New research suggests that entering menopause before age 46 or after 55 puts women at an increased risk of developing type 2 diabetes. These findings were published in the journal Menopause as a result of Women’s Health Initiative (WHI), which aimed to advance knowledge in the field of women’s health issues after menopause.
Estrogen is a hormone that is involved in the reproductive function. It also affects metabolism, body fat distribution and storage, appetite, as well as the reaction of the body to insulin. After menopause, estrogen levels drop, which results in increased appetite, greater tendency to accumulate fat and higher blood glucose levels. It has previously been shown that early menopause increases the risk of diabetes. However, the WHI now showed that late menopause has a similar effect.
This trial analyzed information from over 120,000 women. These participants, aged 50 to 79, were followed for 12 years. They completed a number of questionnaires regarding their health (including questions related to diabetes), reproductive history, age at the onset of their menstrual cycle and age at menopause.
The authors of the study, lead by Erin LeBlanc, established that women who enter menopause before the age 46 were 25 percent more likely to develop diabetes than those who stopped menstruating between 46 and 55. Menopause onset after age 55 was associated with an increase in risk by 12 percent. These findings are intriguing, as they illustrate that there is an optimal window to enter menopause with minimal effect on metabolism and subsequent risk of becoming diabetic.
Consistent with the age of onset of menopause, the total length of a woman’s reproductive period also seems affect her diabetes risk. The reproductive period here refers to the total number of years between the first period in a woman’s life and the last period at the onset of menopause. The authors found that women with the shortest reproductive periods (less than 30 years in total) had a 37% higher risk of developing diabetes than those who fell into the “medium” reproductive period length (between 36 and 40 years). Women with the longest reproductive periods (over 45 years) had a 23 percent higher chance of becoming diabetic. These results are consistent with the hypothesis that shorter lifetime exposure to estrogen is bad for metabolic health, as estrogen is protective against obesity and diabetes, and conversely, estrogen deficit is detrimental. However, the findings that the women on the other end of the spectrum are at increased risk as well, are intriguing. These results suggest that there is a “sweet spot” of estrogen exposure over a woman’s lifetime that seems to be protective. Anything outside of that optimal range puts you at higher risk of developing diabetes.
Dr. LeBlanc advises women who fall outside of this optimal timeframe to take greater care in managing their diet, exercise routine, and have regular checkups to monitor their blood sugar.