We bet you’ve always thought that diabetes and menstrual cycle belong in two completely different doctors’ offices. And honestly, that makes sense. At first glance, they don’t seem connected at all. But the truth is, your blood sugar and your period are in a complicated two-way relationship. Or as some might call it, a situationship.
Now, we all know someone with diabetes, a relative, a grandparent, or a neighbour. And why wouldn’t we? According to the International Diabetes Federation (IDF), India is home to more than 77 million diabetic people.
But what many don’t realise is that, as per research, more women in urban areas are affected by diabetes than men. And we aren’t talking about Type 1, the kind you’re born with. We’re talking about Type 2 diabetes, the one that makes up a whopping 90% of all cases and is deeply linked to our lifestyle, health and… you guessed it… gender.
The statistics are actually wild. Studies show that the lifetime risk of developing diabetes is around 10 times higher for women than men. And this risk keeps on increasing with age. Again, more for women than men.
So what’s going on? Why the gender gap? It’s the cyclical fluctuation of female hormones across the menstrual cycle, perimenopause and menopause. Let’s unpack this in a bit more detail.
How Your Period Messes With Your Blood Sugar Levels
Ever noticed that in the week before your period, you’d fight someone for a piece of chocolate? Or that your craving for carbs is crazy intense? It’s not your failure of willpower. It’s your hormones (estrogen, progesterone and insulin) messing with your blood sugar.
Think of insulin as the key that unlocks your body’s cells to let glucose (sugar) in and make energy. In short, insulin = less glucose in blood, more glucose inside cells.
In the first half of your cycle (the follicular phase), estrogen is the star player. It helps your cells remain sensitive to insulin, which means sugar moves from the blood into the cells, keeping your blood sugar levels stable. All is fine. All is calm.
But after you ovulate, a.k.a. PMS week, your body enters the luteal phase. Now, progesterone takes over. Progesterone’s main job is to prepare your body for a potential pregnancy. To do this, it wants to keep plenty of energy – glucose – available in the blood (and not in the cells) for the growing baby. It achieves this by purposefully making your cells less responsive to insulin. In other words, your cells become insulin-resistant.
And when your cells start resisting the insulin, sugar remains in your blood instead of moving into the cells, causing your blood glucose levels to naturally run higher (hyperglycemia). This increase in glucose levels can be as high as an extra 40 mg/dL.
Your body, sensing your cells aren’t getting energy, sends a panic signal to your brain for more energy, making you want to eat more. Hello, period cravings. If you give in and eat more, it simply means more sugar in the blood on top of what was already there, resulting in even higher blood sugar levels.
But what does this have to do with women having a higher lifetime risk of diabetes?
If progesterone’s plot to make you insulin-resistant was happening once in a while, it’d be okay. Your body would’ve let it slide. But in reality, it happens month after month, every month for decades. Over time, it messes with your glucose levels and insulin sensitivity so much that this repeated stress makes women more prone to diabetes. Research has found that with increasing age, the lifetime risk of diabetes is 37.7% for women while only 27.5% for men.
Of course, this doesn’t happen to every woman. Genetics, diet, activity levels, body weight and even how well your body handles hormonal shifts all play a big role. Some women’s systems adapt better, keeping their insulin balance steady despite the monthly ups and downs.
How Your Blood Sugar Level Messes With Your Period
Your period is actually one of the biggest predictors of your overall health. Doctors even call it the “fifth vital sign,” after body temperature, pulse, respiration rate and blood pressure. What that means is when your cycle is regular, you’re generally overall healthy. But when your periods start getting irregular, something isn’t right.
One of the biggest hidden reasons behind irregular periods is unstable blood sugar levels. When your blood sugar keeps going up and down because of stress, irregular meals, insulin resistance or too much processed food, your body releases more and more insulin to manage it.
Over time, high insulin levels start to confuse your reproductive system because your ovaries have insulin receptors, meaning they can interpret insulin levels. When there’s too much insulin in the bloodstream, it overstimulates the ovaries. In response, the ovaries start producing extra androgens (male hormones, like testosterone) because insulin boosts the activity of certain ovarian cells (theca cells) that are responsible for making these hormones.
This is when your cycle starts getting affected. Extra androgens interrupt the growth and release of an egg (ovulation) each month by throwing off the balance between your reproductive hormones.
Without regular ovulation, your periods become irregular, delayed or even stop altogether. Researchers found that more than 20% of girls with unstable blood sugar levels had irregular periods. And when this pattern continues for months or years, it not only affects your cycle but can also increase the risk of PCOS.
How Perimenopause Makes Women More Vulnerable to Diabetes
Perimenopause is when your hormones are going on one last wild ride before menopause. Instead of a slow, steady change, everything just fluctuates A LOT. ALL THE TIME. And that chaos can really mess with your blood sugar.
Your cycle starts skipping the release of progesterone altogether, making you more insulin-sensitive than usual, which can cause unexpected blood sugar dips (hypoglycemia).
Then there’s estrogen, swinging up and down like a seesaw. When estrogen is high, your body handles sugar better due to good insulin sensitivity. But when it drops, you lose that effect and feel more insulin resistant again. These constant ups and downs make blood sugar levels very, very hard to predict during perimenopause.
And those classic symptoms like hot flashes? They’re not just uncomfortable for you, they’re stressful for your body, too. They trigger your stress hormones (cortisol), which are known to push more and more sugar into your blood, leading to sudden glucose spikes.
Add to that the poor sleep that often comes with perimenopause because even one rough night can make your cells less responsive to insulin the next day.
All of this together, the hormonal swings, the stress and the lack of sleep, puts your blood sugar levels under constant strain, making you more vulnerable to prediabetes or Type 2 diabetes during perimenopause.
How Diabetes and Menopause are Linked to One Another
When menopause begins, your body’s metabolism starts playing by new rules. First, you lose the protective, insulin-sensitising friend you had, aka estrogen, making your cells naturally more resistant to insulin.
Second, the loss of estrogen fundamentally changes where your body stores fat. Your entire life, estrogen has guided fat storage to your hips and thighs. Once estrogen is gone, your body defaults to storing fat in your abdomen.
This belly fat is not just extra weight. It is active tissue that releases inflammatory substances, which can make insulin resistance even worse. That is why many women find it harder to manage their weight and blood sugar after menopause, opening the window to diabetes.
Interestingly, this connection works both ways. Not only does menopause put you at increased risk for diabetes, but diabetes also puts you at an increased risk for early menopause. Why? That’s not clear to scientists yet, but yes, research has shown that women with diabetes undergo menopause 4-5 years before non-diabetic women.
So, Where Does This Leave Us?
Once you understand how your hormones affect your blood sugar levels, you can start taking small steps to lower your chances of developing diabetes.
So, how do you lower your chances of developing diabetes? It is about building a lifestyle that protects your body from those constant hormonal hits. Think of it this way. Every time you choose a whole food meal over a processed one, you are lowering your long-term risk. Every time you make time for a walk, you are making your cells listen to insulin better for years to come. This is not about a perfect diet. It is about consistently adding more fibre, more protein and adequate hydration. Even prioritizing your sleep is a powerful defence.
Also, start tracking your cycle. When you know which parts of your cycle make your blood sugar swing higher or lower, you can plan your meals, workouts and rest days accordingly. Your hormones and blood sugar are constantly in conversation. The more you learn to listen, the easier it becomes to feel balanced.
