Perimenopause and Blood Sugar: Blood Sugar Issues Don’t Always Look Like Diabetes
When Something Feels Off. But You’re Told Everything Is “Normal”
If you’re in your late 30s or 40s and starting to feel like your body is changing in ways you can’t quite explain, you’re not imagining it.
You might be eating relatively well.
You might be exercising.
Your labs may come back “normal.”
And yet:
Sugar cravings feel stronger than ever
Energy crashes hit hard in the afternoon
Weight feels more stubborn, especially around the middle
You feel irritable or shaky if meals are delayed
Willpower doesn’t work the way it used to
This is often the moment women are told:
“Your blood sugar is fine.”
But here’s the truth that rarely gets explained:
Blood sugar issues don’t always look like diabetes.
Especially in perimenopause.
Long before blood sugar numbers cross a diagnostic threshold, subtle dysregulation can be happening at the cellular and hormonal level. And one of the biggest drivers of this shift is changing estrogen.
Understanding the connection between perimenopause and blood sugar is one of the most important steps you can take if cravings, fatigue, and metabolic frustration have become part of your daily life.
What Changes in Perimenopause (And Why Blood Sugar Is Affected)
Perimenopause isn’t a single event, it’s a transition that can begin years before menopause.
During this time, hormones don’t simply decline.
They fluctuate.
Estrogen in particular becomes more unpredictable, rising and falling unevenly from cycle to cycle. Progesterone often declines earlier and more steadily. Together, these shifts change how your body responds to food, stress, and energy demands.
One of the most affected systems during this transition is blood sugar regulation.
Estrogen’s Role in Insulin Sensitivity
Estrogen plays a protective role in metabolism. It helps:
Improve insulin sensitivity
Support glucose uptake into cells
Reduce excessive blood sugar spikes after meals
When estrogen fluctuates, this protection becomes inconsistent.
The result can be a form of functional insulin resistance, where insulin is present, but cells don’t respond as efficiently as they once did.
This doesn’t automatically show up as diabetes.
Instead, it shows up as symptoms.
Signs of Blood Sugar Dysregulation That Aren’t Diabetes
Many women assume blood sugar problems only matter if they’ve been diagnosed with prediabetes or diabetes.
But in perimenopause, blood sugar issues are often subtle, intermittent, and symptom-based.
Common signs include:
Intense sugar or carb cravings
Feeling shaky, anxious, or irritable when hungry
Afternoon energy crashes
Waking at night feeling wired or hungry
Difficulty losing weight despite consistent effort
Feeling better immediately after eating sugar
These symptoms are often dismissed as stress, aging, or lack of discipline.
In reality, they’re signals that blood sugar is not being regulated smoothly.
Why Traditional Diet Advice Fails Women in Perimenopause
When women experience these symptoms, the advice they’re given is often the same advice that worked years ago:
Eat less.
Cut carbs.
Try harder.
But in perimenopause, this approach frequently backfires.
Restriction Increases Cortisol
Undereating, skipping meals, or aggressively cutting carbohydrates raises cortisol.
Cortisol:
Increases blood sugar
Worsens insulin resistance
Promotes fat storage (especially abdominal fat)
Intensifies cravings for quick energy
Instead of stabilizing blood sugar, restriction destabilizes it further.
Skipping Meals Worsens Blood Sugar Swings
Many women unknowingly create a cycle of:
Under-eating during the day
Blood sugar crashes
Evening cravings or overeating
This pattern reinforces insulin resistance and keeps the nervous system in a constant state of stress.
Again, this is not a willpower issue.
It’s a biological response to instability.
Why January “Resets” Are Especially Problematic
January is often when blood sugar issues become impossible to ignore.
After the holidays, many women:
Slash calories
Remove carbohydrates
Increase exercise intensity
Push through fatigue
In a perimenopausal body, this combination sends a clear message:
Food is scarce. Stress is high.
The metabolic response is protective:
Slower metabolism
Increased fat storage
Higher cortisol
Stronger cravings
This is why so many women feel like they “fail” every January.
They’re not failing.
The approach is failing them.
The Nervous System and Blood Sugar Connection
Blood sugar regulation isn’t just about food.
It’s also about safety.
Your nervous system plays a critical role in how glucose is used, stored, and released. When the nervous system perceives chronic stress, whether from emotional load, lack of sleep, or dietary restriction, it prioritizes survival.
That survival response often includes:
Keeping blood sugar elevated
Seeking fast fuel
Conserving energy
This is why sugar cravings often increase during times of stress.
In perimenopause, when hormonal buffering is reduced, this connection becomes even more pronounced.
What Actually Helps Stabilize Blood Sugar in Perimenopause
The solution isn’t eliminating sugar through force.
It’s creating stability.
1. Eat to Regulate, Not Restrict
Balanced meals that include:
Adequate protein
Healthy fats
Fiber-rich carbohydrates
Help prevent sharp spikes and crashes.
Carbohydrates are not the enemy.
In fact, completely removing them can worsen insulin resistance by increasing cortisol and reducing thyroid support.
2. Consistency Matters More Than Perfection
Regular meals and snacks (when needed) help your body trust that fuel is available.
This trust reduces the stress response that drives cravings.
3. Support Hormones Through Metabolic Balance
Stabilizing blood sugar supports:
Estrogen metabolism
Cortisol regulation
Thyroid signaling
These systems are interconnected.
You cannot fix one while ignoring the others.
Why Willpower Isn’t the Solution
If willpower were the issue, you would have solved this already.
The women I work with are motivated, informed, and capable.
What they need isn’t more control.
They need a framework that matches their biology.
A Different Approach: The Sugar Reset Method
This is why I created The Sugar Reset Method.
Not as a detox.
Not as a short-term challenge.
But as a biology-first approach to stabilizing blood sugar for women navigating perimenopause.
Inside the Sugar Reset Method, we focus on:
Regulating blood sugar without eliminating carbs
Reducing cravings by supporting hormones
Creating metabolic safety instead of stress
Rebuilding trust with food and your body
This approach doesn’t rely on discipline.
It relies on understanding.
Where to Start If This Resonates
If you’ve been blaming yourself for symptoms that are rooted in hormonal and metabolic change, I want you to hear this:
You are not broken.
Your body is adapting.
And with the right support, it can feel stable again.
👉 Start with my free 7-Day Sugar Reset Guide.
It will walk you through how to balance meals, reduce cravings, and stabilize blood sugar in a way that supports your hormones, not fights them.
If you want deeper guidance, you can explore working with me inside The Sugar Reset Method, where we address perimenopause, blood sugar, and metabolic health together.
Because blood sugar issues don’t always look like diabetes.
Sometimes, they look like a woman doing everything right, without the right framework.
To your health,
Sarah Seguin,
NUTRITIONAL GARDENS
Certified Nutrition Practitioner
Metabolic Balance Coach
Horticulturist