Evidence check: Insulin in the context of Wechseljahre

Menopause is often accompanied by declining insulin sensitivity, increasing the risk of metabolic syndrome and type 2 diabetes. The primary driver is estrogen decline, which impairs cellular glucose uptake. Evidence is mostly human-observational (cohort studies) and mechanistic. Direct-to-consumer tests like MyBody-X may measure fasting insulin or HOMA-IR, but a single value is not clinically decisive – it fluctuates daily and is influenced by diet, exercise, and stress. Clinically established markers (HbA1c, oral glucose tolerance test) are more reliable. Marketing claims that an insulin test alone can 'optimize' menopause are overstated. A medical workup with holistic assessment is advisable. Lifestyle interventions (high-fiber diet, resistance training, weight management) have moderate evidence for improving insulin sensitivity during menopause.