Postmenopausal women with type 2 diabetes or prediabetes report significantly more menopause symptoms than women without those conditions, according to a study published August 5 in the journal Menopause. Physical symptoms like hot flashes and joint pain were notably worse, while mood symptoms showed little difference between groups.
The study was conducted by researchers at Eulji University and Asan Medical Center in Seoul. They surveyed 296 South Korean women between the ages of 45 and 64. Of those, 220 had type 2 diabetes or prediabetes, and 76 had neither condition. Women who used hormone therapy or had depression, sleep disorders, or diabetes complications were excluded from the study.
Among postmenopausal participants, those with diabetes or prediabetes reported about 19 symptoms on average. Women without either condition reported around 14. The overall symptom severity score was 54 percent higher in the diabetes and prediabetes group, according to Healthline.
Physical symptoms, including hot flashes and joint pain, were 46 percent more intense in the diabetes and prediabetes group across the full sample of 296 participants. Mood symptoms, such as irritability and low mood, scored similarly in both groups. Among premenopausal and perimenopausal women, researchers found no statistically significant differences between the groups.
Two physicians who were not involved in the study offered context on why the two conditions may interact so strongly. Serina Lewis-Everett, a board-certified family medicine physician and owner of Sepia Modern Primary Care in Catonsville, Maryland, explained the hormonal mechanics at work.
"Declining estrogen levels can contribute to increased insulin resistance, changes in body composition, sleep disruption, and mood changes," she told Healthline. "All of these can make blood sugar more difficult to control."
Wedad Rahman, an endocrinologist with Piedmont Healthcare in Conyers, Georgia, described how the body's fat distribution shifts during the menopausal transition. Estrogen and progesterone fall over a period of years, she said, and that change affects where the body stores fat.
"That change leads to lower lean muscle mass, which then makes it easier for fat tissue to accumulate in all the wrong places," Rahman said. She noted that fat settles in the abdomen and around the organs. "That in turn increases insulin resistance and makes it more likely for one to develop type 2 diabetes," she said.
Type 2 diabetes occurs when glucose builds up in the blood because of insulin resistance, leading to higher-than-normal blood sugar levels. Prediabetes is the stage where blood sugar is elevated but not yet high enough to meet the threshold for a type 2 diagnosis.
The researchers found the relationship between hormonal changes and blood sugar control runs in both directions, meaning menopause can worsen diabetes management, and diabetes appears to worsen the menopause experience. The study's design was cross-sectional, which means it captures a snapshot in time and cannot establish that diabetes directly causes more severe symptoms.
The findings add to a growing body of research on how metabolic conditions interact with reproductive aging in women. The study's relatively small sample size and single-country focus may limit how broadly the results apply to other populations.
