Menopause is a process that occurs over a period of five to 10 years. It begins when a woman's body slows down its production of estrogen and progesterone, the hormones responsible for ovulation and maintaining pregnancy, and ovulation and menstrual periods become irregular and eventually cease. The average age for most women to have their last period is 51, although the process can begin any time from age 40 to the late fifties.
The hormone fluctuations that characterize menopause may wreak havoc on your hard-earned blood glucose control. With less progesterone, you may have greater insulin sensitivity, but with less estrogen can also come increased insulin resistance. And the lack of these hormones can also cause other changes which can worsen diabetes complications. For example, lowered estrogen levels increase the risks of cardiovascular disease, which is already higher for people who have diabetes, and osteoporosis.
Added to these problems, many women find that they gain weight and become less active during this time, which compounds blood glucose control difficulties.
So it is vitally important to plan a nutritious, low-fat diet, with calcium supplements if needed, and to maintain, even increase, your activity level. These measures will help lower your risk of cardiovascular disease by keeping your cholesterol level low and protect your bones against the thinning of osteoporosis.
Women should also discuss with their doctor whether hormone replacement therapy to reduce symptoms of menopause (such as hot flashes) and reduce the risks of heart disease, stroke, osteoporosis and vaginitis might be suitable for them.
In the past, estrogen alone was given to menopausal women, which turned out to increase the woman's risk of uterine cancer. However, today a woman who still has her uterus is given a form of progesterone along with the estrogen to prevent this complication. Also, some studies have suggested that hormone replacement therapy may increase the risk of breast cancer, although a post-menopausal woman's risk of dying from heart disease is far greater than the risk of developing cancer from taking hormones. Still, many doctors are reluctant to prescribe hormones for their patients who are already at high risk for developing breast cancer. (Hormone replacement is not considered appropriate for most women who have already had breast cancer or who have some other health problems.)
For women with diabetes, there is the additional consideration of the need to deal with the possible effects of hormone levels on blood glucose control.
Whether you should use hormone replacement is a personal decision you should make after getting all the facts from your physician.
After menopause, the risk of vaginal yeast infections (vaginitis) increases for women with diabetes. As estrogen levels decrease, yeast and bacteria have an easier time growing, especially if blood glucose levels are frequently too high. (That's because yeast thrives in warm, moist places with a good supply of food--glucose.) Here are some ideas for preventing yeast infections after menopause.
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