As women enter their 40s and 50s, many start noticing frustrating changes in their energy, metabolism, and weight — especially around the belly. What’s often overlooked? The connection between menopause, insulin resistance, and blood sugar.
In fact, researchers and women’s health experts like Dr. Stacy Sims and Dr. Mary Claire Haver are speaking up about how hormonal changes during menopause directly impact metabolic health — even in women who eat well and exercise regularly.
Let’s explore why this happens, how to spot the signs, and most importantly — what you can do to feel more in control of your health.
As estrogen and progesterone levels decline during perimenopause and menopause, your body becomes more prone to insulin resistance — meaning your cells don’t respond to insulin as efficiently. This makes it harder for your body to regulate blood sugar, store energy in muscles, and burn fat effectively.
The result? A higher risk of:
Prediabetes and type 2 diabetes
Increased abdominal fat
Energy crashes and sugar cravings
Brain fog, poor sleep, and irritability
Even women who’ve never had blood sugar issues before can start noticing changes in how they feel — and in their A1c, a key lab marker for long-term blood sugar health.
Your A1c is a blood test that shows your average blood sugar over the past 3 months. Unlike a single fasting glucose reading, A1c gives a broader view of how your body handles sugar daily.
Here’s what the numbers mean:
Below 5.7% = Normal
5.7–6.4% = Prediabetes
6.5% or higher = Diabetes
Many women are surprised to learn that even a “normal” fasting blood sugar can coexist with a rising A1c — especially during and after menopause.
Gaining weight (especially around the middle)
Needing more caffeine to feel alert
Feeling shaky or tired between meals
Craving sweets or carbs in the afternoon
Higher A1c or triglycerides on lab work
If these sound familiar, it might be time to look at your blood sugar balance — not just your weight or calories.
Dr. Stacy Sims (physiologist and author of Next Level) and Dr. Mary Claire Haver (OB/GYN and creator of the Galveston Diet) both emphasize that menopause is a time to shift how you eat, train, and recover.
Here are their top strategies:
Lifting weights 2–3 times per week helps your body use sugar more efficiently, supports your metabolism, and preserves lean mass — which naturally declines with age.
Instead of going low-carb, be carb strategic. Eat complex carbohydrates after strength training or in the evening to support recovery and reduce blood sugar spikes.
Start meals with protein to slow down glucose absorption and keep you fuller longer. Aim for 25–30g per meal.
This doesn’t mean cutting out every carb — but ultra-processed foods and sweetened beverages can quickly spike blood sugar and increase inflammation.
High cortisol (your stress hormone) can drive blood sugar up, increase cravings, and worsen insulin resistance. Prioritize rest, movement, and recovery — not just “more workouts.”
Keep healthy fats and protein consistent
Track your A1c yearly after age 40
The transition through menopause isn’t just about hot flashes and hormones — it’s also a metabolic shift that deserves attention, education, and support. If you’ve been feeling off, struggling with your energy, or seeing changes in your labs, it’s not in your head — and you’re not alone.
As Dr. Stacy Sims reminds us:
“Menopause doesn’t have to mean metabolic decline. With the right tools, you can improve how your body uses food, builds strength, and protects against disease.”
And in the words of Dr. Mary Claire Haver:
“You’re not broken — your body is changing. Let’s change how you support it.”
Whether you’re navigating perimenopause or postmenopause, working with a physical therapist, nutrition coach, or other wellness professional can help you build a strategy that supports your hormones, metabolism, and long-term health.