Diabetes hits women hard, especially at midlife.
Women with type 1 diabetes may experience menopause earlier than average. Women with type 2 diabetes may reach menopause later than average if they are above a healthy weight, as estrogen levels do not decrease as rapidly in women who are overweight.
Most women go through menopause in their late 40s or early 50s, this process is called perimenopause, which typically begins 2 -10 years before the menopause.
Hormone fluctuations that occur as the body prepares itself for menopause are the cause of perimenopause symptoms. After years of symptoms, most women reaches menopause around 51.
During perimenopause, the ovaries become less and less active, which causes estrogen and progesterone levels to fall, affecting your hormonal imbalance.
What is Perimenopause?
As much as 8-10 years before natural menopause takes place, a woman’s ovaries gradually start to produce less and less estrogen. This loss increases naturally until one to two years before menopause, at which time a women’s ovaries begin ceasing the production of estrogen entirely. A women may exhibit menopausal symptoms which on average lasts for up to four years. With the halt of estrogen, the woman will not release eggs. During perimenopause, it is possible for the woman to become pregnant. A women should be mindful that this can occur and discuss this with their medical team.
Here are some suggestions that may reduce the discomforts of peri-menopause:
1.Eating well-balanced meals that form the basis of managing your diabetes may also play a role in helping you to feel better at this time.
2.Cutting out alcohol and caffeine may help reduce hot flashes.
3.Consuming more legumes (beans, chickpeas etc) and soy products may also decrease the discomforts associated with menopause as these foods contain phytoestrogens (plant estrogens).
4.Being physically active may help to increase energy levels and give you a mental lift.
5.Get adequate amounts of vitamins and minerals. To keep their bones strong, women going through menopause who are not receiving hormone therapy should be getting 1,200–1,500 milligrams of calcium and 800 international units of vitamin D each day .
Women receiving hormone therapy should aim for 1,000 milligrams of calcium per day. Vitamin E and the B vitamins have also been suggested as beneficial for reducing menopausal symptoms.
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6.Use of herbal teas or supplements may be helpful for treating hot flashes and night sweats. Research is limited, but herbal preparations such as black cohosh, garden sage, and motherwort are used in many Asian and European countries. However, you should speak with your doctor before beginning any sort of herbal regimen.
7.If you are a smoker, stop smoking.
Usually, when menopause symptoms start, they affect women in different ways. However, there are some symptoms that will affect most women, including:
1.Irregular periods. Changes in menstruation are often one of the first signs that a woman is approaching menopause, though irregular periods vary depending on each woman’s cycle.
2.Hot flashes. They are a sudden, transient sensation of warmth or heat that spreads over the body, creating a flushing or redness that is particularly noticeable on the face and upper body.
In addition to lifestyle changes , there are many simple techniques that may help to relieve minor to moderate episodes of hot flashes. These include the following:
A.Avoid heat around the face area from devices such as hair dryers and curling irons.
B.Avoid using hot tubs, and keep baths and showers tepid or cool.
C.Drink cold water or water with ice.
D.Wear layers of clothing so you can take off some clothing, if needed.
E.Sleep with a light blanket or other covering and with the windows open or a small fan blowing directly on you.
F.Use a ceiling fan or air conditioner if you have one.
G.Place cold compresses on your face when you experience hot flashes or sweating.
H.Practice deep abdominal breathing—count to 10 while inhaling slowly, then exhale slowly while counting to 10. Repeat 10 times.
I.Try to identify and avoid your own personal hot-flash triggers.
J.Remind yourself that your symptoms will eventually lessen or abate.
3.Night sweats. Also known as “sleep hyperhidrosis”, night sweats aren’t actually a sleep disorder, but a common perspiration disorder that affects your rest.
4.Mood swings. Menopausal mood swings are surprisingly common, but can be hard to cope with. A woman experiencing mood swings may feel like she is on a rollercoaster of emotions.
5.Vaginal dryness. When estrogen levels drop, the vaginal tissue becomes drier, thinner, and less elastic. Lack of lubrication leads to vaginal dryness.
Topical, nonprescription lubricants can provide temporary relief from vaginal dryness and assist with sexual activity, although they do not reverse the long-term tissue changes that result from estrogen loss.
Over-the-counter vaginal moisturizers can help relieve the symptoms of vaginal dryness such as itching and burning, but such products do not supply estrogen to the tissues and therefore do not treat the underlying cause of the vaginal dryness.
A prescription vaginal estrogen product such as a cream or tablet, on the other hand, can cause genital and urethral tissue to become thicker, more elastic, and moist.
While replacing vaginal estrogen can decrease the risk of urinary tract infections and also tends to decrease the need to urinate frequently that often accompanies estrogen loss, an existing urinary tract infection should be treated with antibiotics.
6.Weight gain.For a number of reasons, women are prone to accumulating excess body fat, whether or not they have diabetes. Unlike male hormones, which keep muscle mass high, female hormones promote fat formation.
The fat is typically deposited first on the thighs and buttocks, then the stomach, followed by the upper body and arms. Women with Type 2 diabetes, however, typically accumulate fat in the abdominal region.
In addition to biological factors, certain lifestyle choices can also lead to increased body fat. Skipping meals and following “crash” diets can actually lead to weight gain in the long term by causing the body to slow down its metabolism and use calories more efficiently.
The key to weight loss, therefore, is to eat regularly scheduled meals, choose healthful foods containing whole grains, fruits and vegetables, reduce your fat intake, and consume smaller portions.
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Losing even 10 to 20 pounds can help you control your blood glucose levels more easily, as well as improve your circulation, blood pressure, and heart health.
Increasing your level of physical activity can help with all of these goals, and it’s good for your diabetes control and heart health even if you don’t lose weight.
The following are some strategies for putting an exercise plan into action:
A.Set small goals. If you are currently not physically active, start out by walking for 5 to 10 minutes, three days a week. Increase your time and distance gradually.
B.Do an activity you enjoy. Try walking, swimming, water exercises, using an exercise bike, or taking yoga or Pilates classes. Doing more than one type of physical activity works different parts of your body and can keep your exercise routine from becoming stale.
C.Exercise with other people who keep you motivated.
D.Keep a log of your activities, both for motivation and to see how physical activity affects your blood glucose levels.
E.Become more active in your daily life. Small steps such as taking a walk during your lunch hour and taking the stairs instead of the elevator can add up.
F.Exercise one to two hours after eating. This will help control blood glucose levels.
Is it Menopause or my Diabetes?
Sometimes women with diabetes, especially those recently diagnosed, may confuse the signs of menopause with some of the symptoms of low or high blood glucose.
For example, if you are occasionally dizzy, sweating, find it hard to concentrate, are unusually irritable, is this due to hormonal changes, high or low blood glucose?
If you are waking up in the night, hot and sweaty, is this menopause or low blood glucose?
The only way to know for sure is to test your blood glucose.
If you have type 2 diabetes and are not taking insulin, night sweats are unlikely to be a result of low blood glucose.
Fatigue can be associated with menopause and with high blood glucose levels. Again, testing your blood glucose is the safest step to take.
Your doctor or diabetes educator will be able to help you decide how often you may need to test by looking at your blood test records or A1C results.
Hormone therapy (HT) can be used to alleviate severe menopausal symptoms, especially unrelenting hot flashes, night sweats, and vaginal dryness.
Estrogen therapy (ET) is appropriate only for women who have had a hysterectomy (removal of the uterus) because estrogen alone increases the risk of uterine cancer.
Women who wish to use hormone therapy who have not had a hysterectomy must use a combination of estrogen and progestin together, called estrogen-progestin therapy (EPT).
HRT is a complicated issue. There are benefits and risks to taking HRT.
HRT can greatly help with symptoms like flushing, but may increase the risk of heart disease, stroke, blood clots and breast cancer, particularly if used for prolonged periods of time after the age of natural menopause.
Different HRT preparations carry different risks. There are oral tablets, transdermal patches or a cream form of HRT.
Many factors can influence the decision to use HRT, like whether you are at risk of diseases like cancer, heart disease and osteoporosis. Family history and lifestyle factors such as smoking, obesity and diet will also need to be taken into consideration.
Because women with diabetes already have an increased risk of heart disease, it is especially important for women with diabetes to discuss the benefits and risks of HT with their health-care provider.
Because it’s common to experience some changes in blood glucose control as you go through menopause, it helps to maintain a regular schedule of blood glucose monitoring, as well as good exercise and eating habits. Using relaxation techniques to reduce stress and trying to get adequate sleep can help, too.
After menopause, hot flashes and night sweats may keep you up at night. In turn, the sleep deprivation can make it tougher to manage your blood sugar level. If you are taking medication that can cause low blood sugar (hypoglycaemia), it is important that you check your blood sugar level during the night to rule out hypoglycaemia.
Low estrogen levels can increase the probability of having yeast and urinary tract infections.
Talk to your doctor about reducing your risk of cardiac problems after menopause.
Talk to your doctor and dietitian about ways to support bone health.
The most significant bone loss occurs within the first two years of menopause.
The risk of bone thinning is great in women with diabetes, and menopause magnifies that.
The by-products of high blood sugar affect all organs, including the bones.
Ask your doctor about taking calcium and vitamin D supplements and getting a DEXA scan, which measures bone density.
Ask your endocrinologist to review other health factors that menopause can affect, such as blood pressure and blood lipids (fats), important for controlling heart disease risk.
For more great Health and Nutrition Tips refer to the website positivehealthwellness.com
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