Insulin Resistance and Menopause

Insulin resistance is when the body’s cells don’t respond well to insulin, a hormone that helps control blood sugar. Normally, insulin acts like a key that unlocks cells so they can take in glucose (sugar) from the blood and use it for energy. When someone is insulin resistant, it’s like the key isn’t working as well; the cells don’t take in glucose easily, so more sugar stays in the bloodstream.

During menopause, hormonal changes—particularly a drop in estrogen—can make the body more likely to develop insulin resistance. Estrogen plays a role in how cells respond to insulin, so when estrogen levels decline during menopause, cells may become less sensitive to insulin. This makes it harder for the body to move sugar from the blood into cells, where it’s used for energy. As a result, blood sugar levels can rise, and the body often responds by producing more insulin to try to keep sugar levels balanced. This is a common precursor to type 2 diabetes, where the body can no longer keep up with the demand for insulin, leading to consistently high blood sugar.

Insulin resistance is implicated in many disease processes including cardiovascular disease, dementia and autoimmune conditions.

Increased insulin levels can lead to weight gain, especially around the belly, which can further increase insulin resistance. This can create a cycle: lower estrogen levels contribute to insulin resistance, which then makes it easier to gain weight, and the extra weight can make insulin resistance worse. Many women find it harder to lose weight or maintain their previous weight during and after menopause, partly due to these hormonal shifts affecting insulin sensitivity.

Lifestyle adjustments, like regular physical activity, a balanced diet, and stress management, can help improve insulin sensitivity during menopause. Exercise is especially beneficial because it helps muscles use sugar more effectively, lowering blood sugar levels. Additionally, certain dietary choices—like whole grains, lean proteins, and plenty of vegetables—can help stabilize blood sugar and improve how well the body responds to insulin during this phase. Additionally stress management can have a positive impact on insulin sensitivity.