Insulin Resistance and Menopause: What You Might Not Know


Insulin resistance might not be on your radar, and you might not know exactly what it is. However, if you’re in the menopausal transition (that’s over 40), it’s something that could be affecting you.

 If you’re noticing weight gain without dietary changes, coupled with typical menopause symptoms like fatigue, brain fog, mood swings, insomnia, or headaches, it’s important to consider that these issues might be related to fluctuating hormone levels, but they could also be linked to elevated insulin levels.

In this article, we’ll unravel the science behind this relationship, shedding light on why insulin resistance becomes more prevalent during menopause and how it can affect overall health. But more importantly we’ll discuss practical steps you can do if you think you might be insulin resistant.

What is insulin resistance?

Insulin is a hormone produced by the pancreas. Its primary role is to regulate blood sugar (glucose) levels in the body. When we eat foods containing carbohydrates, our blood sugar rises. Insulin helps our cells absorb glucose from the bloodstream, allowing them to use it for energy or store it for later use. Insulin is often described as the key that unlocks the door to the cell. Glucose can’t get into the cell without insulin. Insulin resistance is when the key gets stuck in the lock and can’t open the door to let the energy in.

Graphic on How Does Insulin Work

The body compensates by producing more and more insulin, causing you to have higher levels of both blood glucose and insulin. This excess insulin production can contribute to the development of metabolic syndrome. Metabolic syndrome is characterized by a group of conditions, including high blood pressure, high blood glucose levels, abdominal weight gain, high triglycerides, and low HDL cholesterol.

Does menopause cause insulin resistance?

We become more at risk of insulin resistance during menopause because of changes in our hormones. When women go through menopause, the levels of certain hormones, like estrogen and progesterone, change a lot. These hormones play a role in how our cells use insulin. When their levels drop, it can make our cells not respond as well to insulin, leading to insulin resistance.

Loss of muscle mass and increases in abdominal fat, which is also common in menopause, also likely contribute to insulin resistance.

Insulin resistance can also be triggered by various factors, including genetics, specific medications, and certain medical conditions such as polycystic ovary syndrome (PCOS).

In postmenopausal women, an increase in the insulin resistance is associated with an increased risk of diabetes, heart disease, and breast cancer.

Signs and Symptoms of Insulin Resistance in Menopause

During menopause, signs and symptoms of insulin resistance may include:

1. Fatigue: Feeling constantly tired, despite getting enough rest.

2. Increased Hunger: Especially craving sugary or high-carbohydrate foods.

3. Weight Gain: Unexplained weight gain, particularly around the abdomen, even if your diet and activity level haven’t changed significantly.

4. Frequent Urination: Having to urinate more often than usual, particularly during the night.

5. Brain Fog: Having trouble concentrating, mental fogginess, or memory issues.

6. High Blood Pressure: An increase in blood pressure levels.

7. High Cholesterol: Elevated cholesterol levels, particularly triglycerides.

8. Skin Changes: Skin changes, such as dark patches on the neck or in the armpits (acanthosis nigricans), or skin tags (small skin growths).

Visual list of signs and symptoms of insulin resistance in menopause

How to test for Insulin Resistance

The most precise test for insulin resistance is complicated and primarily used in research. Typically doctors rely on simpler blood tests to detect insulin resistance. The two tests frequently used are the fasting plasma glucose (FPG) test and the A1C test.

Fasting Blood Glucose Test: This test measures blood glucose levels after a fast, typically overnight. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal.

Hemoglobin A1c Test: This test reflects average blood sugar levels over the past three months. While primarily used to diagnose diabetes, it can also indicate insulin resistance if the result is consistently higher than normal. An A1c level below 5.7% is considered normal.

Less common approaches include:

Oral Glucose Tolerance Test (OGTT): This test involves fasting overnight, consuming a glucose drink, and then measuring blood glucose levels at specific intervals. It helps assess how well your body handles glucose over time.

Homeostasis Model Assessment (HOMA-IR): This is a mathematical formula using fasting glucose and fasting insulin levels to estimate insulin resistance.

Clinical Assessment: Doctors may also consider your medical history, family history, and other risk factors when assessing insulin resistance. If you have a family history of Type 2 diabetes, you had gestational diabetes during pregnancy, you have high blood pressure or you are more apple shaped than pear, you may be at higher risk of insulin resistance.

How do you fix insulin resistance in menopause?

Treating insulin resistance during menopause involves a combination of lifestyle changes and, in some cases, medical interventions. Here are the best ways to manage:

Healthy Eating: Focus on a Mediterranean style of eating that is rich in high fibre grains, lean proteins, healthy fats, and plenty of vegetables. Keep excessive sugar and refined carbohydrates to a minimum.

Regular Exercise: Engage in physical activity that combines aerobic exercises (like walking, swimming) with strength training. We need to get our muscles moving as they are the highest consumers of the glucose in our blood. High Intensity Interval Training (HIIT) specifically helps improve insulin sensitivity during menopause.

Stress Management: Practice stress-reduction techniques such as mindfulness, yoga, meditation, or deep breathing exercises. High stress levels can impact insulin sensitivity.

Sleep: Insufficient sleep is associated with insulin resistance, so do all you can to get a good night’s sleep. Easier said than done, I know.

Insulin Resistance diet

Following a Mediterranean style of eating, like mentioned above, has been shown to reduce insulin resistance. Key nutrients that help reduce the risk of insulin resistance are:

Fiber: Foods that are high in fiber, especially cereal fibres and whole grain products improve insulin sensitivity and blood sugar control.

Plant proteins: Several large studies have found that individuals with the high meat consumption have a greater chance of developing type 2 diabetes than those with the low intake. Substituting some of the animal protein for vegetable protein (5% of total energy intake) was associated with a 23% reduced risk of type 2 diabetes.

Antioxidants: Women with who eat foods high in anthocyanin and flavones have lower rates of insulin resistance and inflammation markers. Time to load up on berries, oranges, pears, grapes, peppers. And don’t forget the tea-its rich in flavonoids.

Monounsaturated fats: Foods that are high in monounsaturated fats, such as olive oil, avocados, and nuts, may help improve insulin sensitivity.

Magnesium: Low levels of magnesium have been linked to insulin resistance, and increasing magnesium intake through foods, such as nuts, seeds, and leafy green vegetables, may help improve insulin sensitivity.

Chromium: Chromium is a trace mineral that may help improve insulin sensitivity and blood sugar control. Foods that are high in chromium include whole grains, nuts, and vegetables such as broccoli and green beans.

Does HRT help Insulin resistance?

According to the North American Menopause Society, the primary indications for hormone replacement therapy are menopausal symptoms: hot flashes, night sweats, vaginal dryness, and for the prevention of osteoporosis. The effect of menopause hormone replacement on insulin resistance is not well studied, some studies show improvement and others do not. A small study of 40 post-menopausal women who already had diabetes, showed reduced fasting glucose, A1C and levels of insulin during use of hrt.

Understanding and addressing insulin resistance can pave the way for a healthier and more empowered menopause transition. By making informed choices, embracing lifestyle adjustments, and seeking support from healthcare professionals, your well-being is in your hands. If you need some individual support, reach out to me-I am happy to help.

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Sandra Turnbull
Sandra Turnbull

Sandra has 30+ years experience as a Registered Dietitian and Certified Executive Coach, and is passionately committed to sharing evidence-based information while helping women thrive during the monumental transition that is menopause.


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Sandra Turnbull
Sandra Turnbull

Sandra brings over three decades of expertise both as a Registered Dietitian and a Be Body Positive facilitator. As a fellow midlife adventurer herself, she is committed to providing evidence-based guidance and compassionate support to women navigating the pivotal journey of menopause. For her it’s about nurturing bodies and minds with kindness and understanding, knowing its not just about what is on your plate; it’s also about how you feel in your skin.