Influence of menopause on diabetes and diabetes risk

Nat Rev Endocrinol. 2009 Oct;5(10):553-8. doi: 10.1038/nrendo.2009.166. Epub 2009 Aug 18.


Many postmenopausal women live with diabetes mellitus; however, little information is available about how the changes that occur around the time of menopause might uniquely affect management of diabetes mellitus in this population. Although the weight gain that commonly occurs during the menopausal transition is largely attributable to aging rather than the transition itself, changes in body composition have been independently associated with menopausal status. These changes in body composition have, in turn, been associated with alterations in insulin sensitivity and glucose metabolism in postmenopausal women. Hormone therapy seems to have neutral or beneficial effects on the adverse changes in body composition associated with menopause. Whether menopausal status independently influences diabetes risk remains controversial. Nevertheless, consistent findings from large clinical trials suggest that postmenopausal hormone therapy decreases the risk of developing diabetes mellitus. Similarly, many studies suggest that postmenopausal hormone therapy has neutral or beneficial effects on glycemic control among women already diagnosed as having diabetes mellitus. Future studies are needed to elucidate the mechanisms that underlie these relationships and to determine how these observations should influence recommendations for the care of postmenopausal women with diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Body Composition
  • Diabetes Mellitus / chemically induced
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / etiology
  • Estrogen Replacement Therapy
  • Female
  • Humans
  • Menopause / physiology*
  • Risk Factors