One day your blood sugars are smooth sailing, the next…it feels like a hurricane has hit. Sound familiar? If you are a woman with type 1 diabetes, you understand this unpredictable nature of blood sugars all too well.
Managing type 1 diabetes is already complex, but adding in the hormonal fluctuations that come along with being a female can make everything even more challenging. When I was diagnosed with type 1 diabetes at 9 years old, nobody warned me that hormones had such a significant impact on blood sugar levels. I had no idea that different phases of my cycle cause differing levels of insulin sensitivity and that I might need to adjust my insulin doses accordingly.
This article will explore the key hormones involved in the monthly cycle, their impact on blood sugars, and some strategies and tools that can help you learn more about your body, leaving you feeling better prepared to manage your diabetes.
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Key Hormones Involved in the Monthly Cycle
Four key hormones play central roles in regulating the monthly cycle:
Follicle-Stimulating Hormone (FSH): Produced by the pituitary gland in the brain, FSH primarily stimulates the growth and development of ovarian follicles. These follicles are small sacs in the ovaries that contain immature eggs. As FSH levels rise at the beginning of the cycle, several follicles begin to mature.
Luteinizing Hormone (LH): Also produced by the pituitary gland, LH works in tandem with FSH. As estrogen levels rise due to the maturing follicles, LH surges. This LH surge triggers ovulation. After ovulation, LH also plays a crucial role in the development of the corpus luteum, a temporary gland that secretes progesterone.
Estrogen: Primarily produced by the developing ovarian follicles, estrogen plays several vital roles. In the first half of the cycle, rising estrogen levels stimulate the thickening of the uterine lining (endometrium), preparing it for the potential implantation of a fertilized egg. Estrogen also contributes to the LH surge that triggers ovulation.
Progesterone: Primarily produced by the corpus luteum after ovulation, progesterone’s main function is to maintain the thickened uterine lining. It makes the endometrium more receptive to a fertilized egg. If pregnancy doesn’t occur, the corpus luteum breaks down, leading to a drop in progesterone levels, which triggers menstruation.
These four hormones interact and impact each other’s production throughout the menstrual cycle. Fluctuations in these hormones can have significant effects on our bodies, including blood sugar levels.
Hormones and Blood Sugar Levels: Can Your Period Affect Your Blood Sugar?
If you’ve noticed your blood sugar behaving in unpredictable ways throughout the month, your menstrual cycle might be to blame. The hormonal shifts that happen throughout your cycle can have a direct impact on how your body responds to insulin, leading to blood sugar fluctuations that can be frustrating and challenging to manage. Understanding these patterns is a key step in gaining better control.
Let’s break down how the phases of your menstrual cycle can influence your insulin sensitivity:
- Follicular Phase (Approximately Days 1-14): This phase, starting from the first day of your period and lasting until ovulation, is generally characterized by higher insulin sensitivity. As estrogen levels rise, your body may become more responsive to insulin. This means you might find you need less insulin to keep your blood sugar in your target range. Some women find they need to slightly decrease their insulin during this time to avoid lows.
- Ovulation (Around Day 14): The rising estrogen and the surge of luteinizing hormone (LH) around ovulation can sometimes lead to a slight decrease in insulin sensitivity for some individuals. This change usually only lasts a day or two, but it’s something to be aware of. Keep a close eye on your blood sugar around this time.
- Luteal Phase (Days 15-28 approx.): After ovulation, the corpus luteum starts producing progesterone. This hormone often leads to increased insulin resistance. As progesterone levels rise, your body becomes less responsive to insulin, meaning you may need to increase your insulin doses to maintain stable blood sugar levels. This effect can gradually intensify as you move further into the luteal phase.
- Premenstrual Phase (A few days before your period): For many women, insulin resistance can be most pronounced in the few days leading up to their period. Both estrogen and progesterone levels fluctuate dramatically during this time, and the increase in progesterone often outweighs the effects of estrogen, leading to higher insulin requirements. You might need more insulin during this period.
It’s important to remember that everyone’s experience is unique. The intensity and timing of these hormonal shifts and their impact on blood sugar can vary significantly from person to person. Some women may experience very noticeable fluctuations, while others might see more subtle changes.
Other Hormonal Shifts
While the monthly menstrual cycle typically presents a predictable pattern of hormonal fluctuations, other significant life stages involving hormonal shifts can also impact blood sugars for women with type 1 diabetes.
Pregnancy
Pregnancy is characterized by significant changes in hormones like human placental lactogen (hPL) and progesterone. These hormones are known to cause increased insulin resistance, often requiring substantial adjustments to insulin needs throughout pregnancy.
Managing blood sugars tightly during pregnancy is crucial for both the mother’s and the baby’s health, making understanding and adapting to these hormonal changes key. I highly recommend the book Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management by Ginger Viera and Jennifer Smith – this was my bible during my pregnancies!
Perimenopause and Menopause
This transitional period brings about significant changes in hormone production. Perimenopause is characterized by erratic fluctuations in estrogen and progesterone levels, leading to unpredictable menstrual cycles and a host of other symptoms, such as fatigue, mood swings, and sleep disturbances.
As women enter menopause, estrogen and progesterone levels decline significantly and become more stable at lower levels.
These hormonal shifts during perimenopause and menopause can have a big impact on blood sugar control. The fluctuating and eventually declining estrogen levels can contribute to increased insulin resistance, making it harder for the body to use insulin effectively. This can lead to higher average blood sugar levels and a greater need for insulin adjustments.
8 Strategies for Managing the Impact of Hormones and Blood Sugar Levels
While the fluctuations in blood sugars related to hormones can feel unpredictable, implementing the following strategies can help you stay informed and in control:
- Consistent Blood Sugar Monitoring: Pay extra attention to your blood sugar levels in the days leading up to your period, around ovulation, and during the luteal phase, as these are often times of increased variability. CGMs can be particularly beneficial in providing real-time data and highlighting trends you might miss with fingersticks alone.
- Detailed Record-Keeping: A comprehensive log is your best friend in understanding your body’s unique responses. Record your blood sugar readings, insulin doses, carbohydrate intake, exercise, stress levels, sleep, and information about your cycle. Over time, these detailed records will reveal patterns and correlations between your hormones and blood sugar, empowering you to anticipate and adjust.
- Proactive Insulin Adjustments: Work closely with your health care team to develop a plan for adjusting your insulin doses based on the phases of your menstrual cycle and any hormonal tracking data you have. This might involve increases in insulin doses during the luteal phase and potential decreases during the follicular phase.
- Flexible Meal Planning: Be mindful of your carbohydrate intake and consider adjusting it based on your activity levels and the hormonal phase you’re in. You might find you need to be more precise with carb counting during periods of increased insulin resistance.
- Regular Exercise: Exercise is a powerful tool for improving insulin sensitivity. Aim for consistent physical activity, but be aware that hormonal fluctuations can sometimes affect your body’s response to exercise. Pay attention to your blood sugar before, during, and after workouts, and adjust your insulin or carbohydrate intake as needed.
- Stress Management: Stress can wreak havoc on blood sugars, especially when hormones are already adding to the variability. Try to implement some stress-reducing techniques like meditation, yoga, deep breathing exercises, or spending time in nature.
- Adequate Sleep: Sleep is vital for hormone regulation and insulin sensitivity. Aim for 7-8 hours of sleep per night consistently to support hormonal balance and improve blood sugar control. Poor sleep can increase insulin resistance and make blood sugar management even more challenging.
- Open Communication with Your Healthcare Team: Don’t hesitate to discuss your hormonal concerns and any tracking data you have with your doctors. They can help you interpret your data and adjust your treatment plan as needed.
Benefits of Hormone Tracking
Understanding hormones and blood sugar levels is incredibly important when you have type 1 diabetes. Until recent years, women have tracked their menstrual cycles using a calendar or an app, noting the start and end dates of their periods and maybe even logging symptoms like mood changes, bloating, or energy levels. While this method can provide a basic understanding of the cycle’s phases, it relies on estimations and subjective observations. Pinpointing the exact timing of certain events can be challenging with calendar tracking alone.
This is where technology comes in to save the day! Hormone-tracking devices such as Mira are now available to make this process much faster, easier, and more accurate. The Mira device stands out for its ability to accurately measure key hormone levels with quick and simple urine tests from the comfort of your own home.
Unlike ovulation predictor strips that typically only detect the LH surge, Mira measures the actual concentrations of hormones like luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrogen (specifically, the estrogen metabolite, estrone-3-glucuronide or E3G), and progesterone.
To use Mira, you collect urine first thing in the morning and use test wands to test the urine sample. You then insert the wand into the Mira analyzer, and within about 20 minutes, you receive the readings and insights about your hormone levels displayed in your Mira app.
The Mira device provides concrete data rather than just predictions or positive/negative results. By tracking these hormone levels over time, you can actually start to build a personalized picture of your cycle. This detailed information can be incredibly helpful in correlating hormonal shifts with observed blood sugar fluctuations. By gaining insight into your individual patterns, you can anticipate fluctuations in insulin sensitivity and proactively adjust your insulin dosages accordingly.
In addition, hormone tracking can aid in detecting potential hormonal imbalances such as PCOS or thyroid issues that may warrant further medical evaluation. Understanding the hormonal shifts associated with perimenopause and menopause is another benefit of tracking.
What I Learned About My Hormones and Blood Sugar Levels From My Personal Experience with Mira
A few months ago, a team member from Mira reached out to me and invited me to attend a webinar about CGMs and hormone monitoring and offered to let me try out the device for myself. I jumped on the opportunity since I have always been curious about how my hormones actually impact blood sugars, and the nerd in me really wanted to see my hormone data and blood sugar data from my CGM together so I could really nail down some patterns. As a female in my late 30s, I was also curious about what my cycles looked like and if perimenopause could be starting to creep in.
When my Mira shipment arrived, I was pleasantly surprised by how small and easy the device was to use. I was actually excited each morning to pee in the cute little cup that came with the wands and waited anxiously to see my data.
After collecting data on four separate hormones for about a month, I had a Zoom call with Mira’s clinical manager to review my data and get all my questions answered.
Some main takeaways I learned were:
- Even with an IUD in place, I am still ovulating and having “normal” cycle patterns, despite common misconceptions that those with IUDs no longer ovulate.
- Because my blood sugars are relatively well controlled, it is unlikely that they are impacting my hormone levels (though my hormones are obviously impacting my blood sugars).
- Although my cycle looked relatively “normal,” my luteal phase was on the shorter end of normal during the cycle I tracked, and my progesterone levels were slightly low. This could possibly be due to the IUD or perhaps because perimenopause is near. I will definitely follow up with my doctor regarding this.
- My blood sugar levels were much more challenging to manage in the luteal phase following ovulation than the follicular phase, likely due to the increased Progesterone in the luteal phase (see my CGM graphs below). The fact that I feel more hungry and have more cravings and mood swings in the luteal phase is not just in my head! The increasing Progesterone is also to blame for this.
When to Seek Professional Help
Although, as women with type 1 diabetes, we are used to managing a lot on our own, there are times when seeking professional guidance may be helpful. Reach out to your healthcare team if you experience any of the following:
- Persistent and unexplained blood sugar fluctuations: Despite your best efforts with monitoring, insulin adjustments, and lifestyle modifications, if you’re consistently struggling with significant highs and lows that don’t seem to correlate with your usual patterns, it’s time to seek professional advice. There might be underlying factors, including hormonal shifts, that require further investigation and adjustments to your treatment plan.
- Suspected hormonal imbalances: If you’re experiencing irregular periods, severe PMS symptoms, or are noticing signs of perimenopause or menopause, discuss these with your doctor. These hormonal changes can have a big impact on your diabetes management.
- Concerns about fertility: If you have type 1 diabetes and are trying to conceive, it’s important to have open conversations with your endocrinologist and OB-GYN. Hormonal fluctuations play a significant role in fertility, and optimizing your blood sugar control is crucial for a healthy pregnancy.
- Significant changes in overall well-being: If you’re experiencing persistent fatigue, significant mood swings, sleep disturbances, or other changes in your overall well-being that you suspect might be linked to hormonal shifts and blood sugar fluctuations, don’t ignore them. These symptoms may indicate a need for further evaluation and support.
In these situations, tools like Mira can be incredibly valuable in providing objective data to share with your healthcare team. If you are interested in trying Mira out for yourself, make sure to use the code 2MBETES15 at checkout for 15% off your purchase.
Don’t hesitate to bring your tracking data with you to your appointments. It can facilitate a more informed and productive conversation.
Conclusion
From the monthly menstrual cycle to the significant shifts of pregnancy and the transitions of perimenopause and menopause, hormonal fluctuations can present many challenges when you live with type 1 diabetes.
Understanding your body’s patterns, closely monitoring your hormones and blood sugar levels, and making informed adjustments to your insulin doses and lifestyle choices are key.
Remember, you are not alone in this journey. Many women with type 1 diabetes experience similar challenges. By sharing information, supporting each other, and working together with our healthcare providers, we can navigate these wild hormones with greater confidence and control!
Want to experience Mira for yourself? Use this link or the code 2MBETES15 at checkout for 15% off. If you’re a client I work with directly, you’re eligible for an even bigger discount – reach out to Lindsay@mama-betes.com to learn more.