Insulea - Diabetes Blog

Diabetes Blog: Mein Alltag mit Diabetes Typ 1, Angststörungen und Depressionen.

Diabetes, the menstrual cycle and birth control - things you should know!

GER: Interview mit Kora Mikino über Diabetes & MenstruationBeiträge zum Thema Zyklus auf Insulea

Whenever I talk on Social Media about how my menstruation affects my blood sugar and insulin sensitivity there are still people that I leave baffled with my statements. But I guess I shouldn't be surprised considering that nobody in my health care team really talked about Diabetes and the menstrual cycle with me either. I learned at a young age to not really think about what's happening inside my body, I took a small white pill to cope with my period pain and irregular cycles and that was it. 
I can't remember much about biology class or Sex Ed - did we even talk about the menstrual cycles in full length? I honestly doubt it.

Getting to know my own Body

It only occurred to me when I got off the birth control pill that I was missing out on something really important: Getting to know my own body. Of course I knew that there were particular hormones doing this and that in the different stages of the cycle. But did I know what exactly they were doing? Did I know that I could actually determine those stages just by looking at my cervical mucus? Did I ever feel my cervix? Did I know that the clitoris is actually way bigger than what we can see from the outside? Sadly, no, I did not. I somehow learned to not be interested in my own body. I didn't think about it and I didn't listen to it. It's a whole different world now! 

this is a teaser for an honest post about periods © Monika Kozub

A menstrual cycle out of the books 

When I got off the birth control three years ago it didn't take my menstrual cycle long to get steady again. I actually have a menstrual cycle out of the books now: 28 Days nearly every cycle. It's so fascinating for me to determine all the stages of my menstrual cycle now. I can tell you exactly how every cycle affects my Diabetes Management in a certain way. And this is one of the things I want to talk about today! 

The Cycle and Insulin sensitivity/resistance 

As we all know Insulin is the Key. But not only that, Insulin is a hormone also and naturally other hormones have an effect on it. Let's take a look at the hormone levels during the cycle (in a really non-medical professional view)
Your cycle starts with the first day of your period. The three major hormones (estrogen, testosterone and progesterone) are all on a low level on day one. Testosterone and Estrogen start to rise slowly by day three and hit a peak around the ovulation, typically around day 14 or 15. This phase of the cycle is where we have the most energy and feel the best. The rising estrogen makes me super sensitive to insulin and it's easier to handle my blood sugar in those 2 weeks. 
After ovulation progesterone comes into play, trying to secure the assumed pregnancy. This results in a lower energy level and food-cravings, but also in insulin resistance! I can not only feel my monthly ovulation by having a stomach ache, but I can also see it in my rising blood sugar. For this time of the month I need to increase my basal rate between 30-50%! 

There was a time when I was hesitating to do that, as I need a lot of insulin anyway and I didn't want to take any more - but every time it just proofs to me that increasing my basal rate helps keeping my blood sugar in range and thus makes me more energetic and happy during this time. 

Mood swings before my period 

The days before my period are often accompanied by the worst mood swings as all the 3 major hormones are dropping rapidly and taking the mood boosters serotonin, dopamine and endorphins with them. I get easily irritated and frustrated by the smallest things and a blood sugar out of range is definitely not helping. This is what happens for my cycles, but of course every cycle is different. 
Occasionally I still get the worst period cramps where I can't leave the bed, other cycles I rarely have cramps at all. Some cycles the week before my period my insulin resistance is so stubborn that I try to eat a lower carb diet for some days and that helps. 

I think it's just important to have the different phases from the cycle in mind while doing decisions on my diabetes management. Really listening to my body made me learn so much in the past three years and I'm still learning! I was always really sensitive, but now I feel even more connected to my body's functions, it's so interesting!

My skin after coming off the birth-control pill

my skin in 2018 and 2019 (bottom right)

Unfortunately I still have issues with my skin due to all the hormones I took for a decade. When I came off the birth control pill I still had great skin for about half a year, then I got acne (in 2018). The worst point was two years ago and I still struggle with it, but I'm getting there. You can see the vast difference from two years ago to now! This is close up and personal, I do still have flare-ups from time to time and it's hard to not get frustrated, but I need to trust the process. My skin and body just need a little more time to heal and I'm (mostly) fine with that. 
No tips please except you've dealt with acne coming off the pill yourself, thank you. 

My flare-up in October 2020 (after starting new skin care)

Period Panties & other Goodies 

comfy period panty by Kora Mikino

The first question I get asked when I tell people that I stopped using the pill is of course which birth control method I use now. I didn't want to have hormones screwing up my body again (I might talk about that in another post) so I was looking for a safe alternative. For over a year now I use a diaphragm and that works well for me and my partner. It is a very safe method when you learn how to do it right! I had a private workshop and counseling from a midwife in my city. If you want to know more about that just ask! I can't tell you much about it outside of Germany though, sorry. 

Another really great thing I discovered are period panties! Tampons and menstrual cups ain't really my thing so I was looking for a great alternative as free bleeding is not really an option, is it? Well, at least not for me. I found a great start-up and I was actually able to work with them together for a "Summer school" they did on Instagram. I also got gifted one panty, the other ones I bought myself! I love the soft fabric and they really hold in all the blood (and ugh here it comes, fragile (cis)-men please stop reading if you haven't already - I'm a heavy bleeder haha). I do need to change them every 12 hours in the first 2 days. I own 3 panties now, but I want more! I think I told them a hundred times already that they need to get leopard print ones! Take a look at their shop here: Kora Mikino (unpaid not contracted ad, pr goodies)



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