Comprehensive Guide on Role of HRT in Diabetic Women
Table of Contents
- What is hormone replacement therapy?
- Women with Diabetes
- Other Complications of Menopause
- Diabetes and Menopause: A Twin Challenge
- Changes in blood sugar level
- Why Menopause Is Different With Diabetes?
- How Hormone Replacement Therapy Helps Menopausal Women?
- How to Ward off Diabetes in Menopausal Woman
- Is HRT Right for You?
- How HRT Decreases Risk of Diabetes?
- Latest Findings on Type II diabetes and HRT
What is hormone replacement therapy?
Now a days, hormone replacement therapy has given hope to lot of menopausal women who are diabetic and experience very severe symptoms of menopause. Hormone replacement therapy or HRT is a treatment that helps in relieving the symptoms of menopause. In the reproductive cycle of a woman, menopause occurs when she stops having periods and cannot get pregnant naturally. As a woman ages, her periods start becoming less frequent over time and ultimately, they stop altogether. In some cases, they might also stop suddenly.
Menopause is a part of natural aging process which usually happens between the ages of 45 years and 55 years when the estrogen levels start to decline. A number of symptoms develop when a woman undergoes menopause, like vaginal dryness, hot flashes, night sweats, low mood and difficulty in sleeping.
These symptoms develop when the hormonal balance of body gets disturbed. Ovaries stop producing as much estrogen as it used to and do not release egg every month.
In order to relieve most of the symptoms of menopause, hormone replacement therapy for diabetic women is an awesome choice.
Women with Diabetes
Diabetes in women is much worse than in men. This fact surfaced from a 2007 study, in which it was discovered that between 1971 and 2000, the death rate for diabetic men decreased, but no such decline was observed for diabetic women.
Diabetes is a chronic condition that affects both men and women, but some unique symptoms are observed only in women. Some of these symptoms are as follows:
1. Oral and Vaginal Thrush
Increased blood sugar level creates an ideal environment for growth of Candida fungus that results in vaginal infection. Some of the symptoms of vaginal thrush are:
• Vaginal discharge
• itchy sensations
• sore skin in the area of infections
• dyspareunia or painful sex
• white coating on tongue
2. Urinary Tract Infection
Diabetes also increases the risk of urinary tract infection. This is because high blood glucose can weaken the immune system, which increases the risk of developing the infection. Symptoms of urinary tract infection are as follows:
• cloudy urine
• painful, burning urination
• blood in urine
3. Sexual Dysfunction
Increased blood sugar level can damage the nerves and cause diabetic neuropathy. This causes a decrease in sensations in feet, legs and hands along with alteration in sexual function. This can cause a decrease in sex drive.
Other Complications of Menopause
Diabetic women who are undergoing menopause or have undergone menopause might not have wild hormonal swings that affect the blood glucose level. However, they have other possible health issues that need consideration. For example, these women are at a high risk of developing atherosclerosis in which the artery walls become thick and hard, that can lead to heart attack and stroke. Also, menopause when combined with diabetes and sedentary lifestyle increase the risk for osteoporosis in which the bones become thin.
Diabetes and Menopause: A Twin Challenge
Menopause and diabetes might team up to have varied effects on the body of a woman. Menopause is a difficult phase in any woman’s life, which can be further worsened by diabetes. Some of these effects are as follows:
• Changes in blood sugar level
The hormones progesterone and estrogen determine how cells respond to insulin. After menopause, when there is change in the hormone levels, it can cause fluctuations in blood glucose level. You might notice that your blood glucose level becomes more variable and fluctuating than it was before. When your blood glucose level becomes out of control, it can cause a number of complications.
• Weight gain
During menopausal transition and after menopause, some women can gain weight which can cause an increment in the need for oral diabetes medication or insulin.
High blood glucose levels can make the woman more susceptible to vaginal and urinary tract infections, even before menopause sets in. After menopause, a decrease in estrogen level makes it easier for fungus and bacteria to attack the body and thrive in vagina as well as urinary tract infection.
• Sleep problems
Hot flashes and night sweats are commonly observed in women after menopause, which can take a toll on their sleep. It has been found that sleep deprivation can further cause an increase in blood glucose level which can be difficult to manage.
• Sexual problems
Vaginal dryness is a common symptom of menopause and can lead to pain during sex. High blood glucose level damages the nerves which further plays interferes with orgasm and arousal.
•Changes in blood sugar levels
Why Menopause Is Different With Diabetes?
As a woman starts to approach 40, her period starts to become irregular, indicating the approaching menopause. While this is happening, the level of progesterone and estrogen hormones start fluctuating. This starts affecting blood glucose level as well, which can be problematic for women with type II diabetes. In the body of an overweight woman, the cells take anything having a cholesterol ring and convert it into estrogen. Therefore, those people who are overweight have a lot of estrogen stored in their fat cells.
How Hormone Replacement Therapy Helps Menopausal Women
Hormone replacement therapy either makes use of estrogen alone or combines it with progesterone in order to supplement the body’s natural hormone levels. It helps in easing the symptoms of menopause. They come in the form of patches, pills, gels, sprays, gels, creams and a vaginal ring.
Earlier,it was believed that hormone replacement therapy will help in lowering a woman’s chances of developing heart disease. However, later it was found that it helped in preventing several other diseases like breast cancer, stroke and heart attack in post menopausal women.
As per the Endocrine Society, the level of risk of developing serious diseases depends on woman’s age, history and several other factors. For most of the healthy women who have bothersome menopausal symptoms, undergoing limited hormone replacement therapy has more benefits than risks.
Women with diabetes are predisposed to heart diseases and therefore, for them, doctors taken special precautions while prescribing HRT. They worry about coronary heart disease and prefer taking matters rather slow. The picture is a bit black and white. 
It is thought that transdermal options for hormonal replacement is better than oral choices for diabetic women. There are a number of non hormonal prescription therapies available in the market like low doses of anti depressant paroxetine, which also help in controlling the symptoms of menopause. If a woman does not want to go for hormone replacement therapy, she should talk to her doctor and discuss other options.
How to Ward off Diabetes in Menopausal Woman
Those women who want to avoid developing diabetes in their menopausal years can take a number of steps, such as:
• Weight bearing exercises
• High fiber diet
• Low calorie foods
• Talking to your doctor about all your medicines, especially those for treating high blood pressure and asthma
How HRT Decreases Risk of Diabetes?
Menopause is an important event in the life of a woman that can help in diagnosing type II diabetes in those who are unaware of their diabetic status.
Hormone replacement therapy (HRT) can play an important role in decreasing the risk of developing the type II diabetes in postmenopausal women. This is because estrogen is known to target certain cells of pancreas and gut that increase the level of tolerance to glucose, which is an important marker of reduced risk of type II diabetes.
Is HRT Right for You?
Hormone replacement therapy (HRT), after menopause, can be a tricky choice. But, it can be a good option for those menopausal women who have diabetes and have difficulty in keeping blood glucose level under control.
Studies that have been done to determine the safety of HRT have given conflicting results. However, some doctors have now started prescribing HRT, in a careful manner. Not all doctors believe in the wonders of HRT and think that a woman should be prescribed HRT only when her symptoms of menopause are severe. 
Latest Findings on Type II diabetes and HRT
How estrogen affects pancreatic insulin-producing cells is an extensively studied topic, whereas the effect of estrogen on glucagon producing cells is a rather unexplored territory. Glucagon, too, is a pancreatic hormone that helps in regulating blood glucose level. Research is being carried on to determine the effect of estradiol on glucagon as well GLP-1, which is another hormone that increase the secretion of insulin by pancreas. It is being observed that intestinal as well as pancreatic cells secreting GLP-1 and glucagon are extremely sensitive to estrogen. Researchers believe that if estrogen’s mechanism of action in lowering blood glucose level is discovered, it can help in developing novel targeted hormonal therapies.
Hormone replacement therapy is like a bag of mixed goodies for diabetic women. It does have its benefits but should only be used with precaution. It can provide relief from symptoms of menopause but have some side effects of its own, that should not be ignored.