International Journal of Homoeopathic Sciences · May 2026

Impact of Postmenopausal Hormonal Alterations on Carbohydrate Metabolism

By Singh A, Saxena B

Background: Menopause is a major endocrine transition characterized by the permanent cessation of ovarian estrogen production. This transition has profound systemic metabolic consequences, particularly on carbohydrate metabolism. Objective: To comprehensively review the molecular, physiological, and clinical mechanisms by which postmenopausal hormonal alterations impair carbohydrate metabolism. Methods: This narrative review synthesizes evidence from experimental models, mechanistic studies, epidemiological data, and randomized clinical trials. Results: Estrogen plays a central role in glucose homeostasis by regulating insulin signaling, skeletal muscle glucose uptake, hepatic gluconeogenesis, adipose tissue distribution, mitochondrial function, and inflammatory pathways. Estrogen deficiency during menopause promotes visceral adiposity, hepatic insulin resistance, metabolic syndrome, metabolic dysfunction–associated steatotic liver disease (MASLD), and type 2 diabetes mellitus. Menopausal hormone therapy (MHT), particularly when initiated early, improves insulin sensitivity and reduces diabetes incidence. Conclusion: Postmenopausal hormonal alterations significantly disrupt carbohydrate metabolism. Recognition of menopause as a metabolic transition is essential for developing targeted prevention and treatment strategies.

doi.org/10.33545/26164485.2026.v10.i5.a.2684Open accessMechanisms