SUGAR! Oh honey, honey,
Check those HORMONES, girl...
To get you feelin' more like YOU!
In honor of World Diabetes Day and Diabetes Month in both the United States and Canada, my last post covered the basics of diabetes including risk factors, signs & symptoms, pre-diabetes, and prevention tips. You can find it here.
Diabetes is a condition that affects approximately 1 out of every 9 adult women in the United States and up to 30% of women in the US have pre-diabetes. Diabetes increases the risk of other health conditions, particularly complications with pregnancy and heart disease.
Diabetes is a condition that affects approximately 1 out of every 9 adult women in the United States and up to 30% of women in the US have pre-diabetes. Diabetes increases the risk of other health conditions, particularly complications with pregnancy and heart disease.
While prevalence of diabetes in WOMEN is slightly less than men, they also have SPECIAL considerations related to hormonal differences and stress that can increase their risk of complications. These hormonal differences also come into play for those with hormone abnormalities, those taking hormone supplements, and transgender people.
So let's talk a little more about how HORMONES can affect your BLOOD SUGAR!
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
HORMONE FLUCTUATIONS & BLOOD SUGAR
The sex hormones create different challenges when it comes to managing blood sugar. These hormones include estrogen, progesterone, and androgens (the main one being testosterone).
Sex hormones are produced in different quantities in those that are genetically male (XY chromosomes) compared to genetically female (XX chromosomes). For a long time, estrogen and progesterone we thought of as "female" only hormones and testosterone and other androgens were thought of as "male" only hormones. We now know that both sexes produce all of these hormones. There are also genetic variants other than XY or XX that have other hormonal differences. This is another important reason why CUSTOMIZED CARE for your situation is so important.
Most commonly, the OVARIES produce high levels of estrogen and progesterone and low levels of testosterone. Likewise, the TESTES produce high levels of testosterone and low levels of estrogen and progesterone. These hormones are also produced elsewhere in the body in smaller quantities.
ESTROGEN
Progesterone and insulin don’t work as well together. Progesterone is another prominent sex hormone in women and as progesterone levels rise (typically after ovulation and before period) the body is less sensitive (or more resistant) to insulin. This means that blood sugars may be higher during this time or more insulin is needed.
Higher levels of progesterone also contribute to development of GESTATIONAL DIABETES during pregnancy. While this rise of progesterone is normal and necessary so that the fetus gets the proper amount of glucose, it can be problematic for those that already have some level of insulin resistance or whose bodies do not adjust well to the change. Progesterone levels drop dramatically after delivery, and for many women their blood sugars will return to normal. Others may continue to have difficulty regulating blood sugars due to genetic factors, adaptation, diet, activity, or other lifestyle factors. This can put them at risk of developing type 2 diabetes. Gestational diabetes and contributing factors will be discussed in a future post.
MORE THAN JUST HORMONES
ADDITIONAL RESOURCES:
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
ESTROGEN
Estrogen and insulin work well together. Estrogen is considered the "main" sex hormone in women and as estrogen rises, the body is MORE sensitive to insulin. It typically rises at the beginning of the menstrual cycle during a period and before ovulation. This means blood sugars may be lower during this time or less insulin is needed.
If you have type 2 diabetes, you may find that you have better control during these times, even if you eat the same foods. If you have type 1 diabetes, you may find that less insulin is required at this time. This is also one factor why women in menopause tend to have decreased insulin sensitivity and therefore higher blood sugars. Because estrogen production is decreasing during this time.
Lower levels of estrogen contribute to the insulin resistance seen after menopause. This is true for both menopause that occurs naturally with age and with a total hysterectomy that includes ovary removal (oophorectomy). Those that have had a hysterectomy that did not include ovary removal will not experience this sharp drop in estrogen levels. This also means that if you are undergoing hormone replacement therapy (HRT) you may still have the benefit of blood sugar regulation provided by supplemental estrogen.
PROGESTERONE
Progesterone and insulin don’t work as well together. Progesterone is another prominent sex hormone in women and as progesterone levels rise (typically after ovulation and before period) the body is less sensitive (or more resistant) to insulin. This means that blood sugars may be higher during this time or more insulin is needed.
Higher levels of progesterone also contribute to development of GESTATIONAL DIABETES during pregnancy. While this rise of progesterone is normal and necessary so that the fetus gets the proper amount of glucose, it can be problematic for those that already have some level of insulin resistance or whose bodies do not adjust well to the change. Progesterone levels drop dramatically after delivery, and for many women their blood sugars will return to normal. Others may continue to have difficulty regulating blood sugars due to genetic factors, adaptation, diet, activity, or other lifestyle factors. This can put them at risk of developing type 2 diabetes. Gestational diabetes and contributing factors will be discussed in a future post.
TESTOSTERONE
The role of testosterone (and other ANDROGENS) is more complex. Research suggests that INCREASED androgens in WOMEN can result in insulin resistance, therefore contributing to development of diabetes or difficulty regulating blood sugar levels. However, in MEN, it is LOWER levels of testosterone that contribute to insulin resistance.
Testosterone production plays a role in polycystic ovary syndrome (PCOS) and this also affects blood glucose control. While the exact cause of PCOS is unknown, genetics and inflammation are thought to play a role in the development of a hormone imbalance loop. It is thought that insulin resistance results in the body producing even more insulin, which in turn causes the ovaries to produce more testosterone than usual. This can interfere with ovulation and affect fertility. This extra testosterone further contributes to the insulin resistance and results in high blood sugar levels. This is thought to be the reason why more than half of all women with PCOS will develop type 2 diabetes by age 40.
Signs of PCOS:
- irregular periods
- excessive hair growth, particularly in a "male" pattern
- acne
- unintended weight gain or obesity
- fertility issues
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
Despite their very important role in daily functions, estrogen, progesterone, and testosterone are considered "minor" hormones. This is because we are able to survive without them, even altered levels can contribute to disease, poor health, shorten lifespan, or generally feeling off.
INSULIN is considered a "major" hormone. This means that it is prominent in both sexes and that is has a large role in regulation of bodily functions. The body has 3 MAJOR hormones and these are the ones we would not survive without: insulin, adrenaline, and cortisol.
It is possible to measure hormone levels from home but the test kits can be expensive. This is why it is so important to discuss your specific health situation with a knowledgable provider and make a plan that is tailored to you and your lifestyle. You can ask your primary provider for a referral; many now do online or telephone consults if they are not in your area.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
MORE THAN JUST HORMONES
Compared to men, a woman’s risk of developing diabetes and experiencing complications is more sensitive to PSYCHOLOGICAL STRESS and SOCIOECONOMIC FACTORS, such as education, income, and occupation. Stress at home or at work has been shown to have a greater affect on a woman's risk of developing diabetes and complications than men in comparable situations. This is especially true for jobs that involve night shifts (perhaps related to sleep dysfunction).
This is connected to another major hormone: CORTISOL. High stress increases the level of cortisol in our body. This is the hormone involved in the "fight or flight" response you have heard of. Cortisol prepares the body for a FIGHT or a FLIGHT by mobilizing glucose into the bloodstream to be used as energy and by reducing insulin so that glucose does not get stored. This is a perfectly reasonable response if you need to escape an attack from a tiger...run baby RUN! But not so much if you are perpetually in this state day in and day out. It results in prolonged high blood sugar levels.
Addressing these daily stressors with mindfulness, exercise, diet, education, social support, and therapy can go a long way to preventing diabetes or helping with management. Here are some recommendations for mindfulness apps that can help manage stress and improve mindset:
Addressing these daily stressors with mindfulness, exercise, diet, education, social support, and therapy can go a long way to preventing diabetes or helping with management. Here are some recommendations for mindfulness apps that can help manage stress and improve mindset:
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
SYMPTOMS & COMPLICATIONS SPECIFIC TO WOMEN
In addition to the signs and symptoms of diabetes discussed in a previous post, there are some that are specific to women:
- Yeast infections
- Bladder or urinary tract infections (UTIs)
- More common irritability, depression, anxiety
- Vaginal dryness
- Sexual dysfunction or painful sex
- Higher risk of heart disease
- Higher risk of stroke
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
5 KEY TIPS FOR HORMONE REGULATION
1) Reduce weight in a HEALTHY manner. Dropping as little as 5-10% of your body weight (10-20 lbs if you weigh 200 lbs) can improve your insulin sensitivity and regulate your menstrual cycle. Consult a professional to help with specific recommendations that work for you. Be responsible with your activity and nutrition. Don't fall for fad diets or exercise programs. Just MOVE your body EVERY DAY and eat REAL FOOD, mostly plants, and not too much.
2) Start SMALL and in YOUR kitchen for good nutrition. Take a look at what you are eating. Create a food diary. Meal plan. Eat at home more often than not. Don't do a complete overhaul: start ADDING in healthy foods BEFORE (or at the same time) you reduce less healthy foods. Too many changes at once will be harder to stick with. Try to incorporate more plant-based and unrefined foods. The fewer ingredients the better. Start with smaller, frequent meals throughout the day to avoid blood sugar spikes. Work with a dietitian or nutritionist (especially one specializing in diabetes or hormone balancing).
3) Exercise DAILY. At least 20 minutes of moderate-intensity activity each day. You will likely benefit from more, but be sure to check with your healthcare provider before beginning a new activity. Aim for a minimum of 150 minutes per week (about 20 minutes per day or 30 minutes on 5 days of the week). Try not to go more than 2 days without doing some form of exercise. Keeping your activity varied will not only maximize the benefits for your body, but will keep you from getting bored. Maybe try walking, cycling, swimming, Pilates, yoga, or another fitness class. If you have young kids or grandkids get them involved and make it a game!
4) Monitor your menstrual cycles. This is KEY to help you to understand levels, fluctuations, and what is working and what is not. Get a period app, there are many out there but I have found the Clue App to be very thorough. Keep track of ovulation, flow, PMS symptoms, weight gain or loss, blood sugar levels, diet, even body temperature. YES, this is time consuming. But it can give you a LOT of insight as to what affects you and what doesn't and therefore some changes that you can make going forward. Some extra work now can make for easier times later.
5) Ensure quality and quantity of SLEEP. Sleep is not only beneficial for blood sugar control, but also for body repair, immunity, and other functions. You should be getting 7-9 hours of sleep per night. While naps CAN help in a pinch or as extra (and please use them when you need to), a long period of UNINTERRUPTED SLEEP is really more beneficial and you should not use a nap to justify only 5 hours at night. Take a look at this past post on sleep for some tips on maximizing bang for your buck.
6) Consult a specialist. See where the first 5 recommendations get you. Then consult a diabetologist, an endocrinologist, or other expert healthcare provider to get further help from there. Because if you haven't addressed these things, that is probably where they will start with your plan of care. So you may as well get a jump on it! Consider medication on recommendation of a specialist after (or WHILE) you address items 1-5. I am a huge proponent in NATURAL means to restore health. If you do not change lifestyle factors to optimize your health, medication will only take you so far and will likely leave you with OTHER side effects to deal with.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
These are MANY reasons why it is important to monitor your cycles, symptoms, and blood glucose levels and discuss them with your provider. Everyone will have different hormone levels and surges. It is very difficult for the body to be able to balance out it's MINOR hormones until the MAJOR hormones are balanced.
ADDITIONAL RESOURCES:
Comments
Post a Comment