Higher Fasting Insulin Linked to Earlier, More Intense Menopause Symptoms
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A new study reveals a potential link between metabolic health and the severity of perimenopause, suggesting women with higher fasting insulin levels may experience earlier and more prolonged vasomotor symptoms (VMS) like hot flashes and night sweats.
The research, published last month in the Journal of Clinical Endocrinology & Metabolism, analyzed data from approximately 700 American women aged 42 to 52. The participants were part of the long-running Study of Women’s Health Across the Nation (SWAN) and were followed for over a decade. To ensure data accuracy, women currently using insulin-managing medications or who had undergone an oophorectomy or hysterectomy were excluded from the analysis.
Insulin and BMI’s Impact on Hot Flashes
Researchers focused on metabolic measurements taken when participants were 47 years old to determine if insulin levels influenced the timing or duration of VMS. Their findings indicated a clear correlation: both insulin levels and body mass index (BMI) at age 47 were associated with when and how women experienced hot flashes.
“Higher insulin at age 47 was also associated with longer durations of hot flashes and cold sweats and a rise in testosterone levels across the menopausal transition,” explained Faria Athar, the study’s lead author, in a news release. “These findings help us to fill some of the gaps in our understanding of menopause symptoms and why their severity varies for different women.”
A Critical Window for Metabolic Health
The study’s release comes at a time when midlife is increasingly recognized as a crucial period for diabetes prevention and proactive metabolic health intervention. Dr. Alyssa Dweck, a board-certified OB-GYN and chief medical officer of Bonafide Health, stated the results weren’t surprising, aligning with earlier SWAN study reports on the impact of metabolic health during perimenopause and menopause.
“The first association should come as no surprise since metabolic health, in general, is clearly associated with general health, socioeconomic status and ethnicity, all variables of significance as related to the menopause experience as noted in the SWAN study,” she said. “In addition, it is well established from the SWAN study that those with obesity, and thus elevated BMI, have an increased risk of significant VMS.”
Proactive Steps and Future Research
While further investigation is needed, experts are optimistic about the potential for women and their healthcare providers to take proactive steps to mitigate symptom severity. According to Dr. Dweck, the study suggests that fasting insulin and/or elevated BMI could serve as early indicators for women at risk of experiencing significant VMS and related health issues.
“The most exciting take home from this study is that it is possible that fasting insulin and/or elevated BMI may play a role in early identification or prediction of those who might suffer from VMS and its downstream effects,” she added.
Although insulin levels are not solely dictated by lifestyle, the research suggests that steps to lower them – through consistent exercise and a nutritious diet – could potentially ease the perimenopause and menopause experience. This aligns with broader recommendations linking healthy lifestyle choices to less disruptive menopausal symptoms.
“The study results further support the proactive recommendations as related to diet/nutrition and exercise, both controllable variables which can impact the menopause experience,” Dr. Dweck noted. “Further study might lead to a simple blood test done prior to menopause or even at the onset of perimenopause, that could potentially predict VMS severity and onset, which may help with shared decision making about treatment and management tools going forward.”
Ultimately, the ability to identify women who would benefit most from preemptive interventions – whether through lifestyle changes or medication – could significantly reduce suffering and potentially even prevent the onset of VMS.
