Insulin Resistance in Perimenopause: Early Signs Most Women Miss
Many women have insulin resistance long before labs show it.
Perimenopause is often described as a hormonal roller coaster.
Mood swings. Night sweats. Irregular cycles. Stubborn weight.
But there is a deeper shift happening underneath many of these symptoms that rarely gets discussed in conventional care.
Insulin resistance.
And for most women, it starts quietly. Long before fasting glucose rises. Long before A1C flags. Long before anyone uses the word prediabetes.
If you are in your late 30s or 40s and noticing that your body feels different, cravings feel louder, weight feels harder to manage, and energy feels less stable, this is not random. It is often early blood sugar imbalance in perimenopause.
Today we are going to talk about the early signs of insulin resistance in perimenopause that most women miss, why standard lab work often does not catch it, and what you can do now to restore metabolic safety before it progresses.
What Is Insulin Resistance in Perimenopause?
Insulin is your primary blood sugar regulating hormone. It moves glucose from your bloodstream into your cells so you can produce energy.
Insulin resistance happens when your cells stop responding properly to insulin’s signal. Your pancreas compensates by producing more insulin to get the same job done.
In early stages, blood sugar may still look normal. But insulin is elevated behind the scenes.
That elevated insulin shifts your metabolism in very specific ways:
Increased fat storage, especially around the midsection
Stronger sugar and carbohydrate cravings
Energy crashes
Increased inflammation
Hormonal disruption
During perimenopause, fluctuating estrogen directly impacts insulin sensitivity. Estrogen supports healthy glucose metabolism. When estrogen becomes erratic, insulin signaling becomes less efficient.
This is why insulin resistance in perimenopause symptoms often show up before anything appears abnormal on routine lab panels.
Why Standard Labs Miss Early Insulin Resistance
Most conventional lab panels look at:
Fasting glucose
Hemoglobin A1C
These markers reflect blood sugar levels, not insulin levels.
You can have normal fasting glucose and normal A1C while insulin is already elevated.
This stage is often called compensatory hyperinsulinemia. The body is working overtime to keep glucose in range.
By the time glucose rises, insulin resistance has often been present for years.
That is why many women feel dismissed when they say something feels off. Their labs are “normal,” but their physiology is struggling.
Early Signs of Insulin Resistance in Perimenopause
These are the subtle, early symptoms that often get misattributed to stress, aging, or lack of discipline.
1. Cravings That Feel Urgent, Not Casual
If you can go all day eating well and then suddenly feel a powerful pull toward sugar or refined carbs in the evening, that is often unstable blood sugar.
When glucose drops too quickly, cortisol rises to compensate. That creates urgency.
This is not addiction. It is metabolic signaling.
2. Afternoon Energy Crashes
Around 2 to 4 pm, you feel foggy, tired, and unmotivated. Coffee helps temporarily. Sugar helps briefly. But the crash keeps returning.
This pattern often reflects reactive blood sugar swings, one of the earliest insulin resistance perimenopause symptoms.
3. Weight Gain Around the Midsection
Insulin is a fat storage hormone. Chronically elevated insulin signals the body to store energy, especially centrally.
Many women describe doing the same workouts, eating the same foods, yet abdominal weight increases.
This is not a willpower issue. It is hormonal signaling.
4. Feeling “Wired and Tired” at Night
If you feel exhausted but cannot settle down, this can reflect late day blood sugar instability driving cortisol.
Nighttime sugar cravings and difficulty sleeping often share the same root.
5. Increased Anxiety Around Food
When blood sugar is unstable, the nervous system feels less safe.
Food begins to feel louder. Thoughts about eating become more persistent. Discipline feels harder.
This is physiology, not personality.
The Estrogen and Insulin Connection
Estrogen enhances insulin sensitivity. It supports how cells respond to insulin and helps regulate fat distribution.
During perimenopause, estrogen does not simply decline. It fluctuates.
Those fluctuations disrupt metabolic consistency.
Lower estrogen phases are often associated with:
Increased insulin resistance
Stronger cravings
More inflammation
Greater visceral fat storage
If you notice your cravings or energy shift at different times of your cycle, that is data. Your hormones and insulin are interacting.
Blood sugar imbalance in women during perimenopause is not separate from hormones. It is deeply connected to them.
Why Dieting Makes It Worse
When women feel weight gain and cravings increasing, the natural response is restriction.
Smaller portions. Lower calories. Cutting carbohydrates more aggressively.
But under fueling increases cortisol. Elevated cortisol raises blood sugar. Elevated blood sugar requires more insulin.
You can see the loop.
Chronic restriction often worsens insulin resistance long term by increasing stress signaling and reducing metabolic flexibility.
The goal is not to eat less.
The goal is to stabilize glucose and reduce insulin demand.
What Early Intervention Looks Like
The earlier you address insulin resistance in perimenopause, the easier it is to reverse.
Here is what actually supports insulin sensitivity:
Consistent Protein Intake
Protein stabilizes blood sugar and reduces glucose spikes. Many women under consume protein, especially at breakfast.
Starting your day with adequate protein changes the entire glucose curve.
Fiber Diversity
Soluble and insoluble fiber slow glucose absorption and support gut bacteria that influence insulin signaling.
Leafy greens, herbs, seeds, and cruciferous vegetables are powerful tools here.
Mineral Sufficiency
Magnesium plays a direct role in insulin receptor activity. Low magnesium is strongly associated with insulin resistance.
Strength Training
Muscle tissue improves glucose disposal. You do not need extreme workouts. You need consistent stimulus.
Stress Regulation
Chronic stress worsens insulin resistance. Nervous system regulation is metabolic support, not luxury.
The Cost of Ignoring Early Signs
Unchecked insulin resistance increases risk for:
Type 2 diabetes
Cardiovascular disease
Persistent abdominal weight gain
Hormone dysregulation
Cognitive decline
But here is the empowering part.
Early stage insulin resistance is highly reversible.
Perimenopause is not the beginning of decline. It is a metabolic checkpoint.
If addressed correctly, this phase can become a reset point rather than a breakdown.
A Different Question to Ask
Instead of asking:
Why is my willpower weaker?
Ask:
Is my insulin elevated?
Instead of asking:
Why can I not stick to my diet?
Ask:
Is my blood sugar stable enough to support consistency?
This shift changes everything.
How I Approach Insulin Resistance in Perimenopause
In my practice at Nutritional Gardens, I do not start with calorie cutting.
I start with metabolic safety.
We stabilize blood sugar. We reduce insulin demand. We correct nutrient gaps. We support hormone fluctuations rather than fight them.
When insulin comes down, weight shifts more easily. Cravings quiet. Energy stabilizes. Hormones begin to rebalance downstream.
Most women are trying to control behavior when the real lever is biochemistry.
If you recognize yourself in these early signs of insulin resistance in perimenopause, this is your invitation to intervene early.
You do not need to wait for abnormal labs.
You need a structured, insulin first approach that restores metabolic balance before the spiral deepens.
If you are ready to stabilize blood sugar and feel steady in your body again, I invite you to learn more about my 15 week program and how we systematically restore insulin sensitivity. The Sugar Reset Method powered by Metabolic Balance.
Your body is not broken.
It is signaling.
And when you understand the signals, everything changes.
To Your Health,
Sarah Seguin
NUTRITIONAL GARDENS
Certified Nutrition Practitioner
Metabolic Balance Coach
Horticulturist