Are menopause symptoms worsening? Diabetes may be the reason

Hot flashes, sleep disturbances, joint pain, and physical changes are just some of the symptoms many women experience around menopause. Now, a new study points to a factor that may make this period even more challenging: type 2 diabetes and prediabetes. Researchers have found that postmenopausal women with blood sugar disorders reported not only a greater number of symptoms but also more severe symptoms.

The study, conducted by researchers from Eulji University and the Asan Medical Center in Seoul and published in the scientific journal Menopause, included 296 women from South Korea aged 45 to 64. Of these, 220 had type 2 diabetes or prediabetes, while 76 did not have either condition. To minimize factors that might influence the results, the researchers excluded women who were receiving hormone therapy for menopause, as well as those with depression, sleep disorders, or diabetes complications.

19 symptoms versus 14

The most notable gap was found among women who were already postmenopausal. Women with diabetes or prediabetes reported an average of about 19 symptoms, compared to about 14 among women without these conditions. The severity of the symptoms also differed: the total score for the severity of menopause symptoms among postmenopausal women with diabetes or prediabetes was about 54% higher.

When the researchers examined all 296 participants, physical symptoms—including hot flashes and joint pain—were about 46% more severe in the diabetes and prediabetes group. In contrast, no significant difference was found between the groups regarding mood-related symptoms, such as irritability and low mood. No statistically significant differences were found among women who were premenopausal or in the menopause transition itself.

The link between menopause and blood sugar levels

The link between menopause and diabetes is complex and likely works in both directions. During the transition to menopause, there is a decrease in estrogen and progesterone levels, which can coincide with changes in body composition, fat accumulation in the abdominal area, and increased insulin resistance. Sleep disturbances characteristic of menopause may also be significant. Hot flashes and night sweats can impair sleep quality, while insufficient sleep may affect stress hormones and blood sugar balance. Previous studies have already pointed to a link in the opposite direction: severe vasomotor symptoms, including hot flashes, have been associated with an increased risk of developing type 2 diabetes later in life.

Is diabetes the cause?

Despite the gaps found, the study does not prove that diabetes or prediabetes causes menopause symptoms to be more severe. This is an observational study based, among other things, on participant reports, and it was conducted on a specific population of women from South Korea. The researchers did not examine the biological mechanism that might explain the link, so further studies will be needed to understand why it appears mainly among postmenopausal women and whether improving blood sugar balance can also affect symptom severity. However, the findings highlight the importance of an integrated view of women's health during menopause. For women dealing with diabetes or prediabetes simultaneously, symptoms such as sleep disturbances, hot flashes, and pain are not necessarily separate issues—and it may be necessary to consider both conditions together as part of monitoring and treatment.