Vive la Vivelle!

Blood draw for hormone levels at 9:45.  Vivelle dot estrogen patch back on at 9:55.  Yay!  No, I’m not waiting for the lab results.  After 5 weeks of progressive physical chaos, I’m pretty sure I already know what they will be.



Related posts on Type 1 diabetes and hormones:

Medical Deja Vu

Is Type 1 Diabetes Different for Women than it is for Men?

Synthetic Hormones and Type 1 Diabetes: A Call For Sharing Personal Stories

First Things First: Hormones and Insulin Requirements

Medical Deja Vu

You know that restaurant you go to once a year because you can’t quite remember why you don’t like it, so you think to yourself “It can’t possibly be as bad as I think it was!”  Then you go…and you remember “Yeah, it’s that bad and then some.”  You say to your spouse “Honey, if I ever suggest we come here again can you please remind me how bad it was?”

Well, I’m having that kind of sudden bad-memory-recall with a medication change.  Why, oh why did I listen to the doctor’s suggestion?  It’s my body and I knew better.

Fitbit sleep Sept-Oct

This image is from my Fitbit sleep tracker. Note over 30 days without HRT how much more restless my nights have gotten even though I’m in bed for the same amount of time.

The super-short version of what is wrong with me (in this situation) is that I’m post-menopausal and have been for the past 5 years.  Yes, apparently my now 15-month-old son is a complete fluke of nature (another story.)  I’ve been on Hormone Replacement Therapy (HRT) to relieve yucky symptoms such as horrible hot flashes (24 hours a day), completely irregular blood sugar readings, vertigo, trouble sleeping, joint pain, bleeding gums, weight gain, etc.  When I’m taking HRT, “Badda-bing!” I’m completely normal again…all symptoms go.  When I’m not, well obviously from the laundry list of symptoms, I’m pretty miserable.

A few months back I started having other female issues and the obgyn discovered a uterine fibroid that will have to be surgically removed (again, another story) but right before she found it she suggested that I go off of HRT just to see what would happen…to see if something had changed.  Gah!  I’d already had all these conversations with my NP but my medical team doesn’t communicate and I honestly think the obgyn just wanted to cover her bases.  Nevertheless after listening to “If it was my body, I’d do it” and “What’s the worst that can happen?  A few hot flashes?” I reluctantly agreed.

It’s been a month and all I have to say is “Never again!”  After all, my obgyn isn’t me.  She doesn’t have a myriad of other conditions to worry about, all of which are affected by drastic hormone changes.  She doesn’t really get type 1 diabetes or understand what I mean when I say “My BGs are really hard to control when I’m having all those menopause symptoms, not to mention that some of them mimic symptoms of low BG and it’s a real challenge.”  So, why on earth did I get talked into doing it again when I knew that wasn’t the issue?  Maybe I felt guilted into it?  Maybe, for once, I just wanted to be that round peg that actually fits into the round hole?  Maybe I simply let myself forget just how bad that restaurant was?  Regardless of the reason, for the next few weeks at least, I’ll be consciously only hugging my husband while I’m facing to the right because leaning my head back and looking left is guaranteed to bring on the vertigo.

You might also be interested in these related posts:

My Fitbit Flex: A Delightful Surprise

Is Type 1 Diabetes Different for Women than it is for Men?

Synthetic Hormones and Type 1 Diabetes: A Call For Sharing Personal Stories

First Things First: Hormones and Insulin Requirements



Is Type 1 Diabetes Different for Women than it is for Men?

I read this article that’s been circulating the Internet over the past few days entitled “Men With Type 1 Diabetes Are Better at Blood Sugar Control Than Women” and I found myself thinking that maybe this isn’t such a surprise.  Although the media’s inflammatory word choice for the article title seems to imply “men do it better”, the actual study title, “Sex differences in glycaemic control among people with type 1 diabetes” and study content lean towards biological differences.

Why am I so interested in this study?  As a woman I truly believe that hormone balance is a key issue in my BG control.  In fact I’m sure of it because I’ve tested my theories in my own private lab (i.e. my body).  When my hormones are balanced, I’m proactive with my BG control, fine-tuning my basal rates and having reasonably good predictability of bolus outcomes.  Whereas, when my hormones are not balanced, suddenly my fine-tuned basal rates and boluses don’t work as well as they used to, my insulin resistance goes up, and I’m constantly chasing highs and treating lows.  Even PWDs who don’t have extra complications beyond a normal monthly cycle often mention having higher BGs the week prior to their periods.  Are there type 1 diabetes issues related specifically to women that we should be aware of?

I decided to look further into it.  First, I wanted to actually see the real study this media story was based on.  It took some digging but I found the Abstract and Poster submitted by Dr. Wild to the European Association for the Study of Diabetes (EASD).  The study divided individuals into 3 age groups, under 15, 15-24, and over 24.  womens life stages 3The final conclusion states: “In this cross-sectional analysis of international data, there was a small difference in glycaemic control in males and females in the youngest age group, however control of type 1 diabetes was poorer in women than men in the two older strata.  This association did not appear to be confounded by age or duration of diabetes.”   Seems reasonable to me that the youngest strata is the least different from males, in that most of that age group hasn’t started a monthly cycle yet.  (Yes, I’m sure there are also many other biological reasons to consider.)

Secondly, I looked up information about Dr. Wild and found an interesting recent article she authored related to female cycles, diabetes, and diabetes-disease correlations, entitled “Diabetes in women − A life-course approach”.  I’m hoping this means more future studies will be conducted related to PWDs and hormones.  The lack of information on this has been frustrating for me, to say the least.  A few specific women’s health correlations to diabetes from the article are below.  While most of the correlations are negative, I’m certainly not trying to be Ms. Diabetes Doomsday.  But I do feel that as PWDs, these are women’s health correlations that we should be aware of.  If for no other reason, than that our local OBGYN, Endo, or Primary Physician may not be (mine weren’t aware of quite a few).

And after all, let’s call a spade a spade; women do tend to be more complicated ^_^

  • T1 diabetes appears to be associated with a delay in menarche and with menstrual irregularities.
  • Diabetes is associated with less frequent ovulation and the ability to conceive was about 75% of that of a non-diabetic.
  • There is evidence to suggest that women with diabetes undergo earlier menopause than women without diabetes.
  • Women lifecycles 2Effect of pregnancy on pre-existing diabetes:  Pregnancy leads to increased insulin resistance and is associated with a higher frequency of hypoglycaemic episodes (and reduced hypoglycaemia awareness) in women with type 1 diabetes.
  • If you have gestational diabetes, you are at increased risk for developing subsequent T2 diabetes.
  • Odds of developing T2 diabetes were 4-fold higher for women with PCOS than those without.
  • Post Menopausal Hormone Replacement Therapy (HRT) in PWDs:  Given the risks of both diabetes and the menopause, each case needs to be evaluated on its individual merits. Do the vasomotor and osteoporosis benefits outweigh the risks of endometrial or breast cancer? A large meta-analysis found that women with diabetes taking HRT had significantly reduced insulin resistance (12.9%, 95%CI 19.8–51.7%), reduced fasting glucose (11.5%, 95%CI 5.1–18.0%) and reduced fasting insulin (20.2%, 95%CI 4.2–36.3%), compared to those taking placebo or no treatment.
  • HRT in PWOD’s:  A meta-analysis of 107 randomized controlled trials found a 30% reduction in the incidence of diabetes in women taking HRT vs no treatment or placebo.  They also found non-diabetic users had significantly lower abdominal adiposity and waist circumference and more positive lipid profiles than non-users. Again individual women need to weigh the risks and benefits of HRT.
  • A number of studies have repeatedly confirmed osteoporosis as a complication of T1 diabetes.
  • Women with T1 diabetes were 12.25 times more likely to report an incident hip fracture than women without diabetes.
  • A number of researchers have looked at the relationship between diabetes and endometrial cancer and consistently found an increased risk of endometrial cancer amongst women with T2 diabetes.   No association has been shown for T1 diabetes.

You might also be interested in these related posts:

Synthetic Hormones and Type 1 Diabetes: A Call For Sharing Personal Stories

First Things First: Hormones and Insulin Requirements

Synthetic Hormones and Type 1 Diabetes: A Call For Sharing Personal Stories


There are many reasons for taking synthetic (and largely female) hormones, including fertility treatments, sustaining pregnancy after IVF, Premature Ovarian Failure (POF), Primary Ovarian Insufficiency (POI), perimenopause, and menopause.

All these conditions (and normal menopause without hormone replacement therapy – HRT) greatly affect our insulin sensitivity and can require seemingly radical (and scary) changes in one’s insulin regime.

In addition, Premature Ovarian Failure and Primary Ovarian Insufficiency can be caused by an autoimmune disorder.  Ugh, sound familiar?  AND, it’s common for individuals with one autoimmune endocrine disorder to develop others.  Boo Hiss!  Studies on both of these phenomena are ongoing and the mechanisms aren’t fully understood (or easily determined with lab tests).

major endocrine glands     hormone balance

Here’s a pic showing all of the endocrine glands in our bodies and another showing how hormones made by some of these glands are interrelated.


I experienced major insulin sensitivity changes when I developed sudden-onset POF (at age 35) and started on HRT (the most bioequivalent versions I could find).   I also went through my second pregnancy while on synthetic estrogen and progesterone (same hormones as women who undergo IVF), and am now looking to get regulated back on HRT since I’m done breastfeeding (and apparently still post-menopausal).

As a T1 with Grave’s Disease (autoimmune thyroid condition), I was able to find a lot of information and personal stories shared online (years ago!) about people with thyroid disorders and type 1diabetes.  But, when it came to a diagnosis of POF and subsequent HRT and pregnancy, I couldn’t really find anything.  My Endo didn’t even know there was a link between POF and other autoimmune endocrine disorders (Gah! Needless to say, I see a different Endo now).


I wish I had been educated (at least a little bit) about some of these issues and how all of our endocrine glands and hormones really affect one another before my body became the ultimate lab experiment.  I’d like to share my experiences in the hopes of helping and relating to others and am looking for other women who would be willing to share their experiences as well.

What hormones were you on/missing?  Were you undergoing hormone treatment for infertility, POF, POI, IVF, normal menopause?  Was your hormone treatment cyclic in nature?  Was it bioequivalent?  How did your insulin sensitivity change?

I’d love to start a page on my blog that could serve as a central place for women to share their stories about major hormone changes (especially synthetic hormones and menopause) and how they affected blood sugar and insulin requirements.  Drastic hormone changes are bad enough without also feeling isolated on the diabetes front.  Please contact me if you have a story to share.

While I’m sure our experiences were quite different in some respects, one thing we’ve all faced is trying to adjust our diabetes management to meet the demands of hormone-induced insulin sensitivity changes.  Let’s share our stories!


Here are a few more-scientific articles related to hormone-insulin relationships and autoimmune hormone disorders.