Myths vs facts: Insulin and Wechseljahre

During menopause, declining estrogen reduces insulin sensitivity, increasing the risk of insulin resistance. This is well-established (human-strong). Many women experience changes in glucose tolerance, but not all develop diabetes. A common myth is that hormone replacement therapy (HRT) always worsens insulin resistance – in fact, low-dose transdermal estrogen may improve it. Another myth: 'Fluctuations are normal and harmless.' Fact: persistently elevated fasting glucose or HbA1c warrants medical evaluation, as the risk for type 2 diabetes rises. Lifestyle interventions like exercise and a Mediterranean diet low in sugar and refined carbs are evidence-based. Genetic tests for TCF7L2 or other variants have small effect sizes and are not clinically actionable (evidence: marketing/unclear). Caution: do not supplement without blood tests – iron overload (hemochromatosis) can be worsened by unnecessary supplementation.