Perimenopause 101: Understanding Its Impact on Blood Sugar and Weight Management

Key Takeaways

• Perimenopause is the transitional phase leading up to menopause, marked by hormone changes that can last several years.
• Perimenopause brings significant hormonal changes that can affect blood sugar regulation, metabolism, and fat distribution.
• Lifestyle changes like daily exercise, a balanced diet rich in fiber and protein, stress management, and tools like continuous glucose monitors (CGMs) can help stabilize blood sugar and support weight management during perimenopause.

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Perimenopause is a natural stage of life, but the hormonal shifts it brings can feel anything but ordinary. These changes don’t just affect your menstrual cycle; they can influence nearly every aspect of your health, including your blood sugar and weight. For many women, this period comes with new challenges, like sudden changes in metabolism, difficulty managing weight, or unexpected blood sugar fluctuations.

Understanding how perimenopause and blood sugar impact your body is the first step toward feeling more in control. Armed with the right knowledge and strategies, you can adapt to these changes in a way that supports your overall health. 

This guide will explain the science behind perimenopause and its effects on blood sugar and weight, and offer practical tips for managing these changes confidently.

What Is Perimenopause?

Perimenopause refers to the years leading up to menopause, when levels of sex hormones begin to shift. Menopause itself is defined as the point at which a full year has passed without a menstrual cycle. Think of perimenopause as the body’s gradual shift from its reproductive years to the end of menstruation. On average, it starts around age 45 and can last anywhere from a few years to a decade.

Perimenopause and all the associated symptoms of menopause are caused by changing hormone levels. Estrogen and progesterone, the two primary hormones that regulate your menstrual cycle, begin to fluctuate and eventually decline. This hormonal rollercoaster is responsible for many of the symptoms women experience during this time.  

Menstrual cycles might become irregular, with heavier or shorter periods, and ovulation becomes less predictable. Symptoms such as hot flashes, night sweats, mood swings, and sleep disturbances may also occur.  Bone health also becomes a concern, as estrogen plays a key role in maintaining bone density, which starts to decline faster during the later stages of perimenopause.

Hormonal Changes and Their Effects on Blood Sugar

During perimenopause, the natural fluctuations and eventual decline in estrogen and progesterone levels do more than impact reproductive health. These shifts play a significant role in the connection between perimenopause and blood sugar, affecting how your body processes glucose and regulates energy. This can make it more challenging for many women to maintain healthy blood glucose levels and manage their weight effectively.

Estrogen levels influence insulin sensitivity, which refers to how effectively your cells respond to insulin to regulate blood sugar levels. With less estrogen, your body may not handle blood sugar as efficiently, even when the pancreas is releasing plenty of insulin, leading to high blood sugar levels and increased fat storage.

Blood sugar imbalances, slower metabolism, and shifts in body composition can lead to an increased risk of chronic conditions like prediabetes, type 2 diabetes, heart disease, and obesity during and after menopause.^,

The Link Between Insulin Resistance and Weight Gain

Insulin resistance is also closely tied to perimenopause and weight gain. When your body becomes less sensitive to insulin, it struggles to utilize glucose efficiently for energy, resulting in higher blood sugar levels and a greater tendency to store excess glucose as body fat. Insulin resistance during perimenopause can make it harder to lose weight, even with consistent efforts.

The drop in estrogen also affects how your body switches between burning carbs and fats for energy. It becomes increasingly difficult for your metabolism to adapt, resulting in less efficient fat-burning during fasting periods and a higher reliance on storing calories as fat after meals.²

These changes in metabolism can feel frustrating. You might notice it takes more effort to maintain your weight or that fat accumulates more around your abdomen than before. Estrogen plays a role in fat distribution, helping to keep more stored in the hips and thighs during your reproductive years. As estrogen levels decline, fat often accumulates more in the midsection, sometimes called an "apple shape." This type of fat, known as visceral fat, increases the risk of metabolic syndrome.

Combined with a natural decline in muscle mass in midlife, which slows your basal metabolic rate, it’s no wonder many women feel like they’re gaining weight despite no major changes in diet or lifestyle. 

Strategies for Managing Blood Sugar Levels

Maintaining blood sugar balance is possible with a few simple strategies. Here are some practical approaches to help you get started:

Move More to Support Metabolism and Sleep

Regular physical activity is one of the most effective ways to support your blood sugar, bones, and weight.  A combination of aerobic activity and strength training is essential. Strength training is key for building and maintaining lean muscle mass, which naturally declines with age. Exercise not only keeps you strong but also makes your cells more responsive to insulin.

Exercise can also contribute to better sleep, which is often a challenge during perimenopause. Sleep directly impacts blood sugar, as poor sleep is also linked to insulin resistance.

Eat More Fiber for Better Hormonal Balance

Dietary fiber supports blood sugar stability, weight management, and hormone metabolism. Fiber feeds the beneficial bacteria in your gut, which play an important role in breaking down and managing hormones effectively.  Adding more fiber to your meals can help reduce blood sugar spikes and support a more balanced microbiome.

Good sources of fiber include fruits, vegetables, whole grains, nuts, seeds, and legumes. Aim for at least 25 grams per day to reap the benefits. For example, you could start your day with oatmeal topped with berries and chia seeds or include hearty salads with beans and a variety of vegetables as part of your lunch or dinner.

Combine Carbohydrates and Proteins for Steady Energy

Pairing carbohydrates with protein at every meal or snack is a simple yet impactful way to steady your blood sugar levels. Protein slows down the absorption of sugars from carbohydrates, minimizing spikes and keeping you feeling full longer. Additionally, protein is essential for maintaining muscle mass and supporting metabolic health as you age.

Try combining whole-grain crackers with hummus, Greek yogurt with a handful of nuts, or grilled chicken with roasted sweet potatoes. These balanced combinations can help stabilize your energy throughout the day.

Don’t Overlook Stress 

Chronic stress can significantly impact blood sugar regulation. Stress hormones, such as cortisol, which rise in response to stress, can interfere with insulin sensitivity, leading to higher blood sugar levels. Stress management techniques such as deep breathing exercises, time in nature, or mindfulness can help minimize these effects and promote overall well-being.

Effective Weight Management During Perimenopause

Managing weight in perimenopause can feel like an uphill battle, but understanding the connection between hormones, blood sugar, and lifestyle habits can make a big difference. Many strategies listed above that stabilize blood sugar also directly support weight management, making it easier to address both goals with the same approach. 

Here are more key factors to focus on:

Prioritize Protein to Preserve Muscle 

One of the most important nutrients during perimenopause is protein. Eating protein-rich meals helps preserve lean muscle, which is crucial as muscle naturally declines with age.¹⁷ Muscle supports a healthy metabolism and burns more calories at rest. Protein also promotes feelings of fullness, reducing cravings or the likelihood of overeating.

Every person has unique protein needs, which vary depending on age, activity level, and overall health status. Aim for about 20 to 30 grams of protein at each meal as a general recommendation. A balanced mix of lean proteins like poultry or fish and plant-based options like beans and soy is the best way to get variety and essential nutrients.

Load Up on Fiber 

As you just read, high-fiber foods help stabilize blood sugar, support healthy digestion, and feed beneficial bacteria in your gut. Fiber is also linked to healthy weight management, with some research suggesting that it can aid in weight loss even without calorie restriction. Fiber slows down digestion and keeps you full longer, which can prevent overeating. Try to consume at least 25 grams of fiber per day from various plant sources.¹⁶

Keep Tabs on Foods to Limit

Certain foods and beverages can worsen symptoms or interfere with weight loss. Here are a few to keep in check:

• Alcohol: While it may feel relaxing at the end of the day, alcohol can amplify symptoms like sleep disturbances, anxiety, and even hot flashes. It also adds empty calories, making weight management harder. 
• Caffeine: While a morning coffee is fine for many, too much caffeine can worsen anxiety, disrupt sleep, and intensify hot flashes. If you notice these symptoms, consider reducing your intake or switching to herbal teas. 
• Ultra-Processed Foods: Fast foods and snacks, such as chips, candy, and instant meals, often lack essential nutrients. Ultra-processed food is a risk factor for weight gain and blood sugar issues. Limit these foods and focus on whole, minimally processed options instead.
  

When to Seek Professional Help

Navigating perimenopause can feel overwhelming if symptoms become unmanageable or your efforts to maintain a healthy weight and blood sugar levels don’t seem to be working. If you’re struggling with persistent hot flashes, insomnia, mood swings, or feeling stuck despite trying to eat well and stay active, it may be time to seek help from a healthcare professional. They may order additional blood tests or suggest hormone replacement therapy (HRT) as part of your plan.

Working with a healthcare provider, such as your doctor, a registered dietitian, or a hormone specialist, ensures you receive personalized support tailored to your unique needs.

The Bottom Line

Managing blood sugar and weight during perimenopause can be challenging, but making small, consistent changes, such as prioritizing protein, fiber, and regular physical activity, can make a significant difference. Taking proactive steps can help you feel your best and set the stage for a healthier future.

Learn More About How to Improve Blood Sugar Health With Signos’ Expert Advice

There is no one-size-fits-all solution for managing blood sugar and weight. Everyone’s body responds differently to food, which makes it essential to find what works best for you. Tools like the Signos app, when paired with a Continuous Glucose Monitor (CGM), can make a significant difference in women’s health. By tracking your real-time blood sugar fluctuations in perimenopause, Signos helps you identify how specific foods and activities affect your body, allowing you to make personalized choices.

Curious about how it works? Learn how Signos can improve your health and get expert tips on better blood sugar control by visiting Signos’ blog. If you’re ready to take the first step toward a healthier you, take a quick quiz to find out if Signos is the right fit for your needs.