The Diabetes Connection in Menopause and What You Can Do About It.

With info for women who have had a hysterectomy.

We spend a great deal of our lives being happy and healthy. We usually eat what we want, drink what we want - but what do you do when your lifestyle suddenly takes a turn? 

I went to visit a dear friend who shared with me she is now diabetic.  She was never a sugar fiend or someone who would be considered high-risk based on habits.  

Since I am now having this conversation with her as someone who is informed and understands so much more about the impact of hormones, I realized a common thread: 

• She had a partial hysterectomy some time ago and was never offered hormone replacement therapy.  

• Her glucose was unusually high even though she is now on medication. 

Her doctor never mentioned hormone replacement therapy (HRT) as an option to stabilize her glucose.  

Diabetes, hormone changes, and menopause are all deeply connected and yet, Black and Brown women are rarely offered the therapies we need to manage them. HRT was never mentioned to her. 

Most women are surprised to learn the severity of their diagnosis, and this is not the first time I’ve seen this happen to someone that I know.  

Let’s break this down.

According to the SWAN Study, Black and Brown women are 3-4 times more likely to develop diabetes during their menopausal years. Approximately 24.5% of Black women in the US will find themselves in this position; 19.1% of Latina/Latinx women and almost 30% of Indigenous women.

The Hormone-Diabetes Connection

When estrogen levels decline during menopause (naturally or due to a hysterectomy), our bodies become more insulin resistant. This can increase blood sugar levels and raise the risk of Type 2 diabetes, especially for Black, Indigenous and Latina women, who are already disproportionately affected.

Add in belly weight gain, fatigue, and inflammation, and the risk climbs even higher. But guess what? Most of us are never told how our changing hormones affect our metabolic health.

Insulin resistance shows up in a number of ways and we may experience all or some of these symptoms: 

• Unexplained weight gain

• Tiredness after a meal, especially a meal high in carbs

• The appearance of dark, thick skin and body tags to form in the folds and creases of your body, usually in your underarms, groin and neck

• Increase in blood pressure

• Increase in triglycerides, which is a type of fat in your body

• Decrease in HDL cholesterol, the “good” cholesterol that you want high levels of

What Exactly Happens After a Hysterectomy?

When a woman has a hysterectomy, especially one that includes removal of one or both ovaries, there’s an abrupt drop in hormones like estrogen, progesterone, and testosterone. This sudden shift can:

   •   Spike your risk for diabetes and heart disease

   •   Trigger hot flashes, night sweats, and joint pain

   •   Lead to brain fog, anxiety, and depression

   •   Impact intimacy and sexual health

Yet, hormone replacement therapy, the very thing that could ease symptoms and reduce long-term risks, is often not offered to us. 

Therapy Isn’t Optional; It’s Essential

After a hysterectomy, your body goes into a sudden menopause that can be more intense than natural menopause. 

Whether our menopause is natural or induced, without hormonal balance, mental and emotional health can suffer. 

We MUST advocate for:

   •   Hormone therapy that supports your unique body

   •   Glucose and metabolic testing post-surgery

   •   Sexual health support

   •   Mental health care to manage mood shifts

Question: What if I’m diagnosed with  Prediabetes & Early Type 2?

Prediabetes can often be managed or reversed if you are very diligent. Your diet and activity are often the key.  In prediabetes, your fasting glucose levels can fall between 100-125/mg

Below are important guidelines: 

   •   Diet: Include low-glycemic, whole foods, balanced carbs

   •   Exercise: 150+ minutes per week of moderate activity.  Add resistance to your routine such as a weighted vest, dumbbells and/or hand weights. 

   •   Weight Management: Even 5-10% weight loss improves insulin sensitivity. Invest in a smart scale and watch for inflammation that may increase body weight via excess fluids.  

   •   Stress & Sleep: Cortisol affects blood sugar and does an irregular sleep cycle.  Create a ritual to manage cortisol levels and make sure you are hitting an average of 7 hours of sleep daily.  

Medications (usually added as diabetes progresses) will help manage symptoms.  Some may carry additional side effects.  

   •   Metformin reduces liver glucose production.

   •   GLP-1 (e.g., Ozempic, Trulicity)  improves insulin response, aids in weight loss

   •   SGLT2 inhibitors (e.g., Jardiance)  help kidneys eliminate excess glucose

   •   Insulin therapy  used in Type 1 and later stages of Type 2

Medications can be extremely effective and can help with weight loss.  Using medication in combination with HRT has been very effective for a lot of women.  

As always, consult your medical professional and if you feel you are not getting the support you need, you have the right to change physicians.  

Question: What Happens When Diabetes Progresses?

When you are diagnosed with diabetes, your body is no longer responding well to insulin and your blood sugar is consistently high.  Your insulin not working or not adequate. Upping testing, your fasting glucose will be in the range of ≥126 mg/dL and your A1C will be ≥6.5%

One key factor is that your pancreas is producing less insulin and you will require  more intense treatment to stabilize your health.  

Complications You Need to Avoid

Should you reach the complications stage, you will face damage to your organs including your heart, kidneys, eyes, nerves. and a highly increased risk of stroke, heart disease, kidney failure, neuropathy and amputations  are highly increased.  The decline in health is gradual but can reach an irreversible stage if not managed.   

What You Can Do Now

If you suspect you may be heading in this direction, here are a few steps you can take to mitigate the progression: 

• Track your symptoms. Keep a journal to monitor changes in mood, blood sugar, energy, and cycles. 

• Keep track of your diet and watch for spikes in blood sugar. 

• Get tested. Ask your doctor to check your A1C, hormone levels, and inflammation markers. There are also measurement tools you can purchase on your own.  

• Should your doctor had not discussed options, Ask the hard questions:  Why wasn’t HRT discussed? What support is available now?

• Ramp up your exercise and diet to help support the mitigation of further development. 

• Integrate supplements to support the reduction of insulin resistance such as Ceylon Cinnamon, Chromium Picolinate, Berberine, Probiotics, Tumeric.

As a rule of thumb, aim to schedule check-in’s with your physician at least every 6 months, especially for a blood panel.  If you monitor your levels on your own, you may also be able to manage any spikes if you are still in the prediabetic range.  

Diet and exercise are always the best routes to take in managing the onset of diabetes.  Make sure you implement more activity and monitor any eating and lifestyle habits.   

Join our community conversations. You’re not alone and we’re building the table where our healing is the priority.

---

Join the Melanated Menopause Alliance on Facebook.

Connect with sisters navigating these same challenges and reclaiming our health on our terms.