Could Blood Sugar Spikes Trigger Hot Flashes?

Researchers have found a growing connection between insulin resistance and menopausal symptoms, especially hot flashes and night sweats. Most of the research and medical writing discusses the idea of hormone replacement improving insulin resistance and diabetes. Most medical articles focus on how hormone replacement therapy may improve insulin resistance. Less attention has been given to the reverse question: Could improving insulin resistance reduce menopausal symptoms? It is worth looking into, because between 10% and 25% of women on hormone replacement therapy continue to have night sweats or hot flashes.

Inflammation and Hot Flashes

Increased inflammation sets the stage for worse menopausal symptoms, like hot flashes and night sweats [click here to read the article and the research]. Insulin resistance doesn’t just affect blood sugar. High insulin levels promote inflammation throughout the body. Since inflammation has been linked to worse hot flashes and night sweats, improving insulin sensitivity may help some women feel better.

Studies Show a Connection Between Menopausal Symptoms and Insulin Resistance

Insulin resistance can lead to metabolic syndrome, and studies have linked metabolic syndrome to more severe menopausal symptoms. In 2012 a small study involving 183 women established a link between metabolic syndrome and hot flashes [1]. A later meta-analysis supported these findings [2]. In one study of over 3,000 women, those with frequent hot flashes had higher levels of insulin resistance than women without hot flashes [3]. Researchers followed more than 700 women and found that higher insulin levels were linked to earlier and longer-lasting hot flashes [4]. In another study, researchers followed more than 3,000 women for 8 years and found that women with frequent hot flashes and night sweats were more likely to have insulin resistance than women without these symptoms [5].

Hot Flashes and Diabetes Medication

Back in 2009 researchers gave 500 mg of Metformin, twice each day to three women with hot flashes and excessive sweating along with insulin resistance. Metformin improved the menopausal symptoms [6]. There have not been huge studies about this, but over the years, diabetes/insulin insensitivity medications have been used “off label” to treat menopausal symptoms.

Can Addressing Insulin Resistance Naturally Reduce Hot Flashes?

Menopause and Diet: Dietary changes have been studied for their effect on menopausal symptoms. Different diets have been studied. They all seem to have a few things in common; they consist of low glycemic foods, are anti-inflammatory, and eschew processed Franken foods. In one study, a group of 84 women were randomly given either a low fat, vegan diet that included cooked soybeans or no dietary changes. Hot flashes decreased by 88% in the group following the diet, compared to 34% in the control group [7]. Another study found a strong link between poor carbohydrate quality and menopausal symptoms [8]. Processed food consumption is linked to more severe menopausal symptoms [9]. Consider following the Roadmap to Health, it is low glycemic, anti-inflammatory, and free of processed foods.

Berberine for Insulin Resistance and Menopause

Berberine is one of the most widely studied natural compounds for improving insulin sensitivity, making it a logical supplement to consider when insulin resistance may be contributing to menopausal symptoms. Hormone therapy may be appropriate for many women, but estrogen is not the only issue during menopause. Insulin resistance, inflammation, abnormal cholesterol, and weight gain can also become more common. Berberine has been studied for many of these metabolic problems. It has not been proven to stop hot flashes by itself, but it may be especially worth considering when high insulin and inflammation are part of the picture [10].

Not Treating Hot Flashes, Using Hot Flashes as a Guide to Basic Health

The point of this article is not to give you a quick fix for hot flashes and night sweats. It is more about looking at symptoms to understand what your body needs. Hormone replacement therapy (HRT) can get the symptoms under control most of the time (10% – 25% of women will continue to have hot flashes and night sweats while on HRT). If the symptoms are severe, HRT is not a possibility, or if the HRT falls short of giving you relief, consider looking at diet, general inflammation, and insulin resistance.

Selected References:

  1. Arch Gynecol Obstet. 2012 Feb;285(2):541-8. Association between menopausal symptoms and metabolic syndrome in postmenopausal women
  2. 2023 May 16;15(5):e39069 Prevalence of Metabolic Syndrome and Its Association With Menopausal Symptoms in Post-Menopausal Women: A Scoping Review
  3. 2023 May 16;15(5):e39069. Prevalence of Metabolic Syndrome and Its Association With Menopausal Symptoms in Post-Menopausal Women: A Scoping Review
  4. J Clin Endocrinol Metab. 2026;111(6):e1544-e1553. Insulin Levels Early in Perimenopause Inform Vasomotor Symptom Incidence Across the Menopausal Transition.
  5. J Clin Endocrinol Metab. 2012 Jul 31;97(10):3487–3494. Vasomotor Symptoms and Insulin Resistance in the Study of Women’s Health Across the Nation
  6. Endocrine Practice Volume 15, Issue 1, January–February 2009, Pages 30-34 Hot Flashes and Fatigue Relieved by Metformin
  7. 2023 Jan 1;30(1):80-87 A dietary intervention for vasomotor symptoms of menopause: a randomized, controlled trial
  8. Maturitas Volume 150, August 2021, Pages 42-48 Carbohydrate quality index: Its relationship to menopausal symptoms in postmenopausal women
  9. Women Health. 2025 May-Jun;65(5):429-441 Association of ultra-processed food consumption with menopausal symptoms in postmenopausal women
  10. Oxid Med Cell Longev. 2015 Feb 17;2015:723093. Potential Benefits of Berberine in the Management of Perimenopausal Syndrome