Hormones & Prediabetes in Women: What the Research Shows
Hormonal fluctuations across a woman’s life—especially during menopause, PCOS, and stress—can significantly impact insulin sensitivity and blood glucose levels.
1. Estrogen & Insulin Sensitivity
Estrogen enhances how muscle, fat, and liver cells respond to insulin.
A review in the American Journal of Pathology confirms estrogen’s protective role against insulin resistance (ajp.amjpathol.org, pubmed.ncbi.nlm.nih.gov).
Postmenopausal hormone therapy has been shown to improve insulin sensitivity and lower fasting glucose (pmc.ncbi.nlm.nih.gov).
2. Menopause & Metabolic Changes
During perimenopause, declining estrogen leads to reduced insulin sensitivity and impaired β-cell function.
Evidence shows each extra year of being premenopausal modestly increases diabetes risk; menopause amplifies that risk .
3. PCOS & Insulin Resistance
Up to 80% of women with PCOS have insulin resistance, independent of body weight (pmc.ncbi.nlm.nih.gov).
Even lean women with PCOS show reduced insulin-stimulated muscle glucose uptake .
Women with PCOS have a 4 to 10‑times higher risk of progressing to diabetes .
4. Cortisol & Stress Hormones
Chronic stress elevates cortisol, which raises blood glucose and promotes abdominal fat—both of which worsen insulin resistance.
Women with PCOS often exhibit abnormal cortisol metabolism alongside their insulin resistance (academic.oup.com, pmc.ncbi.nlm.nih.gov).
5. Sleep Disruption from Hormonal Fluctuations
Hormonal changes during perimenopause and PCOS often lead to poor sleep, which is directly linked to decreased insulin sensitivity.
Studies consistently show sleep disturbances in these women worsen metabolic issues surrounding glucose regulation .
Summary Table
Hormonal Factor Effect on Glucose & Diabetes Risk ↓ Estrogen (menopause) ↑ Insulin resistance Perimenopause changes ↑ Annual diabetes risk PCOS ↑ Strong insulin resistance ↑ Cortisol (stress) ↑ Insulin resistance & visceral fat Sleep disruption ↓ Insulin sensitivity
