Perimenopausal Insulin, BMI Have Distinct Links With Menopausal Changes

Elevated insulin at age 47 years linked to younger onset of hot flashes, night sweats and longer duration of hot flashes and cold sweats
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THURSDAY, Feb. 5, 2026 (HealthDay News) -- Perimenopausal fasting insulin and body mass index (BMI) are associated with distinct menopausal changes, according to a study published online Jan. 3 in the Journal of Clinical Endocrinology & Metabolism.

Faria Athar, Ph.D., from the University of Victoria in Canada, and colleagues examined whether midlife insulin levels are associated with vasomotor symptom incidence or reproductive hormone trajectories in a longitudinal analysis of community-based data from 704 participants in the Study of Women's Health Across the Nation. The participants, without oophorectomy or hysterectomy, had metabolic data for age 47 years and did not take insulin or medications for hyperglycemia.

The researchers found that younger onset of hot flashes and night sweats, longer duration of hot flashes and cold sweats, and a greater increase in testosterone were predicted by higher insulin at age 47 years. Associations of BMI with vasomotor symptoms paralleled those of insulin, but BMI was more closely linked to slower decline in estradiol and blunted increase in follicle-stimulating hormone. Elevated insulin at age 47 years was associated with an increased likelihood of hot flashes; with BMI and glucose as covariates, this association remained significant.

"These findings help us to fill some of the gaps in our understanding of menopause symptoms and why their severity varies for different women," Athar said in a statement.

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