Insulin Resistance and Perimenopause

INSULIN RESISTANCE

Insulin resistance is a term that we are hearing a lot at the moment, and it is becoming increasingly common in conversations about health and well being.

It is also linked with perimenopause and the menopause.

In this blog, I will explore insulin resistance and what it could mean for your health.

What is insulin resistance?

Firstly, insulin…

Insulin is a hormone made by the pancreas. Its main role is to help move glucose from the bloodstream into the cells, where it is used for energy or stored for later use.

When insulin and its effect are as they should be - blood sugar levels stay within a healthy range and the body’s cells receive a steady supply of energy.

Insulin resistance happens when the body’s cells become less responsive to insulin.Because the cells are not responding as they should, the pancreas produces more insulin to try to keep blood sugar normal.

Over time, this can lead to:

• Higher insulin levels in the blood

• Rising blood sugar levels

• Increased risk of type 2 diabetes, heart disease, and fatty liver disease

Insulin resistance often develops gradually and may be present for years before blood sugar becomes abnormal.

 

Why does perimenopause increase the risk of insulin resistance?

In perimenopause, oestrogen and progesterone levels are changing. These hormonal fluctuations influence how your body responds to insulin.

1. Decreasing oestrogen

Oestrogen plays a protective role in metabolic health. It helps to:

·       Control insulin sensitivity

·       Support muscle mass

·       Regulate fat distribution

As oestrogen fluctuates and declines, the body becomes more prone to:

·       Storing fat around the abdomen

·       Decreased insulin sensitivity

·       Higher fasting glucose levels

2. Increased cortisol sensitivity

Sleep disturbances, night sweats, and stress can often increase during perimenopause.Poor sleep and long term stress can raise cortisol levels, which can cause the following:

·       Increased blood sugar levels

·       Increased risk of insulin resistance

·       Increase in abdominal fat storage

3. Loss of muscle mass

As we age, we start to lose muscle, especially without resistance training.

Muscle is one of the body’s major areas for glucose to be used.

So, less muscle = reduced glucose uptake = greater insulin demand.

4. Changes in fat distribution

Even without significant weight gain, fat tends to shift toward the abdomen during perimenopause.Visceral fat (far around the organs) is more metabolically active and more strongly linked with insulin resistance.

What are the signs of insulin resistance in perimenopause?

There are several symptoms of insulin resistance such as lower energy levels and more intense carbohydrate cravings but NICE guidance shows that if your fasting blood glucose is 5.5-6.9mmol – this could be indicative of insulin resistance.

HbA1c is another measure used to keep an eye on blood glucose levels – in someone who is not pre diabetic or does not have Type 2 diabetes, this level should be below 42mmol; and in type 2 diabetes, the aim is below 48mmol

Please remember that all of this is due to changing physiology. It is not a will power problem

What can be done about insulin sensitivity in perimenopause?

Restriction is often the first move for perimenopausal women. But, overly restrictive eating can worsen metabolic health and increase stress levels.

It is about focussing on eating smart and working with your changing body...

1.   Include protein at every meal

2.   Choose higher fibre carbohydrates

3.   Eat more plants

4.   Strength train regularly

5.   Support sleep

6.   Manage stress load

7.   Consider medical support (individualised nutrition guidance, HRT, blood tests)

Perimenopause often coincides with other demanding life stages careers, teenagers, ageing parents – which makes the physiological challenges all the more overwhelming.

If your body feels different, it is because your hormonal environment is changing and your body is changing along with it.

With informed, sustainable adjustments, insulin sensitivity can improve significantly.

In Summary…

Insulin resistance in perimenopause is common, biologically driven, and modifiable.

Small, consistent habits – not over restriction or extreme diets - are what will support metabolic health during these changing times.

If you are experiencing physiological changes and are feeling confused or overwhelmed by all the information online, take a look at my programme: Midlife Nutrition Solution, launching in March 2026…