Perimenopause may disrupt how your body manages blood sugar, increasing the risk of prediabetes or type 2 diabetes. During this phase, hormonal shifts like declining oestrogen can lead to insulin resistance, unpredictable glucose levels, and associated symptoms such as fatigue, cravings, and weight gain.

Key takeaways:

• Hormonal impact: Lower oestrogen reduces the body's ability to stabilise blood sugar, while progesterone fluctuations can cause spikes.
• Common symptoms: Carb cravings, brain fog, energy dips, and abdominal weight gain might signal blood sugar issues.
• Lifestyle adjustments: Balanced meals (protein, complex carbs, and healthy fats), strength training, and quality sleep are essential for managing glucose.
• Technology helps: Continuous glucose monitors (CGMs) provide real-time insights into how food, activity, and stress affect blood sugar.

Taking proactive steps during perimenopause can help maintain stable blood sugar and reduce long-term health risks.

Signs of blood sugar problems during perimenopause

Spotting blood sugar issues during perimenopause can be tricky since the symptoms often overlap with the hormonal changes happening at this time.

However, being aware of certain warning signs can help you figure out if glucose sensitivity might be a concern. Below, we’ll break down common symptoms and how they might point to blood sugar troubles.

Symptoms to look for

During perimenopause, changes in hormones can affect how your body processes sugar. If you notice any of the signs below, it could be a clue that your blood sugar regulation is shifting:

• Increased hunger or strong cravings for carbs
• Feeling extremely tired 1–2 hours after eating, especially after carb-heavy meals
• Difficulty concentrating or persistent brain fog
• Unexplained weight gain around the waist
• Intense sugar cravings
• Noticeable energy dips throughout the day
• Feeling shaky or irritable when going too long without eating

These symptoms are often tied to insulin resistance and may be your body’s way of signalling that support is needed.

When perimenopause and blood sugar symptoms overlap

The challenge with identifying glucose sensitivity during perimenopause is that many of the symptoms overlap with typical hormonal changes. For example, hot flashes could be tied to both hormonal shifts and blood sugar fluctuations.

Similarly, mood swings, trouble sleeping, and fatigue are common to both conditions. On top of that, blood sugar imbalances can make menopausal symptoms worse.

For instance, insulin resistance has been associated with more frequent hot flashes. Keeping a symptom journal that tracks how you feel in relation to meals, stress, and sleep could help you pinpoint patterns and understand what’s happening.

Curious about the link between weight gain and glucose changes later in life? This article on menopause, weight, and blood sugar explores how to break the cycle and support your body through the transition.

Ways to manage blood sugar during perimenopause

Managing blood sugar during perimenopause requires a well-rounded strategy to tackle the hormonal changes that can disrupt glucose levels. By combining thoughtful dietary choices, regular physical activity, and stress and sleep management, you can better regulate blood sugar during this transitional phase.

Food choices for stable blood sugar

Your diet plays a pivotal role in managing blood sugar, especially as hormonal changes during perimenopause can lead to insulin resistance. The key is to balance your intake of protein, complex carbohydrates, and healthy fats at every meal instead of consuming them separately.

Protein should be your focus

Aim for 20-30 grams per meal to help maintain lean muscle mass and keep hunger at bay. This could mean a portion of chicken, fish, or tofu, or a serving of Greek yoghurt with nuts and seeds.

When it comes to carbohydrates, opt for low-glycaemic complex carbs instead of refined ones that cause quick blood sugar spikes. Foods like whole grains, legumes, and vegetables release glucose steadily, while refined options like white bread or sugary snacks lead to sharp fluctuations.

Don’t overlook fibre

Aim for at least 25 grams daily from plant-based sources like vegetables, fruits, beans, lentils, and whole grains. Fibre helps stabilise blood sugar and supports digestion.

Stay hydrated throughout the day to support blood sugar regulation and overall metabolism. Water is ideal, but herbal teas and unsweetened drinks work too. Avoid large meals within three to four hours of bedtime. If you need a late-night snack, consider options like apple slices with almond butter, berries with nut milk, or hummus with carrots.

While a balanced diet is essential, pairing it with regular exercise will further enhance blood sugar control.

Exercise for better blood sugar control

Exercise is a powerful tool for improving glucose sensitivity during perimenopause. It works by increasing insulin sensitivity and enabling muscle cells to absorb glucose more effectively during activity.

Strength training is key

Incorporate 2-3 sessions per week targeting all major muscle groups, gradually increasing resistance as you build strength. This is crucial because muscle mass naturally declines with age, accelerating during perimenopause. Studies show that muscle mass decreases by about 1% per year starting in your 30s, making strength training a priority.

Research also indicates that physical activity tends to drop by 40% during perimenopause, making it even more important to stay active. A 2006 study found that high-intensity aerobic exercise provided greater improvements in insulin sensitivity compared to moderate-intensity exercise, with noticeable benefits within nine months.

High-intensity interval training (HIIT)

HIIT is particularly effective for reducing visceral fat, especially around the midsection. Start small with 5-10 minute sessions and gradually increase duration. While the CDC recommends 150 minutes of exercise per week, you can break this into shorter, manageable sessions.

Even short bursts of activity, like a quick walk or some stretching, can help your muscles use glucose more efficiently. A well-rounded exercise routine should include strength training, cardiovascular activity, and mobility exercises.

To maximise the benefits of exercise, ensure your protein intake supports muscle recovery – 1.2–1.6 grams per kilogram of ideal body weight is a good target. Beyond exercise, managing stress and getting quality sleep are equally important for maintaining steady blood sugar levels.

Managing stress and sleep for hormone balance

Stress and poor sleep can wreak havoc on both hormones and blood sugar during perimenopause. Since up to 80% of women experience significant symptoms during this time, and 42% rate them as "very severe", addressing these factors is critical.

Prioritise sleep

Aim for 7-9 hours per night by sticking to a consistent sleep schedule, even on weekends. Develop a calming bedtime routine, such as reading, listening to soft music, or taking a warm bath.

Create a sleep-friendly environment by keeping your bedroom cool, dark, and quiet. Avoid screens before bed, as the blue light from devices can interfere with your natural sleep cycle. Steer clear of heavy meals close to bedtime, and while exercise improves sleep quality, avoid working out too late in the evening, as it can be stimulating.

Sleep disturbances affect 39-47% of women during perimenopause, and the consequences go beyond fatigue. Poor sleep can lead to irritability, memory issues, and increased cortisol levels, all of which can disrupt blood sugar regulation.

Stress management is just as important

Techniques like meditation and deep breathing can lower cortisol levels and improve insulin sensitivity. Women often report higher levels of stress than men, with 42% experiencing moderate stress and 19% reporting high stress weekly.

Stay connected with loved ones, as social support can help reduce stress. If sleep issues persist, consider cognitive behavioral therapy (CBT), which has been shown to improve sleep quality effectively.

Cut back on alcohol

Alcohol disrupts sleep and raises cortisol levels, negatively impacting blood sugar. Similarly, limit caffeine and sugary foods, which can spike cortisol and interfere with both sleep and glucose control.

Manual tracking vs. technology solutions

When it comes to managing glucose sensitivity during perimenopause, you have two main options: the traditional approach of manual tracking or the modern convenience of technology solutions like continuous glucose monitors (CGMs). Both come with their own set of advantages.

Tracking method comparison

Manual blood glucose meters (BGMs) work by measuring glucose levels in the blood through finger pricks, giving you a single snapshot of your blood sugar at a specific moment.

On the other hand, CGMs continuously monitor glucose levels in the interstitial fluid without requiring finger pricks, offering a broader view of your glucose trends over time.

While BGMs are often more precise for immediate readings, CGMs shine when it comes to identifying patterns and trends.

It’s worth noting that CGMs measure interstitial glucose, which can lag 15–45 minutes behind blood glucose readings.

Here’s a quick comparison of the two methods:

For women navigating perimenopause, CGMs provide a unique advantage by delivering real-time insights into how hormonal changes impact blood sugar levels.

This continuous feedback can be incredibly useful for making lifestyle adjustments to better manage insulin resistance and other metabolic challenges.

These differences highlight how technology can enhance the effectiveness of lifestyle changes.

Lifestyle changes alone vs. technology-supported approaches

Lifestyle changes are a cornerstone of managing glucose sensitivity, but the tools you use to track progress can make a big difference. Without tracking tools, lifestyle adjustments often involve guesswork.

While general advice on diet and exercise is helpful, it doesn’t always reveal how your body reacts to specific foods, stress levels, or sleep patterns.

Relying solely on lifestyle changes means basing decisions on subjective symptoms, which can lead to trial-and-error strategies. You might unnecessarily cut out certain foods or miss subtle patterns that could optimise your health.

Technology-supported approaches, such as programs using CGMs, take the guesswork out of the equation. Real-time feedback connects your lifestyle choices directly to your blood sugar levels, offering a clear picture of what works for your body.

For instance, CGMs can highlight how a 30-minute walk after a meal impacts your glucose or how different meal compositions affect your readings. This kind of detailed insight empowers you to make informed decisions about your diet, exercise, and even meal timing.

Additionally, CGMs can facilitate more meaningful conversations with your doctor about treatment options like hormone replacement therapy, as they provide concrete data to guide these discussions.

By combining lifestyle changes with technology, you can take a more tailored and effective approach to managing glucose sensitivity during perimenopause.

How Vively can help during perimenopause

Navigating the hormonal shifts of perimenopause can be overwhelming, especially when it starts affecting your blood sugar and energy levels. Vively gives you the tools to take control of your health, with support that’s backed by real data.

One of Vively’s standout features is the Metabolic Health Score. This score pulls together your glucose trends and key lifestyle behaviours like sleep, nutrition, movement, and stress into one simple number that reflects how your body is tracking metabolically.

This is especially helpful during perimenopause when subtle changes, such as increasing insulin resistance, often go unnoticed. With Vively, you can:

• Track your real-time glucose levels using a continuous glucose monitor (CGM)
• Understand how specific foods, workouts, and sleep patterns affect your blood sugar stability
• Get a personalised Metabolic Health Score to see how your daily habits are supporting or straining your health
• Receive support and insights from accredited health experts to guide your next steps
• Make confident decisions with data-driven feedback tailored to your unique hormonal stage

Vively’s platform goes beyond monitoring—it empowers you to take meaningful action. Whether you're noticing more fatigue, cravings, or changes in weight, the program gives you clarity and practical ways to support your metabolic health during this transition.

Curious how your body’s adapting during this stage of life? Vively makes it easier to see, understand, and improve what’s happening beneath the surface.

Conclusion

Managing blood sugar during perimenopause requires practical strategies tailored to hormonal changes, especially the drop in oestrogen and progesterone that directly affect how your body processes glucose.

Start with consistent daily habits. Focus on balanced meals that include plenty of protein, complex carbohydrates, and healthy fats. Opt for whole food sources like quinoa, sweet potatoes, and rolled oats instead of processed carbs. Add healthy fats from avocado, nuts, and olive oil to slow glucose absorption and keep you feeling full longer.

Be mindful of symptoms like persistent fatigue, brain fog, irritability, abdominal weight gain, or feeling "hangry" between meals. These can signal blood sugar issues but often overlap with typical perimenopause experiences, so track patterns and timing to understand your body's signals better.

Quality sleep is a must. Aim for 7–9 hours each night, as poor sleep affects up to 51% of women during peri- and post-menopause and can raise blood sugar levels. Stick to a consistent bedtime routine and consider magnesium glycinate supplements, which may improve sleep, reduce insulin resistance, and curb sugar cravings.

Strength training is another key piece. Regular exercise helps maintain muscle mass, which supports insulin sensitivity and counters metabolic changes tied to shifting hormones.

If balanced meals and exercise don’t seem to help with symptoms like unexplained weight gain, consider using a continuous glucose monitor (CGM). These devices can provide insights into how your body reacts to specific foods, stress, and activity levels.

Small, simple actions can also make a difference. For example, a quick two-minute walk after meals can help stabilise blood sugar. Staying hydrated throughout the day is equally important, as dehydration can cause blood sugar levels to rise.

It’s worth noting that postmenopausal women face higher risks, including nearly five times the likelihood of abdominal obesity and elevated fasting glucose levels compared to premenopausal women. Taking steps now during perimenopause can help you avoid these complications and set a foundation for better health in the future.

FAQs

How can I tell if my symptoms are due to perimenopause or glucose sensitivity?

Perimenopause and glucose sensitivity often share symptoms like fatigue, mood swings, and cravings, which can make distinguishing between the two a bit challenging. However, some signs are more closely tied to glucose sensitivity. These include weight gain around the abdomen, skin tags, and feeling hungry again shortly after eating, which may suggest insulin resistance.

In contrast, symptoms such as night sweats, hot flashes, and irregular periods are more typical of the hormonal shifts that occur during perimenopause. If you're finding it hard to pinpoint the cause, tracking your symptoms over time and consulting a healthcare professional can provide clarity and guide you toward the right approach.

What lifestyle changes can help manage blood sugar during perimenopause?

Managing blood sugar during perimenopause calls for a few thoughtful changes to your daily routine. Start by focusing on balanced meals that include protein, healthy fats, and fibre.

Opt for complex carbohydrates like whole grains, legumes, and vegetables, which provide steady energy. Paying attention to portion sizes and spreading out your carbohydrate intake throughout the day can help keep blood sugar levels in check.

Adding regular physical activity to your routine, like taking a walk after meals, can also aid in better glucose regulation. On top of that, practising relaxation techniques to manage stress and prioritising good sleep habits are equally important. These small but consistent adjustments can go a long way in supporting your metabolic health during this phase of life.

How can continuous glucose monitors (CGMs) help manage blood sugar changes during perimenopause?

Continuous glucose monitors (CGMs) offer a clear picture of blood sugar levels in real-time, making it easier for women in perimenopause to see how hormonal shifts influence glucose metabolism. By monitoring trends and pinpointing triggers, these devices support smarter choices around diet, exercise, and other lifestyle habits to help maintain steady blood sugar levels.

CGMs also shed light on how factors like certain foods, stress, or sleep patterns affect glucose levels. This information allows women to craft tailored strategies to address issues like insulin resistance or energy dips. With CGMs, managing the metabolic changes of perimenopause becomes more straightforward and personalised.

How can I tell if my symptoms are due to perimenopause or glucose sensitivity?

Perimenopause and glucose sensitivity often share symptoms like fatigue, mood swings, and cravings, which can make distinguishing between the two a bit challenging. However, some signs are more closely tied to glucose sensitivity. These include weight gain around the abdomen, skin tags, and feeling hungry again shortly after eating, which may suggest insulin resistance.

In contrast, symptoms such as night sweats, hot flashes, and irregular periods are more typical of the hormonal shifts that occur during perimenopause. If you're finding it hard to pinpoint the cause, tracking your symptoms over time and consulting a healthcare professional can provide clarity and guide you toward the right approach.

What lifestyle changes can help manage blood sugar during perimenopause?

Managing blood sugar during perimenopause calls for a few thoughtful changes to your daily routine. Start by focusing on balanced meals that include protein, healthy fats, and fibre.

Opt for complex carbohydrates like whole grains, legumes, and vegetables, which provide steady energy. Paying attention to portion sizes and spreading out your carbohydrate intake throughout the day can help keep blood sugar levels in check.

 Adding regular physical activity to your routine, like taking a walk after meals, can also aid in better glucose regulation. On top of that, practising relaxation techniques to manage stress and prioritising good sleep habits are equally important. These small but consistent adjustments can go a long way in supporting your metabolic health during this phase of life.

How can continuous glucose monitors (CGMs) help manage blood sugar changes during perimenopause?

Continuous glucose monitors (CGMs) offer a clear picture of blood sugar levels in real-time, making it easier for women in perimenopause to see how hormonal shifts influence glucose metabolism. By monitoring trends and pinpointing triggers, these devices support smarter choices around diet, exercise, and other lifestyle habits to help maintain steady blood sugar levels.

CGMs also shed light on how factors like certain foods, stress, or sleep patterns affect glucose levels. This information allows women to craft tailored strategies to address issues like insulin resistance or energy dips. With CGMs, managing the metabolic changes of perimenopause becomes more straightforward and personalised.