Introduction

The hormonal changes that come with menopause bring unique challenges, including an increased risk of inflammation-related conditions.

Poor sleep quality brought on by menopause exacerbates chronic inflammation, often referred to as "inflammaging", which plays a major role in the development of several age-related conditions like diabetes, Alzheimer’s, and cardiovascular disease, and worsens your defenses against everyday illness.

Immune Weakness

Research shows that a woman’s immune system is at its strongest during her reproductive years—when estrogen is at its highest and hormones are the most balanced. Estrogen helps maintain protective barriers in your skin and gut that defend against bacteria and viruses.

Estrogen also helps the immune system defend against infections linked to atherosclerosis, the buildup of fats, cholesterol, and other substances in and on the artery walls.

During menopause, the drop in estrogen and new hormonal imbalance weakens the immune system. Postmenopausal women often have higher levels of inflammatory markers like C-reactive protein (CRP).

Interestingly, high estrogen can also increase inflammation, leading to the development of autoimmune diseases like rheumatoid arthritis and lupus, which may improve after menopause when estrogen levels drop and the immune system calms down.

Diabetes Risk and Blood Sugar

Declining estrogen levels also have a big impact on blood sugar control and how your body processes insulin, potentially raising the risk of type 2 diabetes or insulin resistance. For women who already have diabetes, managing blood sugar levels can become more challenging after menopause.

Estrogen plays a key role in helping your cells use insulin effectively—the hormone that moves glucose (sugar) into your cells for energy.

Before menopause, estrogen makes cells more responsive to insulin, keeping blood sugar levels stable. But when estrogen levels drop, your cells may become less sensitive to insulin, leading to insulin resistance. This means your body has to work harder to manage blood sugar.

Inflammaging can make insulin resistance worse and raise your diabetes risk even further.

Many women in menopause now use a Continuous Glucose Monitor (CGM) to track how blood sugar responds to food, stress, exercise, and daily life—helping to proactively manage or reverse prediabetes and insulin resistance.

Weight Gain and Hormonal Imbalance

After menopause, the body’s production of estrogen shifts from the ovaries to fat tissue.

This is particularly significant for women who gain weight or develop diabetes after menopause, as their fat tissue produces more estrogen—increasing the risk of breast cancer.

The enzyme aromatase, found mostly in fat tissue, converts androgens (hormones from the adrenal glands) into estrogen. This process, called aromatization, becomes a primary source of estrogen in postmenopausal women.

The more fat tissue a woman has, the more aromatase is available to produce estrogen, leading to higher circulating levels of estrogen without counterbalancing progesterone or testosterone.

Unregulated estrogen can promote the growth of estrogen-sensitive tissues, like the breast and uterus, increasing the risk of breast cancer and endometrial cancer.

That said, don’t be alarmed by small weight gain—our bodies change as we age, often redistributing fat without major changes in overall composition. Most physicians recommend maintaining 15% to 25% body fat for optimal health in women.

Exceeding that range, however, increases the risk of diabetes, hormonal imbalances, and all-cause mortality.

Alzheimer’s and Brain Health

Inflammatory processes also contribute to Alzheimer’s disease risk.

Estrogen helps suppress the buildup of amyloid-beta plaques, a hallmark of Alzheimer's. Without sufficient estrogen, plaque accumulation and inflammation may accelerate, contributing to neurodegeneration.

Estrogen supports brain function by:

• Promoting neuron growth
• Maintaining neural connections
• Reducing oxidative stress
• Regulating glucose metabolism in the brain

New research is shifting focus from plaques to inflammation and metabolic dysfunction, drawing connections between Alzheimer’s, insulin resistance, diabetes, obesity, and heart disease.

After menopause, the decline in estrogen can impair brain energy metabolism, resembling early stages of Alzheimer’s disease.

Cardiovascular Disease (CVD)

The connection between menopause and cardiovascular disease (CVD) is well-established.

Estrogen supports heart health by:

• Maintaining blood vessel flexibility
• Promoting healthy cholesterol levels
• Reducing inflammation

Before menopause, estrogen helps protect against atherosclerosis, supports good cholesterol (HDL), and lowers bad cholesterol (LDL). After menopause, this protection fades, raising the risk of heart attacks and strokes.

Without estrogen, inflammation increases, arteries stiffen, and oxygen delivery to cells worsens, weakening heart muscles over time.

Women who experience early menopause (before age 45), especially due to ovary removal, face even greater risk of heart disease. However, early menopause itself may also signal underlying health issues and accelerated aging.

The Sleep Connection

Lifestyle changes such as insulin monitoring (CGM), weight training, clean eating, stress reduction, and better sleep can significantly lower the risk of CVD.

One Swiss study found that napping once or twice a week cut the risk of heart attack, stroke, and heart failure by 48% compared to those who never nap.

Still, naps aren’t a replacement for quality nighttime sleep.

Restful sleep is crucial for:

• Lowering inflammation
• Healing damaged cells
• Supporting digestion and gut health
• Balancing cortisol
• Producing growth hormone

If sleep is disrupted by vasomotor symptoms like hot flashes or night sweats, our Terra cooling device may help. Terra detects hot flashes before they happen and adjusts your sleep temperature in real-time, keeping you comfortable and improving recovery overnight.

References

• PMC4581591
• PMC8063246
• PubMed 30298180
• PubMed 39163895
• PubMed 36339406 – Glucose Metabolism
• PubMed 17261796
• PubMed 20813470