Insulin sensitivity and premenstrual syndrome

Abstract

Maintaining normal blood glucose levels is a constant challenge for women with diabetes. Anecdotal reports reveal that many women question if menstrual cycle phases may affect their blood glucose levels. However, results from studies investigating the effect of the menstrual cycle on insulin sensitivity in diabetic women have been conflicting. One variable that may account for the conflicting results is the presence or absence of premenstrual syndrome (PMS), which may exacerbate menstrual cycle-related effects on insulin sensitivity. Treatment of PMS with serotonin reuptake inhibitors may alleviate the symptoms of PMS, as well as improve insulin sensitivity and help regulate blood glucose levels.

Emerging Perspectives on the Impact of Diabetes Mellitus and Anti-Diabetic Drugs on Premenstrual Syndrome. A Narrative Review

“…SSRIs were found to facilitate GABAminergic transmission by affecting progesterone metabolism and by increasing levels of allopregnanolone. SSRIs can also improve insulin sensitivity and improve glucose homeostasis [ 95 , 96 ]. These actions allowed prescribing these medications to control some of the PMS symptoms.…”

“…SUs have the highest risk of hypoglycemia among the different anti-diabetic drugs. As mentioned before, hypoglycemia associated with catecholamine surge is manifested by PMS-like symptoms [ 65 , 96 ]. Moreover, chlorpropamide, one of the old-generation SUs has the tendency to cause fluid retention due to an anti-diuretic hormone (ADH)-mediated action [ 99 ].…”

Association between dietary patterns and premenstrual disorders: a cross-sectional analysis of 1382 college students in China

“…First, patients with PMDs may exhibit unique insulin/glucose interaction patterns, potentially intensifying the menstrual cycle's impact on insulin sensitivity. 6 Notably, during both the follicular and luteal phases, women with PMDs showed lower blood glucose levels and less insulin resistance compared to controls. 7 Second, PMDs might partially originate from childhood adiposity and continue to be associated with increased body mass into adulthood, a connection especially evident in PMDD cases.…”

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“…[2] Several factors have been suggested to correlate with the emergence of PMS. These factors include social factors, [3] genetic, [4] abnormality in endocrine system including progesterone, [5][6][7] estrogen , [6][7][8][9] testosterone, [10] thyroid hormones, [11,12] change in micronutrients including calcium, [13][14][15] magnesium, [14,16] vitamins, [14,15,17,18] insulin resistance, [19] changes in brain neurotransmitters including endogenous opioids, [20][21][22] serotonin, [23,24] norepinephrine, [23,25] gamma amino butyric acid, [26] substance abuse including alcohol, [27] and nicotine, [28] psychological factors including stress, [29] depression, [30] and personality disorders. [31,32] One of the factors suspected to influence on PMS is high BMI.…”