As a woman with diabetes, you may have wondered how diabetes will affect your menopause, and how menopause may affect your diabetes. You may also have questions about taking hormones.

Menopause is usually defined as the point when your periods stop. The average age in the US is around 50-51, although women with diabetes may be younger. Many symptoms are attributed to menopause, the most common are hot flashes, disturbed sleep, nightsweats, and the decreased ability to think clearly.

You may have noticed that your blood sugar is affected by your menstrual cycle. Hormones can affect blood sugar. The changes in your hormone levels during menopause can also affect your blood sugar.

Some women choose to take hormone replacement therapy or HRT. These hormones (estrogen and progesterone) replace the hormones that the body no longer makes. You may have heard that women with diabetes can't take hormones because of their affect on blood sugar. But the doses with HRT are so low that they don't have much affect. Because hormones can affect your blood sugar, your diabetes medicines may need to be adjusted also.

There are benefits to taking hormones.

• Protects your heart.
• Protects your bones from the loss of calciumwhich can lead to brittle bones.
• Eliminates the symptoms, such as hot flashes (which are easy to confuse with hypoglycemia), helps you sleep and think more clearly.

As with all therapies, there are some risks however.

• May increase your risk for breast cancer for women who have a strong family history or other risk factors.
• Estrogen taken alone can increase the risk of uterine cancer. Taking progesterone with the estrogen eliminates this risk.
• Spotting or bleeding, much like a period.
• Headaches.

Talk with your provider about hormone replacement therapy. Then weigh the risks and the benefits and decide what is right for you.

Written by Martha Funnell MS, RN, CDE