Perimenopause is a time of intense hormone fluctuations, which eventually lead to a wide range of symptoms. But along with changes in hormones, blood sugar may be affected during perimenopause, with spikes and drops in your level.e60dc2a1-f33c-4a05-9b50-8e3e8e59762911b7f959-46f2-44a6-a806-0e8eb00208fa An unstable blood sugar level can then worsen perimenopausal symptoms, as well as cause symptoms of its own. Making dietary changes, such as cutting down on added sugar and opting for whole unprocessed foods, can help stabilize your blood sugar and manage perimenopause symptoms.
How Perimenopause Affects Blood Sugar How Perimenopause Affects Blood Sugar “During perimenopause, estrogen, which is protective, walks out the door. Progesterone also makes a quick exit, and testosterone begins to wane,” says Maya Feller, RD , founder and lead dietitian at Maya Feller Nutrition in New York. Estrogen plays an important role in regulating blood sugar and insulin sensitivity. Insulin sensitivity refers to how well your body moves sugar out of the bloodstream and into your cells for energy.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291586dccc-3ed7-47c4-8040-01fc1d3dd9df As estrogen levels decline in perimenopause, your body may become less responsive to insulin, resulting in higher circulating levels of sugar in the bloodstream.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6e27826-8009-4e52-a1f2-2398cf770824
How Sugar Can Worsen Perimenopause Symptoms How Sugar Affects Perimenopause Symptoms Symptoms of unstable blood sugar can mimic those commonly seen in perimenopause or worsen those caused by perimenopause itself: Hot Flashes Research suggests that unstable blood sugar levels can trigger or worsen hot flashes. A study that looked at the relationship between high blood sugar and hot flashes in more than 3,000 women found that higher blood sugar levels correlated with more frequent hot flashes.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291230903e-754f-4295-90e9-1e5cb8c89c0f Another study found that premenopausal or early perimenopausal women with persistent hot flashes and night sweats had a 50 percent increased risk of diabetes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629273386a4-34dc-43e0-9f7e-8cd1c35ed223 “Hot flashes and night sweats that occur with these hormonal fluctuations can lead to fatigue, less exercise, and more unhealthy food cravings, creating this unhealthy cycle,” says Mindy Goldman, MD , the director of the gynecology program for cancer survivors and at-risk women at the University of California, San Francisco. Mood Swings and Anxiety Emotions can become volatile during perimenopause, but unstable blood sugar can acutely exacerbate symptoms or mimic them.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e081eb83-10dc-4728-b330-53b87ab5417d Fatigue Generalized fatigue is a common symptom during perimenopause, but a lack of sugar being efficiently used by the body can also lead to low energy.e60dc2a1-f33c-4a05-9b50-8e3e8e597629869efbb8-1ace-4197-a320-d7d23eca7537 Brain Fog or Memory Issues These symptoms are believed to be caused by hormonal fluctuations, which can affect brain function. Blood sugar fluctuations can also cause similar symptoms, as the brain relies on blood sugar for energy.e60dc2a1-f33c-4a05-9b50-8e3e8e59762927044f86-d707-4907-8e4a-20085c243e2ee60dc2a1-f33c-4a05-9b50-8e3e8e597629a5012502-eb83-4d6c-a9c4-95d527e83394 Abdominal Fat Weight gain around the midsection is common during perimenopause, but higher sugar intake also increases visceral fat, says Dr. Goldman. “This is associated with increased insulin resistance and more inflammation, and it increases risks for cardiovascular disease,” she says. Sleep Disturbances Issues such as difficulty falling asleep or staying asleep often occur during perimenopause. Poor sleep can also complicate blood sugar control.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ed2557df-e5cf-4644-b824-24ad08beac37 Joint Pain Some women may experience joint pain in perimenopause as a result of declining estrogen levels. “It is also thought that diets high in processed sugars increase inflammatory cytokines, which might worsen joint pain that is often seen during perimenopause and menopause,” says Goldman. Frequent Urination and Excess Thirst If blood sugar is high, the body will flush out excess amounts, leading to increased urination. This may cause dehydration and subsequent thirst.e60dc2a1-f33c-4a05-9b50-8e3e8e59762977898156-693a-479b-88a1-0f956c6366f2e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6d6cc75-bbdb-4158-8c19-de8f6b37197b
How Much Sugar Is Okay to Eat? How Much Sugar Is Okay to Eat? Many Americans consume more than the recommended amount of sugar. The average daily intake of added sugar is about 17 teaspoons, or about 270 calories per day.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e6dc567c-94ba-4e15-8dd1-c66b27814703 This may not seem like a large amount, but it adds up to about 60 pounds of added sugar per year.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8a9de3d-fe9b-439d-bfa6-4f7b8dbe3b45 “Overall, the average American consumes an excessive amount of added sugar, and much of it is found in sauces, dressings, breads, and hand-to-mouth snacks,” says Feller. So how much is too much? “For most women, the sweet spot is about 6 teaspoons, or 25 grams a day or roughly 100 calories,” says Lena Beal, RDN , a cardiovascular dietitian at Piedmont Atlanta Hospital and a spokesperson for the Academy of Nutrition and Dietetics. “The real issue is when added sugars displace nutrient-dense food, which can contribute to inflammation, weight gain, and higher risk for heart disease and type 2 diabetes.” Several major health organizations have issued recommendations for reducing sugar, and although the numbers are in the same ballpark, there are slight differences between them. The Dietary Guidelines for Americans, jointly issued by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services, recommend that adults limit added sugars to less than 10 percent of their total daily calories. For example, if you consume 2,000 calories a day, added sugars should account for not more than 200 calories (about 12 teaspoons).e60dc2a1-f33c-4a05-9b50-8e3e8e5976293f2c87e9-9cd1-4024-ab4f-75e2e4744c4a The American Heart Association’s recommendations are a little more stringent, since its focus is heart health. It suggests that added sugar account for no more than 6 percent of your daily calories, about 100 calories a day.e60dc2a1-f33c-4a05-9b50-8e3e8e597629de22dadb-8411-4672-9831-c98acf9a5b2f The World Health Organization recommends reducing all sugars, both added and sugar naturally found in foods such as honey and fruit juice, to less than 10 percent of your total daily calories.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291a47e3ce-5459-414f-9d72-daff0e7c7d3a However, this recommendation doesn’t apply to the natural sugars found in fresh fruits, vegetables, and milk, as those have no evidence of harmful effects.
Tips for Cutting Down on Sugar Tips for Cutting Down Reducing your sugar intake can be challenging because much of the sugar we consume is hidden within processed foods. As a result, you may not even realize how much sugar you’re actually eating. Beal recommends starting small and focusing on swaps, not sacrifice. “Sugar isn’t bad. The key is keeping it in check while prioritizing whole, minimally processed foods that nourish your body,” she says. Here are some practical tips to help you cut down on your sugar intake: Learn the Lingo Sugar comes in many forms and goes by many names, including brown rice syrup, corn syrup, molasses, coconut sugar, honey, date syrup, dextrose, barley malt, and agave. Familiarize yourself with the different forms. Identify Hidden Sugars Look for added sugars on nutrition labels of the foods and beverages you purchase . “I encourage people to become informed consumers and learn to read nutrition labels,” says Feller. “The added sugars are listed on all packaged goods.” Some products to scrutinize more closely include condiments, sauces and marinades, cereals, and flavored yogurt. Cut Back on Added Sugars Try cutting the amount of sugar you regularly add to beverages or food. “When cooking at home, making swaps such as using whole fruit in place of added sugar can significantly reduce the total sugar content,” says Feller. She also recommends cutting the amount of sugar any recipe calls for in half. Taper Gradually “Reduce how much sugar you add to coffee or cereal each week to help your taste buds recalibrate, says Beal. She also suggests “flavoring smarter,” by using cinnamon, vanilla, citrus zest, or berries for sweetness without sugar. Cut Down on Sugary Beverages Rethink your drinks. “Water, seltzer with fruit slices, or unsweetened tea can cut sugar intake dramatically,” says Beal Choose Whole Foods As much as possible, eat whole foods that are minimally processed and unrefined. These foods are packed with nutrients and free from added sugar. What About Artificial Sweeteners? Artificial sweeteners have been used for decades and offer an alternative to sugar. These compounds are designed to taste like sugar but have very few or even zero calories. They don’t affect blood sugar levels in the same way that sugar does, and they are often used by people with diabetes for that reason.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296abfa1d2-8d15-4238-94aa-0ff3b7c1a1dc As they tend to be much sweeter than sugar, very little is usually needed when added to foods or drinks. The U.S. Food and Drug Administration (FDA) has approved the following sugar substitutes:e60dc2a1-f33c-4a05-9b50-8e3e8e59762904e4b0ca-bca4-4f0b-a7b8-bfbf7ca256ff Acesulfame potassium Advantame Aspartame Neotame Saccharin Sucralose Stevia, monk fruit, and allulose are derived from plants and the FDA considers them to be generally recognized as safe for use as low-calorie sweeteners.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d9c0ab60-ebc2-46fa-8454-d109be100378 “Low- and no-calorie sweeteners are a good alternative for people who are looking for sweet taste without added sugars,” says Feller. “It’s really a case of personal preference. Many of my patients prefer monk fruit or stevia.” Beal agrees and notes that these alternatives can help women reduce added sugar, especially when transitioning away from sugary beverages or desserts. The FDA and other health agencies around the world consider artificial sweeteners to be safe for use among the general population. However, some research suggests that when you use artificial sweeteners every day and over a long period of time, there may be a higher risk of stroke and heart disease. A study published in 2022 that included over 100,000 people found that artificial sweeteners were linked to a 9 percent higher risk of any type of heart problem and an 18 percent greater risk of stroke.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292245f64b-4e3d-401b-b81f-131e6463660c Specifically, three of the sweeteners carried the highest risk: aspartame (NutraSweet, Equal) was linked to a higher risk of stroke, and both acesulfame potassium (Sunnett, Sweet One) and sucralose (Splenda) were linked to a higher risk of coronary artery disease. However, it remains unclear why these products might be contributing to heart disease, and the study authors note that further research is needed to confirm these results. Research on the effect of these sweeteners on the gut microbiome and long-term metabolic effects is also still evolving.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ef26398-83ba-44ea-a934-ad6676fe2571 The American Heart Association recommends using artificial sweeteners when necessary; the organization calls them a “good bridge” when trying to cut down on added sugars. These products can work as a short-term solution for people who are gradually training their palates to become accustomed to less sweetness in their diet.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a32d58b4-41bf-4436-a376-9776fc61fd92 “My advice is to use them sparingly — as a bridge and not a crutch,” says Beal. “If you rely heavily on sweeteners, you may still crave sweet tastes. For the best long-term results, focus on retraining your palate with naturally sweet whole foods like fruit, sweet potatoes, and dairy.”
The Takeaway Declining levels of estrogen and progesterone can lead to fluctuations in blood sugar levels. Symptoms of blood sugar fluctuations can mimic those commonly seen in perimenopause and may also worsen existing perimenopause symptoms. A high sugar intake can impact blood sugar levels, which may worsen perimenopausal symptoms such as hot flashes, mood swings, and fatigue. Cutting back on added sugar and opting for foods in whole and minimally processed forms can help stabilize blood sugar.
Resources We Trust Mayo Clinic: The Reality of Menopause Weight GainAmerican Heart Association: Tips for Cutting Down on SugarCenters for Disease Control and Prevention: Get the Facts: Added SugarHarvard Health: Sleep, Stress, or Hormones? Brain Fog During PerimenopauseWorld Health Organization: WHO Calls On Countries to Reduce Sugars Intake Among Adults and Children
