-- Question: How do hormonal fluctuations during my menstrual cycle affect my blood sugar levels?
Answer: The menstrual cycle can be challenging for most women, but particularly to women with diabetes, and this is because the hormonal fluctuations that occur during the menstrual cycle do affect blood sugar levels.
What we typically see in clinical practice is that the week before a woman starts to menstruate, these hormonal changes increase what we call 'insulin resistance,' and so, the insulin that either the woman makes or that she takes by injection doesn't work quite as well. Then, when menstruation begins, the blood sugar levels tend to drop a little bit.
So, there are a variety of strategies that women can use to improve blood glucose control during the pre-menstrual period. If a woman is not taking insulin, she could try a greater emphasis on diet to control blood glucose levels or even more exercise, which also can relieve some other pre-menstrual symptoms. If a woman is on insulin, what I've tried with some of my patients before is, she can take a little bit more of the basal, or background insulin during that pre-menstrual week, to help control blood glucose levels. And, of course, if a woman wants to change her therapy, she should consult her primary care provider or her diabetes care provider and present the pattern of symptoms and of blood sugar levels that she's experiencing that are related to her menstrual cycle.