Current evidence and research gaps in menopause management in women with type 1 diabetes mellitus: a narrative review
Abstract
The menopause transition represents a period of complex hormonal, metabolic, and psychosocial change that poses unique challenges for women living with type 1 diabetes mellitus (T1DM). Despite an expanding population of midlife women with T1DM, evidence to guide optimal menopause management remains limited. This narrative review synthesises current clinical and mechanistic evidence on the impact of menopause in women with T1DM. A literature search was conducted in MEDLINE (PubMed), the Cochrane Library, and professional society guidelines between January and May 2025. Across studies, women with T1DM appear to experience an earlier onset of menopause and an increased risk of osteoporosis, cardiovascular disease, psychological distress, metabolic deterioration and sexual dysfunction compared with women without diabetes. Oestrogen deficiency may exacerbate insulin resistance, dyslipidaemia, and vascular dysfunction, while glycaemic variability and altered insulin requirements are frequently reported during the menopause transition. Evidence regarding the safety and efficacy of hormone replacement therapy (HRT) in this group is sparse. In the absence of disease-specific data, clinicians should adopt an individualised approach - screening proactively for menopausal symptoms, bone loss, and cardiovascular risk, tailoring HRT decisions based on individualised risk profiles, and recommending transdermal oestradiol when HRT is used. This review highlights the urgent need for…
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.