Hormones, Sugar, and Metabolism: A Complete Guide for Peri- and Post- Menopausal Women

Hormonal changes during perimenopause and postmenopause can dramatically affect metabolism, body composition, and overall health. Understanding the roles of estrogen, progesterone, testosterone, and insulin — and how sugar impacts each — is key to maintaining energy, strength, and hormonal balance as you age.

Estrogen in Perimenopause and Postmenopause: What Every Woman Needs to Know

Estrogen regulates reproductive function, bone health, heart health, mood, and metabolism. There are three main types: estradiol (E2), the potent ovarian estrogen; estrone (E1), produced mainly by fat; and estriol (E3), important during pregnancy.

During perimenopause, fluctuating estradiol and declining progesterone create estrogen dominance, leading to bloating, breast tenderness, mood swings, sleep disturbances, and midsection fat gain. Estrone and estriol are lower but contribute to unpredictable hormone activity.

After menopause, ovarian estradiol and estriol production drops, leaving fat-derived estrone as the primary estrogen. Excess body fat can elevate estrone, subtly promoting estrogen dominance and increasing risk for abdominal weight gain, mood changes, and estrogen-sensitive conditions such as breast cancer, endometrial hyperplasia, and uterine fibroids. Maintaining a healthy body fat percentage — typically 21–33% for perimenopausal women and 25–31% for postmenopausal women — along with resistance training, walking, and mindful nutrition, helps optimize estrogen balance and metabolic health.

Sugar and estrogen: High sugar intake elevates insulin and increases body fat, which produces more estrogen, creating a vicious cycle that worsens blood sugar regulation and fat storage, especially around the belly.

Insulin Resistance and Blood Sugar Management in Midlife Women

Insulin is the hormone that acts as the “key” to your cells, allowing sugar to enter and fuel your body. In insulin resistance, the key becomes “rusty,” leaving sugar circulating in your bloodstream, triggering inflammation, and storing fat around your organs (visceral fat) or in your liver (non-alcoholic fatty liver disease).

Not all carbohydrates are equal. Processed sugars spike insulin rapidly, while complex carbohydrates like fruits, vegetables, whole grains, and sweet potatoes slow absorption, lower glycemic impact, and curb sugar cravings.

Chronically high insulin also lowers sex hormone-binding globulin (SHBG), a protein that binds excess estrogen and testosterone for removal. Reduced SHBG can lead to estrogen dominance, acne, hair loss, and belly fat accumulation.

Symptoms of insulin resistance include:

• Afternoon energy crashes
  
  

• Sugar cravings
  
  

• Mood swings, anxiety, irritability
  
  

• Belly fat accumulation
  
  

• Brain fog
  
  

• Early morning waking (2–4 a.m.)
  
  

Fasting glucose and A1C often appear normal, so insulin resistance can go undiagnosed. Perimenopausal women should ask for a fasting insulin test, and comprehensive panels like those at Evolved Women’s Health can provide the answers you need.

Progesterone: The Balancing Hormone During Perimenopause

Progesterone counteracts estrogen and supports hormone balance, regulating menstrual cycles, mood, sleep, and bone and heart health. In perimenopause, declining progesterone causes bloating, breast tenderness, mood swings, sleep disturbances, and midsection fat accumulation.

High sugar worsens progesterone decline. Blood sugar spikes and elevated insulin increase cortisol, which competes with progesterone production, while exacerbating estrogen dominance. Keeping sugar in check helps protect progesterone levels, maintain hormone balance, and support metabolic health during this transitional phase. After menopause, ovarian progesterone production is minimal, so sugar has little direct effect, though it still influences insulin, fat, and overall hormone balance.

Testosterone in Perimenopause and Postmenopause: Small But Mighty

Testosterone supports muscle mass, bone density, energy, libido, and mood. In perimenopause, the ovaries produce some testosterone; postmenopause, production shifts primarily to adrenal glands and peripheral tissues. Maintaining healthy testosterone is crucial for metabolism, strength, and vitality.

High insulin lowers SHBG, temporarily increasing free testosterone, but chronic insulin resistance and excess belly fat can convert testosterone into estrogen. In perimenopausal women, this can worsen estrogen dominance, causing fatigue, low libido, and muscle loss. Postmenopausal women are less affected by SHBG changes, but managing blood sugar, insulin, and body composition is still essential to preserve muscle, metabolism, and overall hormone balance.

Two Actions to Improve Hormonal and Metabolic Health Today

1. Start Weight Training
Muscle mass isn’t just for strength — it improves insulin sensitivity and blood sugar regulation. In a lab study using a “clamp” test — which measures muscle sugar uptake — postmenopausal women who lifted weights 2–3 times per week for 4 months improved sugar uptake by 29% (Ryan, Pratley, Elahi, Goldberg, & Hagberg, 1996).

If you’ve never lifted weights before, schedule a free consultation to create a safe, personalized plan to start your strength journey.

2. Take a 10-Minute Post-Meal Walk
Walking after meals activates muscles to pull sugar out of the bloodstream for energy, reducing spikes and improving insulin sensitivity. Weight training increases muscle mass for even greater long-term sugar uptake — combining both is ideal.

If this article resonated with you, left you with questions, or motivated you to take action to improve your health, book your free 30-minute consultation today. Get personalized guidance tailored to your hormones, metabolism, and lifestyle, and start taking control of your health now.

References

Arora, S. (2025, October 31). Is sugar sabotaging your hormones? Women’s Health Network. https://www.womenshealthnetwork.com/hormonal-imbalance/hormonal-imbalance-caused-by-sugar/

Lynne. (2025, May 18). Blood sugar chaos: How perimenopause could quietly lead to diabetes. Menopause Network. https://menopausenetwork.org/blood-sugar-chaos-perimenopause-diabetes-risk/

Ryan, A. S., Pratley, R. E., Elahi, D., Goldberg, A. P., & Hagberg, J. M. (1996). Resistive training increases insulin action in postmenopausal women. Journal of Gerontology: Medical Sciences, 51(4), M223–M230. https://pubmed.ncbi.nlm.nih.gov/8808989/