Estrogen and Progesterone are the primary female hormones produced by the ovaries needed for optimal reproductive and sexual health. They’re also important in controlling blood sugar and how your body reacts to insulin. Women with diabetes need to pay extra attention to hormonal fluctuations.


What Type Are You?

Type 1 diabetes is an autoimmune disease where cells attack the pancreas so it can no longer produce insulin, a hormone necessary for regulating sugar. Type 1, or T1D, comes on rather quickly as glucose enters the bloodstream in dangerous levels without insulin counteracting it. So those with T1D must take insulin injections usually several times a day.

Type 2 diabetes is generally caused from prolonged insulin resistance. Your pancreas can make insulin, but not enough to keep up with the amount of sugar/glucose it encounters, and eventually loses its ability to function properly. Generally, you don’t need to take insulin injections for type 2, but there are other medications that may help, along with a healthy diet low in sugar and simple carbs, and regular exercise.


Insulin and Estrogen are Partners

Estrogen has many important functions including the development of the female sex characteristics; breasts, widened hips, smaller bone structure, and also regulating the menstrual cycle and controlling mood. Estrogen, as it moves through the bloodstream, also improves insulin sensitivity, which means you require less insulin to move sugar out of your bloodstream.

Premenopausal (the time between puberty and perimenopause) women with normal estrogen levels, are less likely to develop type 2 diabetes than men in the same age group because higher levels of estrogen work together with insulin to regulate blood sugar.

As we get older and begin producing less estrogen, along with symptoms of hot flashes, mood swings, and vaginal dryness, the loss of estrogen can also lead to insulin resistance, the opposite of insulin sensitivity, requiring more insulin to regulate sugar in your bloodstream.


Insulin and Progesterone are More Like Frenemies

Progesterone, also produced in the ovaries, prepares our bodies for the possibility of pregnancy by thickening the uterine lining. If a pregnancy does not occur during menstrual cycle, the levels of progesterone drop significantly and menstruation happens. If pregnancy does occur, progesterone levels rise to protect the placenta and prepare breasts for lactation.

However, high levels of progesterone (usually during pregnancy) causes insulin resistance which is necessary so the fetus gets the proper amount of glucose, but those high levels may also contribute to gestational diabetes in some women.


The Highs and Lows of Estrogen and Progesterone

Several times during a woman’s life, these two hormones fluctuate, and for diabetics, these fluctuations can pose additional problems.

Puberty – Puberty begins the production of estrogen and progesterone in the ovaries and also the start of a girl’s period. Those with type 1 diabetes who are not getting enough insulin, or do not have their diabetes under control, may have a delay in starting puberty or irregular menstrual cycles. It’s important, especially during puberty, to manage T1D.


Menstrual Cycle – The first day of menstruation begins your cycle and the levels of both estrogen and progesterone are low. Estrogen slowly rises during those first few days, increasing sensitivity to insulin. If you take insulin for type 1, you may need less during these times. You should check your blood sugar often, because you can also become hypoglycemic which should be treated immediately with emergency candy or glucose tablets.

About 3 weeks into your cycle, during ovulation, progesterone levels rise which can increase insulin resistance. Those with T1D may need extra insulin during this time.

Progesterone levels drop in the last week up to your next period, which can cause symptoms of PMS in some women who are more sensitive to hormonal fluctuation. As progesterone drops, so does your insulin resistance.

And then it repeats with the appearance of your period as your cycle begins again.

If you take insulin, talk to your doctor about regulating it during your menstrual cycle. For women with type 2, you may be able to control your insulin resistance with regular exercise and a healthy diet or adding a medication for type 2.


Pregnancy – At the beginning of pregnancy, your body makes more estrogen. Some women with type 1 may even produce some of their own insulin during this short period of time. Where your immune system generally destroys the beta-cells in your pancreas which produce insulin, pregnancy can interfere and actually allow your body to produce its own insulin. It’s very important to check your blood sugar and if it’s getting too low, decrease the insulin you are taking.

Morning sickness can also affect blood sugar. If you’re not eating because you’re too nauseous, that can lower your blood sugar and affect your insulin levels.

Progesterone is the main attraction during pregnancy as it’s preparing the placenta for birth and your breasts for lactation. As levels of progesterone reach enormous highs, so will insulin resistance.

These levels drop dramatically once you’ve delivered. If you breastfeed, Estrogen levels will remain low.

It’s important to check blood sugar levels regularly at the beginning and throughout your pregnancy. High levels of sugar in the bloodstream are not only dangerous for you, but also for your baby. Work with your doctor for a plan make sure you’re both safe.


Menopause – As we age and enter the period of perimenopause, our bodies begin producing less estrogen until the point we stop ovulating and then estrogen production in the ovaries stops completely, marking menopause.

Many women begin having symptoms of hot flashes, mood swings, and decrease libido during perimenopause. But many women also gain weight that’s more difficult to get rid of, especially in the belly. Estrogen, although no longer produced in your ovaries, is produced by fat cells. So, menopausal women are more likely to have insulin resistance, especially if they are overweight, which can lead to type 2 diabetes.

For those with type 1, menopause can cause a need for higher insulin doses and more frequently.

If you’re going through menopause, it’s important to check your blood sugar and talk with your doctor.


Tying it All Together

For women with diabetes, hormones are affected even more than women without throughout various stages of life.

High levels of estrogen can create insulin sensitivity, meaning that you may not need as much insulin if you are type 1. You may also be less insulin resistant during those times, so your pancreas also works less.

High levels of progesterone can make you more insulin resistant, and you may require more insulin.

Low levels of progesterone, which can cause symptoms of PMS, including craving foods that contain sugar or simple carbohydrates, also affects blood sugar, especially if you are estrogen dominant (high estrogen and low progesterone).

It’s most important for women with type 1 or type 2 to maintain a healthy weight by eating a balanced diet, low in sugar and processed carbohydrates, and get enough exercise. It’s been proven that exercise increases insulin sensitivity, so your pancreas, if it can produce insulin, won’t have to work as hard.

Mainly, be aware of the changes in your estrogen and progesterone so you can better control your blood sugar and your diabetes, for a long and healthy life.

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