DR MAXWELL ADEYEMI

Menopause uniquely affects the management of diabetes mellitus and some opined it may contribute to the risk of diabetes.

Although the weight gain that commonly occurs during the menopausal transition is largely attributed to ageing rather than the transition itself, changes in body composition have been independently associated with menopausal status. These changes in body composition have in turn been associated with alterations in insulin sensitivity and glucose metabolism in post-menopausal women.

Menopause is the phase of life after your period have stopped, it generally starts around the age of 45 -55 years of age but may vary from person to person, a variety of situations may interplay in menopause and diabetes.

GLUCOSE CONTROL

You may feel moody sometimes and think your sugar level is low, but it may be due to the menopause symptoms, occasioned by hormone fluctuations, so check your sugar a little more regularly, eating more at these times may throw your glucose levels out of control.

HEART DISEASE

Diabetic women are four times more likely to have heart failure and twice more likely to have heart attacks - menopause further increases the risks. This is because high blood pressure, high cholesterol and increased body fat which are linked to heart disease are typical symptoms associated with this stage of life. Weight loss, blood pressure control, cholesterol control and tight glucose control will reduce this risk.

HOT FLASHES

This can be heralded by sleep disruption, racing heart and crashing headaches, believed to be due to a drop in oestrogen level which interferes with the hypothalamus (the area that regulates body temperature in the brain). Hot flashes can be worse for diabetic women because the hormonal imbalance of menopause makes it harder to control high blood glucose levels; and a sudden drop in blood glucose can lead to more intense hot flashes. You can minimise hot flashes by avoiding common triggers such as smoking, caffeine, alcohol and stress, getting regular exercise and weight loss as overweight increases the chances of hot flashes.

SLEEP DEPRIVATION

This causes glucose fluctuations - this is because sleep deprivation decreases leptin- hormone that helps control appetite - and increases ghrelin - the hormone that stimulates appetite, which causes weight gain. The associated high blood glucose also increases urine output as the body tries to eliminate excess sugar, this leads to further sleep disturbance as this causes more frequency of urination while sleeping.

SEXUAL PROBLEMS

For women going through menopause, drastic reduction in hormones can cause vaginal dryness that makes sex uncomfortable and even painful. It is worse for diabetic women because diabetes can damage nerves and blood vessels of the vagina making it harder to get aroused and have orgasm or sexual satisfaction. The vaginal dryness caused by menopause and the high glucose in diabetes causes increased risk of vaginal infections and makes sex an uncomfortable experience.

INFEC