Low blood sugar during perimenopause and menopause
We know that falling oestrogen levels can interfere with insulin regulation (1), so when we eat food and when we don't, our insulin production isn't quite as efficient as it should be. So, our blood sugar levels tend to become much more erratic. They can swing up and then dip down very quickly. It's this inability to keep the blood sugar balanced that can cause a lot of symptoms that are identical to menopause symptoms.
Sometimes, it can be really difficult to figure out what's what. And if you think that these symptoms are all to do with menopause, then you're not addressing the real issue. Also, if they are low blood sugar issues, then taking hormonal remedies would probably not really help, so you have to treat this in a completely different way.
For those of you who are post-menopause whose symptoms may have eased off a number of years ago, if you suddenly get these back again, then very often it has more to do with low blood sugar rather than your sex hormones flaring.
Signs of low blood sugar to be aware of
Some signs of low blood sugar levels which are also very similar to perimenopause and menopause symptoms can include:
Sweating: This can happen anytime, but it's not due to hot weather, physical exercise, or being a little bit anxious.
Shakiness: You might find that you get shakes or you're physically trembling. And that's a really horrible one.
Dizziness: You can feel lightheaded or feel a little bit faint.
Brain fog: This is a really classic one. You can struggle to concentrate and have difficulty focusing or remembering things
Irritability or mood swings: Low blood sugar can affect your mood, making you feel irritable, anxious, or even aggressive. And these mood changes can come on really, really quickly.
Hunger and cravings: You can get sudden, intense hunger pangs even if you've just eaten recently; and very often you get sugar cravings. If you're trying to lose weight, or if you're trying to modify what you're eating, these sugar cravings, which are part of the body's natural response to low blood sugar, can be uncontrollable.
Headaches: You can get that kind of thumping headache in the background.
Nausea: You may feel queasy or nauseous.
Blurred vision: Low blood sugar can affect your vision, causing blurriness or difficulty focusing.
Overwhelming fatigue: With this one, you could be fine one minute and then the next minute, you just want to lie down and fall asleep.
What can you do to help yourself?
Here are a few things I recommend to help your blood sugar balance during perimenopause and menopause:
Eat a balanced diet: You want to keep your blood sugar as stable as possible. So, eat foods that are going to keep your blood sugar stable and avoid foods that are going to make them go all over the place. Look at introducing a small amounts of complex carbohydrates into you diet, such as whole grains, legumes, things like lentils, vegetables, and lovely starchy vegetables.
You want to limit simple carbohydrates or avoid them completely if you can; so, that's things like sugary food, biscuits, cakes, sweets, prepacked breakfast cereals, anything like that, which is going to break down really quickly and give you a big shot of sugar.
Include protein in your meals: You need to try and get protein with every meal. Protein is one of the best things for stabilising your blood sugar, so try and get some kind of protein at every meal, such as white meat, fish, beans, tofu, and eggs.
Vegetarians and vegans may find it a little more challenging because you can only eat so much tofu and beans. If you feel you need more but cannot incorporate this into your daily diet, you may want to consider plant-based protein powder shakes to help you increase your intake. One of those on a daily basis can be really helpful, just to keep your blood sugar really stable.
Choose healthy fats: You're looking at healthy fats. So, protein and fats are the best things to keep your blood sugar stable, so it's things like extra virgin olive oil, it's nuts, and seeds, things like avocados, having those in your diet. And nuts and seeds are an absolutely fabulous midmorning or midafternoon snack if you just feel that your blood sugars are getting a little bit shaky.
Eat regularly and don’t skip meals: Have regular balanced meals, and don't skip meals, especially breakfast. This is the one meal of the day that is really important. If you skip breakfast, then you're starting your whole day's journey in a low blood sugar state, and it can be a lot harder to make it up. Your body will just crave sugary foods for the rest of the day, regardless of what else you eat, so a good breakfast with protein and fats in it, or your protein shake, is really the best way to go as often as you can.
Watch your portion sizes: If you have a really huge meal, not only does that stress your digestion, but that can have an impact on your blood sugar as well; so, don't eat too little, but don't eat too much as well. Try and keep things in a really good balance.
Stay hydrated: Dehydration can cause blood sugar to rise, so drinking plenty of water can help regulate blood sugar levels. This is one that can happen two or three times a day if you are not drinking enough water.
Things to avoid: Try and keep caffeine, sugary drinks, and fruit juices to a minimum. Also, things like fruit smoothies are really not a good idea at this particular point. Although you're getting the benefit of the fruit, the sugar in these smoothies will be absorbed into the bloodstream very, very quickly, and that can have quite a big impact on your blood sugar control as well.
And please, please, please don't have coffee the minute you get out of bed, because that will rev up everything, and it will take hours for your body to rebalance again after that cup of coffee; so, have your water first. If you need a cup of coffee, have it after your meal, where it will do less damage.
Regular exercise: This is going to improve your insulin control. Try to do a mix of some sort of aerobic and muscle-strengthening exercise.
Get a good night's sleep: Poor sleep will affect blood sugar levels, especially first thing in the morning. So, anything you can do to sleep better at this time will help.
Manage your stress: Stress revs up your nervous system, and that can affect your blood sugar control as well. Stress remedies, magnesium, deep breathing: all of these can really help.
Are you Menopausal? Need help with your symptoms? Try our Menopause Symptom Checker.
Answer 3 question to find out if you could be menopausal and get personalised tips and advice straight to your inbox based on your results.
When do you need to go to the doctor about this?
As these symptoms are identical to other health issues, if this is happening regularly every day, if you find that the tips I've given don't make any difference at all, this is the point where you should check with your doctor.
The problem is that prediabetes is so common in perimenopause and menopause. It's one of the things that seems to come on with all these hormonal changes, so we are more prone to prediabetes or diabetes (Type 2).
It could be low vitamin D or a vitamin D deficiency. It may be a B12 deficiency. It could be thyroid issues. It could also be heart disease. All of these conditions can give symptoms that are identical to low blood sugar ones; so it's always a good idea if you're really struggling with this, just ask your doctor to test for these.
If they're ruled out, that's absolutely great. It just means that you might have to do a little bit of work on doing all the other things to stabilise your blood sugar.
So, I hope you found this one helpful. It's so common, and for those of you who have been following for a while, you know that I mention controlling blood sugar levels on a regular basis. So today, I've just given you a little bit of extra information. If any of you have experienced this, how did you sort it out? What happened? Please share your stories.
Until next time, have a lovely week and take care.
You may also find these topics helpful:
3 health conditions to watch out for during menopause
6 good habits every menopausal woman needs to have
