Periods and the menstrual cycle can affect people in many different ways. Alongside symptoms such as cramps, headaches, bloating and mood changes, some people with diabetes notice changes in their blood sugar levels at different points in their cycle.
Everyone's experience is different. Some people notice clear changes in their blood sugar at certain points in their cycle, while others notice little or no effect.
Understanding your menstrual cycle and how it affects your diabetes can help you better manage your blood sugar levels and symptoms.
- Understanding your menstrual cycle
- How periods affect blood sugar levels
- Managing blood sugar levels during your cycle
- Managing period symptoms
- Puberty, periods and diabetes
- Further support
Understanding your menstrual cycle
The menstrual cycle consists of different phases. The follicular phase starts on the first day of your period and ends with ovulation. The luteal phase (Around day 15-28) begins after ovulation and continues until your next period.
Throughout your cycle, hormones will fluctuate. This may lead to certain physical and emotional symptoms and influence blood sugar levels. Knowing your cycle and its effect on you and your diabetes can help you manage your symptoms and blood sugar.
How periods affect blood sugar levels
Oestrogen and progesterone are female sex hormones that help regulate your cycle and thicken the uterine lining. Oestrogen also plays a role in ovulation, while progesterone creates a good environment in your uterine lining for a fertilised egg to implant.
Throughout your menstrual cycle, levels of these hormones rise and fall, and this can influence insulin sensitivity.
People have reported changes in their glucose readings during the course of their menstrual cycle, but the research on how common this is and why it happens is ongoing. If you are worried or have any concerns, your healthcare team can offer advice if you notice that at certain times of your cycle, your blood glucose becomes more difficult to manage.
During the week after your period, oestrogen levels rise, and some studies suggest a link between this and increased insulin sensitivity. This means your blood sugar might be lower leading up to ovulation.
Some people find their blood sugar rises a few days before their period, when progesterone is at its highest. Studies suggest progesterone can lower insulin sensitivity and cause a spike in blood sugar.
Low insulin sensitivity is the same thing as insulin resistance, when your body’s cells don't respond properly to the hormone insulin.
Not everyone releases the same levels of these hormones, and they can vary across life stages. Don’t worry if your blood sugar acts differently from someone else’s. Some people don’t notice any effect, some do, and some say it changes each month.
Managing blood sugar levels during your cycle
If you're not sure whether your menstrual cycle affects your blood sugar levels, try keeping a record of your periods and your glucose levels before, during and after your period. There are plenty of Apps available to help you track your period. Tracking both these things over several months can help you spot any patterns.
If you use a continuous glucose monitor (CGM), you should be able to view trends and graphs on the app or device connected to your sensor that show how your glucose levels change throughout your cycle.
If it looks like your blood sugar levels run a bit higher before, during or after your period, and you take insulin to manage your diabetes, you might want to speak to your healthcare professional about altering your insulin doses at different times during your cycle.
If your blood sugar levels run lower at certain points of your cycle, you might need slightly less insulin than usual.
If you use insulin injections or an insulin pump, your healthcare team may suggest adjusting your insulin-to-carb ratio or basal rates at different stages of your cycle.
If you use a hybrid closed loop (HCL), while the system will try to automatically adjust insulin levels to keep you in range, current evidence suggests they may not be able to fully manage this.
You should speak to your diabetes team if you're finding your blood sugar levels difficult to manage. You can ask them to help you analyse any blood sugar patterns during your menstrual cycle and give tips and advice on how to manage your blood sugar levels.
If you're increasing your insulin, make sure you have hypo treatments nearby, as insulin sensitivity can sometimes return quickly.
Managing period symptoms
Period symptoms can change from month to month and throughout your life. Common symptoms include cramps, headaches, bloating, backache, fatigue, food cravings and mood changes. Painkillers can help with some of these symptoms if needed.
Mood changes
During the luteal phase, fluctuations in oestrogen and progesterone, particularly the decline in these hormones just before menstruation, can contribute to low mood, irritability, and mood swings in some women.
These changes can sometimes affect food choices and diabetes management.
Food cravings and appetite
Many people experience cravings or feel hungrier before or during their period. Hormonal changes can increase appetite and make you more likely to want high-sugar or high-fat foods.
Studies show that your body releases serotonin, the hormone that helps you feel happy, when you eat starchy or sugary foods. So, some people might find they’re more likely to reach for them during this part of their cycle.
If you’re craving carbs, why not try whole fruit and vegetables, or healthier, fibre-rich carbs, such as wholewheat bread, wholegrain cereal, lentils, oats and quinoa.
Wholegrain carbohydrates and protein-rich foods, including eggs, fish, chicken, turkey, tofu, unsweetened yoghurt and nuts, are a great way to feel full for longer, manage appetites and cravings, and keep your blood sugar levels stable.
If you do eat foods that aren't part of your usual routine, try not to be hard on yourself. This is OK once in a while and won’t have a long-term effect on your health.
Fatigue and iron levels
It's common to feel more tired during your period. If your periods are heavy, blood loss can sometimes contribute to lower iron levels.
Iron-rich foods such as leafy green vegetables, beans and lentils can help support healthy iron levels. Foods such as spinach and kale can maintain normal iron levels and are rich in magnesium to help combat fatigue, dizziness and bodily aches and pains.
If periods are making you feel unwell mentally or physically, including experiencing heavy periods or severe pain, then it’s very important you get advice from your GP.
Exercise and periods
Staying active during your period may help reduce symptoms such as cramps, bloating, fatigue and low mood. Physical activity can also support long-term blood sugar management.
However, it’s important not to push yourself and put additional stress on your body when it might not already be feeling its best.
Gentle activities such as walking, swimming, cycling, stretching and yoga can all help.
Puberty, periods and diabetes
Puberty is a time of significant hormonal change, and these changes can affect blood sugar levels.
Hormones released during puberty can make the body less sensitive to insulin, which can make blood sugar levels more difficult to manage. This is a normal part of growing up and can happen in people with any type of diabetes.
The average age for a first period is around 12, but periods can start earlier or later and still be completely normal. As long as diabetes is being managed well, it shouldn't delay or speed up when periods begin.
Periods are often irregular in the first year or two after you start. They may also be quite heavy or uncomfortable. This can make it harder to spot patterns between the menstrual cycle and blood sugar levels. Keeping a record of periods alongside blood sugar readings might help identify trends.
If periods have started but remain irregular, or if there are concerns about diabetes management during puberty, speak to your diabetes team or GP.
Further support
It’s important to remember that everyone’s menstrual symptoms and their blood sugar levels during their cycle can look different, so don’t worry if your experience isn’t the same as others.
Remember, if you have concerns about your periods outside of your diabetes, you can discuss them with your GP.
Period problems can be common in women with diabetes, especially those with type 2 who are living with overweight or obesity.
Living with overweight or obesity can lead to a complication known as anovulation, where an egg is not released during ovulation. This can lead to irregular periods and create more difficulty in becoming pregnant.
Although the reason for this is unknown, if you’re experiencing irregular periods, speak to a healthcare professional or GP.
If you’re concerned about the effect your periods are having on your diabetes and you’re having difficulty managing your blood sugar levels while on your period, raise this with your healthcare professional, who will be able to offer advice.
Remember that everyone's menstrual cycle is different. The most important thing is understanding your own patterns and working with your healthcare team to out what works for you.
Talk to other people with diabetes
Your family, friends and healthcare professionals are all there to support you, but sometimes you need to talk to other people who have diabetes and experienced the same things you are.
We can help you get in touch with others who are ready to chat through our online support forum.
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