There is a strong link between insulin resistance and perimenopause. And it’s so important for every woman to know what they can do to either prevent or reverse insulin resistance. The opposite of insulin resistance is insulin sensitivity.
Insulin resistance is a situation in which the body’s cells do not respond properly to insulin, a hormone that helps manage blood sugar levels. Most people who have metabolic syndrome have insulin resistance. Women post 40 are at higher risk of metabolic syndrome.
It is one of the main risk factors for developing type 2 diabetes, diabetes mellitus, and other metabolic disorders, such as obesity, high cholesterol, high triglycerides, and high blood pressure.
If you’re gaining weight without changing your diet or suffering with perimenopausal symptoms, then insulin resistance may be at play. Low energy, brain fog, low mood, anxiety, irritability, mood swings, headaches, trouble sleeping and aching joints are all linked to insulin resistance.
In this post, I’ll explain what insulin is and its role, how insulin resistance occurs, and how to prevent or reverse it.
What does insulin do?
When eating a meal, the carbohydrate components are broken down into glucose (sugar). The glucose enters the bloodstream and in response to this, the pancreas releases the hormone insulin into the bloodstream.
Insulin’s job is to shuttle glucose out of your bloodstream and into your cells (body and brain) for energy. Some of the glucose gets stored in liver and muscle cells for use later, a storage form of glucose called glycogen.
Once cells are full, any remaining glucose is stored in fat cells as body fat, also known as adipose tissue. Most of which is stored around your middle.
The more carbohydrates a person eats, the more glucose is leftover to be stored as fat. ‘Carbohydrates’ refers to a large umbrella of foods ranging from broccoli, lentils and carrots to white wraps, bagels, crisps and cakes.
Maintaining healthy blood sugar levels is crucial for preventing various health issues, including cardiovascular disease and diabetes.
What is insulin resistance and how does it occur?
Insulin resistance occurs when cells become less ‘sensitive’ or responsive to insulin. This starts to happen when there is chronically too much glucose coming in. After a while, cells struggle to keep up and eventually start to ‘ignore’ insulin’s request to take in glucose.
This results in high blood sugar levels, which is not a good thing. This alerts the pancreas to secrete more insulin to try to remove the excess glucose.
The opposite of this situation is ‘insulin sensitivity’. Insulin sensitivity means the cells remain receptive or ‘sensitive’ to insulin’s request to allow glucose into the cell.
Insulin sensitivity is a foundation of good health.
Having insulin resistant cells results in less energy is available for the body and brain. This is because the glucose cannot be shuttled into the cells to fuel your mitochondria. Mitochondria are small structures found in the fluid that surrounds the cell nucleus in every cell that produce energy. When brain cells can’t access fuel, symptoms such as brain fog, blank mind, memory issues, headaches and fatigue can ensue.
You may also hear insulin resistance referred to as Metabolic Syndrome, pre-diabetes or hyperinsulinemia. It can play a role in hormone issues such as PCOS, endometriosis, and infertility.
Blood sugar highs or ‘swings’ drain your energy, fuzz your brain, upset your mood, and mess with your sleep. They also leave you with constant sugar cravings, excess belly fat, and a dysregulated appetite. Chronically elevated insulin is a significant stress on the body and a major health risk.
Insulin resistance is one of the biggest contributing factors to a more challenging experience of perimenopause.Women 40 plus are more prone to insulin resistance because of the metabolic changes that occur.
Specifically, changes to progesterone and oestrogen and adrenal and thyroid hormones results in reduced tolerance of carbohydrates and higher susceptibility to insulin resistance.
The quickest way to insulin resistant cells is a diet high in sugar, refined carbohydrates and ultra processed foods. AKA the standard Western diet. Add to this, low protein, low fat, low fibre, poor sleep, chronic stress and you’ve got the perfect recipe for blood sugar dysregulation and elevated insulin.
Lifestyle changes, such as dietary modifications and increased physical activity, are crucial to reduce insulin resistance and prevent complications associated with conditions like type 2 diabetes.
How Insulin resistance Is Linked To Perimenopause
Declining Muscle Mass
After 40, the female body is less efficient at maintaining muscle mass and becomes better at storing fat. Severe insulin resistance, characterized by abnormal glucose homeostasis and other metabolic changes, can exacerbate muscle loss and negatively impact metabolic health.
Insulin resistance is one of the biggest underlying causes of weight gain, especially around the middle. Learn more about perimenopausal weight gain in my blog post here.
Changes In Oestrogen
Oestrogen plays a significant role in keeping the cells of the body and brain sensitive to insulin. It supports healthy muscle mass, which is essential for insulin sensitivity and metabolic rate.
In the earlier stages of perimenopause, when oestrogen is still high AND fluctuating erratically, its sharp drops can put cells into a temporary insulin resistance state. Then, in the later stages of perimenopause when oestrogen starts to decline, a state of insulin resistance can remain.
Gestational diabetes, a temporary type of diabetes occurring during pregnancy, is caused by insulin resistance due to hormonal changes from the placenta.
Chronic Stress
Even with the best blood sugar balancing diet, you can still be at risk of insulin resistance. That’s because stress alone can cause insulin resistance!
As part of the body’s “fight or flight” stress response, cortisol releases glucose into the bloodstream, leading to high blood sugar levels.
This provides energy to muscles and the brain to help you fight or flee (even though you probably don’t need to move at all).
This process is called gluconeogenesis and is where proteins in the liver (and even muscle mass) are turned into glucose. In addition to putting sugar into the bloodstream, cortisol can prevent insulin from doing its important job of transporting glucose into cells – leading to insulin resistance.
how to prevent or reverse insulin resistance
Eat A Blood Sugar Balancing Diet
A blood sugar balancing diet is one where each meal is rich in protein, with quality fibre, good fats, and a small amount of complex carbohydrates.
Three to four balanced meals should be spread out evenly across a maximum 12 hour and minimum 8 hour period. This approach helps manage both high and low blood sugar levels effectively.
Protein is the NUMBER ONE nutrient for good blood sugar regulation. Protein supports a much slower release of glucose (sugar) into the bloodstream from carbohydrate foods and meals. THIS is how you can keep your cells SENSITIVE to insulin, the opposite of insulin RESISTANCE.
Protein also helps you feel fuller for longer and keeps cravings at bay. It’s the number one way to reduce your reliance on high carb meals and snacks and sugary foods. Always aim for a minimum of 30g of pure protein with all 3 meals.
Strength Training
Strength training, AKA lifting, pushing and pulling weights, increases the efficiency of glucose uptake by your cells. The more muscle you have the more glucose your cells can take in. In other words, the more insulin sensitive they are.
Support Your Sleep
Your daily sleep – wake cycle (circadian rhythm) is significantly linked to your ability to manage blood sugar levels and insulin. A body clock that’s out of whack increases the likelihood of insulin resistance. The best way to regulate your body clock is to get into daylight within an hour of waking. A good evening wind down routine where lights are dim and screens are kept to a minimum is also key.
Supportive Supplements
There are certain nutrients that can be very supportive of good blood sugar management and thus insulin sensitivity, these include:
- Chromium
- Magnesium
- Omega 3 fatty acids (EPA & DHA)
- B vitamins (particularly B3, B6 and biotin)
- Alpha Lipoic Acid
- Inositol
- Berberine
- Zinc
Testing For Insulin Resistance
If you would like to check your current blood sugar health you can ask your GP to check your HbA1c. Hemoglobin A1C is a blood test marker that shows what your average blood glucose level was over the past 2-3 months.
Other helpful markers include Fasting Glucose, Fasting Insulin, fasting plasma glucose, or an oral glucose tolerance test.
Tracking blood sugar levels for a week or so, to see how your body responds to your diet and lifestyle habits, can be extremely insightful and empowering. You can use a simple finger prick device with a simple blood glucose monitor or wear a continuous glucose monitor (CGM).
If you would like support with any of this you can explore ways to work with me here.
