptom management during perimenopause. Regular monitoring, especially with the FSH test, enables early detection and proactive symptom management. Hormone replacement therapy (HRT) may offer relief from perimenopausal symptoms but requires careful consideration regarding its interaction with diabetes management.


For more information on hormone replacement therapy and testing, listen back to Episode 27 with Dr. Tabitha Barber on managing hormone levels and your symptoms.


Community Support and Resources

Staying connected with a supportive community is validating and very necessary. I provide free resources and consultations to help women navigate discussions with doctors about hormone replacement therapy and perimenopause, fostering community and sharing knowledge.


Our Type 1 In Midlife community is here to provide encouragement and guidance during perimenopause and beyond. Download the free Honey Health Diabetes App and join us.


Managing perimenopause with T1D can be tough, but by focusing on hormone health, staying on top of diabetes, and seeking support, women can navigate this phase with confidence. Let's embrace the changes, prioritizing health and well-being along the journey.


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Melissa reading at a desk and Melissa with arms up and happy



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