PopulationsHumans1,315 womenCohort study

Insulin resistance rose faster around menopause

For a modelled reference woman, an insulin resistance measure rose 4.3% yearly during the transition, compared with 1.2% before and 0.9% after.

Blood samples beneath upright, faceless women show cells, sugar and hormone forms, with the largest increase in density in the central pair.

JCI Insight

An observational study followed 1,315 women aged 42–52 who were before or in the early stages of the menopause transition in 1995–1996. They had up to 16 follow-up visits through 2018. Researchers estimated insulin resistance up to 12 times. This is when the body responds less well to insulin, a hormone that controls blood sugar. They also recorded each woman’s final menstrual period.

The estimate rose faster from 1.5 years before the final period to 2.5 years after it than in the years outside that interval. Models accounted for factors including changes in body mass index, a measure of weight relative to height. For an example woman defined in the model, the adjusted annual increases were 1.2% before the interval, 4.3% during it and 0.9% afterwards.

Why it matters

Understanding midlife insulin resistance requires separating changes linked to menopause from those linked to aging. The researchers called for studies of the underlying mechanisms and whether lifestyle could dampen menopause-associated increases.

Caveats

This observational study cannot show that menopause caused the faster rise. Insulin resistance was assessed using a calculated estimate, and the quoted rates describe a modelled reference woman rather than every participant.

The paper

Development of insulin resistance in women over the menopause transition

Arun S Karlamangla, Wei Juan Han, Preethi Srikanthan,
Show 4 more authorsAlbert Shieh, Duncan Thomas, Barbara Sternfeld, Monique M Hedderson,
Gail A Greendale

David Geffen School of Medicine at UCLA

JCI Insight · 6 Oct 2026

doi.org/10.1172/jci.insight.206342PubMed 42837175