Menstruation

Being physically active in the week before your period can help control fluctuations in your blood glucose.

Hormones control the menstrual cycle in a woman. These hormones can also affect your blood glucose. Many women notice fluctuations in blood glucose at certain times in their monthly cycle, such as an increase in blood glucose a few days prior to the beginning of their period and then a decrease once the period begins. This increase usually occurs after ovulation and before menstruation. Changes are due to two hormones, estrogen and progesterone. When these hormones are at their highest level just before your period, they affect another important hormone, insulin, which may, in turn, cause blood glucose to rise. Some women find their blood glucose rises considerably, while others do not notice a difference. In some women, blood glucose levels are lower before and during their periods. Each woman needs to discover her own pattern.

Often it is the fasting blood glucose before breakfast that tends to fluctuate the most in women with type 1 diabetes during the time just before a period begins. Adjusting your insulin often helps. When your period begins and your blood glucose levels go down, readjust your insulin back to its former level.

If you have type 2 diabetes and do not take insulin, remember regular exercise can lower blood glucose, therefore it is important to maintain physical activity during this time of the month. Besides better blood glucose levels, you will likely have more energy and have fewer unpleasant side effects from menstruation if you can be active on a regular basis.

If you notice fluctuations in your blood glucose and are not sure if these are related to your menstrual cycle, it is easy to find out. In your blood glucose record book, indicate when you start your period each month and watch for a relationship between the two.

Some women suffer more from premenstrual syndrome (PMS) than other women. It does not seem to be related to the type of diabetes you have nor is it more common in diabetes. Women commonly experience moodiness, bloating, water retention and food cravings at this time. Food cravings for carbohydrates and fats combined with a reduction in activity may contribute to fluctuations in blood glucose.

Here are a few suggestions that may help to minimize food cravings:

	Alcohol, caffeine and chocolate may affect your mood, so omitting them from your diet may make you feel less edgy and less inclined to overindulge on high carbohydrate, high-sugar snacks.
	Eat at regular meal times to try and avoid large swings in blood glucose and to keep you from overeating later.
	Low fat, low carbohydrate snacks such as vegetable sticks or a cup of unbuttered popcorn may take the edge off your appetite and minimize the rise in blood glucose.
	Try to maintain your regular exercise pattern as this helps to decrease blood glucose and will help you to feel better emotionally.

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