How Does Insulin Resistance Affect My Hormones?
Understanding the Hidden Connections in Perimenopause and Menopause
If you’ve been dealing with stubborn belly fat, low energy, or mood swings, you might have wondered: Could insulin resistance be playing a role? Most of us think of insulin as a “blood sugar hormone,” but the truth is, insulin reaches into almost every part of your hormone system.
And during perimenopause and menopause—when estrogen, progesterone, and other hormones are already shifting—insulin resistance can tip the balance even more. Let’s talk about how it works and why it matters.
Insulin: More Than a Blood Sugar Hormone
Insulin’s main job is to help your cells absorb glucose from your blood and turn it into energy. But when your body becomes resistant to insulin, it doesn’t just affect blood sugar. Insulin acts like a master signal in your endocrine system. When it’s out of balance, other hormones—like estrogen, testosterone, cortisol, leptin, and even thyroid hormones—get pulled off track too (National Library of Medicine).
That’s why insulin resistance is linked to more than diabetes. It can drive weight gain, fatigue, mood changes, hot flashes, and even worsening PMS-like symptoms in perimenopause.
How Insulin Resistance Affects Your Hormones
Here’s what’s happening behind the scenes:
1. Estrogen Becomes Less Stable
Estrogen naturally drops during perimenopause and menopause, but insulin resistance adds another layer. Belly fat actually produces its own estrogen, which can cause levels to fluctuate unpredictably. Too much belly fat can mean higher circulating estrogen at times, while overall ovarian production is falling. This uneven pattern can worsen symptoms like bloating, irregular cycles, or heavy bleeding in perimenopause (GREM Journal, 2023).
2. Progesterone Drops Faster
Progesterone tends to decline earlier than estrogen in perimenopause. When insulin resistance is present, high insulin levels stimulate the ovaries in a way that can suppress progesterone production. Lower progesterone can mean more anxiety, sleep issues, and mood swings.
3. Testosterone May Climb
Here’s where many women are surprised: insulin resistance can lead to higher testosterone. That’s because high insulin stimulates the ovaries and adrenal glands to make more androgens (male hormones). This is why women with PCOS—who almost always have insulin resistance—often experience acne, hair thinning, or facial hair. Even in menopause, excess belly fat and insulin resistance can drive testosterone up relative to estrogen, which may worsen abdominal fat gain (Future Woman).
4. Cortisol Rises
High insulin often pairs with high cortisol (your stress hormone). When your body stores more visceral fat, it releases inflammatory compounds that keep cortisol elevated. This creates a double hit: cortisol promotes belly fat storage, and belly fat increases cortisol. It’s a loop that feels hard to escape.
5. Thyroid Gets Sluggish
Insulin resistance is linked with a higher risk of hypothyroidism and altered thyroid function. Thyroid hormones control metabolism, so when they slow down, it’s easier to gain weight and harder to lose it—even with diet changes (Endocrine Connections, 2019).
6. Hunger Hormones Lose Their Balance
Two hormones—leptin (which signals fullness) and ghrelin (which signals hunger)—get disrupted by insulin resistance. This is why you might feel constantly hungry or never satisfied after eating. Many women describe it as “a switch flipped” where cravings for sugar or carbs feel uncontrollable.
Why Belly Fat Makes It Worse
Abdominal fat isn’t just sitting there—it’s hormonally active.
Visceral fat produces inflammatory chemicals and hormones that mess with estrogen, testosterone, and cortisol. This means the more belly fat you gain, the more your hormones swing out of balance.
That’s why belly fat during menopause feels so different from weight gain in your 20s or 30s. It’s not just a “cosmetic” change—it’s deeply tied to your hormone health and metabolic future.
Signs Your Hormones May Be Affected by Insulin Resistance
Some red flags that your hormones and insulin might be clashing include:
Weight piling up around the waistline, even if your habits haven’t changed
Hot flashes or night sweats that feel worse with sugar or alcohol
Constant cravings for carbs or sweets
Low energy or brain fog after meals
Mood swings, anxiety, or irritability that feel tied to eating
Irregular cycles, acne, or hair changes
What You Can Do to Break the Cycle
The good news is, improving insulin sensitivity doesn’t just help blood sugar—it can bring your whole hormone system into better balance. Here are some hormone-friendly steps to try:
Eat balanced meals
Pair protein with fiber and healthy fats at each meal to keep insulin steady.
Strength train
Building muscle improves how your body responds to insulin and supports hormone balance.
Prioritize sleep
Poor sleep makes insulin resistance worse and raises cortisol.
Reduce alcohol and added sugar
Both spike insulin and can worsen hot flashes and belly fat.
Support your gut health
Fiber, fermented foods, and hydration all improve how your body processes hormones and insulin.
Work with a healthcare provider if needed
Tools like metformin, inositol, or hormone replacement therapy may be appropriate in some cases.
Final Thoughts
Insulin resistance isn’t just about blood sugar—it’s about the bigger picture of hormone balance. During perimenopause and menopause, when your body is already navigating lower estrogen and progesterone, insulin resistance can magnify symptoms and drive belly fat, mood changes, and fatigue.
The empowering part? You can influence this. Even small, consistent changes—like eating more protein, lifting weights a few times a week, and getting better sleep—can reset how your body responds to insulin and help bring your hormones into a healthier rhythm.
This stage of life is challenging, but it’s also an opportunity to take back control of your health in a deeper way.