Your Menstrual Cycle and Diabetes: A Complete Guide

Diabetes and Your Period: They’re Connected

Have you ever noticed high blood sugars before your period? Or maybe low ones once it starts? This can be a frustrating part of diabetes because it may feel random and unmanageable.

I have good news for you: this is normal. It’s something you can plan for once you learn your menstrual cycle and how it affects your diabetes and insulin needs.

In this post, we’ll focus on progesterone’s and estrogen’s role in the menstrual cycle. Both of these hormones are responsible for changes in your diabetes and your period.

How to Track Your Period and Why You Should Do It

The first step in figuring out how to sync diabetes and your period is to track your cycle. The easiest way to do this is by using an app on your phone – there are a ton available for all phone operating systems. You can also use a paper calendar if that is easier for you.

Throughout your cycle, which should average 28-31 days, make notes on the different symptoms you’re feeling (think cramps, acne, mood changes). Note changes in your blood sugar as well (high blood sugars during your period, low blood sugars before ovulation, etc.)

After a few months of tracking, you’ll have a better idea of patterns that occur each month. If you notice irregularities during your cycle, bring this up to your gynecologist for further evaluation. An irregular period can mean many different possibilities. It can make managing blood sugars difficult as well, so it’s important to find the source. 

Diabetes and Your Period Days 1-14: A Time to Carb-Load & Decrease Insulin

The first phase of the menstrual cycle is the follicular phase. It occurs during days 1-14 of the cycle and starts the first day of bright red bleeding. The hormones estrogen and progesterone are at their lowest point here. As the phase progresses, estrogen will begin to rise as the body prepares to release an egg.

Blood Sugars

Because your progesterone levels are so low during this phase, your insulin sensitivity is at its peak. Most women find they need 20-30% less insulin when their period starts to prevent hypoglycemia.

Use a temporary basal or “period” profile if you are an insulin pump user. If you are using multiple daily injections to manage your diabetes, you may also decrease your basal insulin a bit during your period.

You might need to adjust your insulin to carb ratio and correction factor to fit your sensitivity. Pre Bolus timing will likely decrease as well.

Once estrogen begins to rise, you may notice your insulin sensitivity decreasing. You can go ahead back to your “base” insulin settings when this occurs. 

Diabetes and Your Period Days 14-28: Focus on Veggies and Increased Insulin

The luteal phase is next and it occurs during days 14-28. It starts the day of ovulation. Women identify ovulation by egg-white discharge and cramping for some women. Estrogen reaches its peak here which releases an egg to get ready for fertilization. 

Progesterone will now begin to rise. This is the hormone responsible for insulin resistance. If the egg is not fertilized, progesterone will plummet a few days before your period begins. This drop in progesterone is what causes the uterine lining to shed and for bleeding to begin.

Insulin Needs

The luteal phase and progesterone cause those high blood sugars before your period.  Most women will need to increase their insulin needs by 10-30% or more.

Again, using temporary basal rates/profiles as well as more aggressive insulin to carb ratios and correction factors may be necessary to lower high blood sugars before your period.

You may also find it helpful to eat foods lower on the glycemic index and high in fiber. These foods digest more slowly and will give your insulin time to work. Aim for lots of vegetables by eating a side salad before each meal.

Final thoughts on diabetes and your period

Understanding your cycle’s patterns can help you better understand diabetes and your period. Knowing that progesterone is the main component of insulin resistance will allow you to better prepare for and prevent those high blood sugars before your period and low blood sugars after your period. Make use of different insulin pump profiles and foods during both phases to optimize your blood sugars.

It’s important to note that the above information does not apply to women on hormonal birth control. This is because hormonal birth control suppresses ovulation. You may notice that these patterns do not apply to you.

Rachel Halverson, BSN, RN, CDCES
Rachel Halverson has lived with T1D for 23 years and has learned a lot from a personal perspective as well as working as a CDCES-RN. Her company Give Me Some Sugar aims to provide diabetes management education for women in order to uncomplicate their routines and gain more time in their day to spend on the things that are important to them. Instagram: @givemesomesugardiabetes Website: www.givemesomesugar.coach .

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