Insulin Levels Early in Perimenopause Inform Vasomotor Symptom Incidence Across the Menopausal Transition
Authors' conclusion
Perimenopausal fasting insulin and BMI show complementary but distinct associations with menopausal changes. Elevated insulin predicts earlier and prolonged vasomotor symptoms, and is associated with higher T.
Study context
- Population
- Midlife women in SWAN without oophorectomy or hysterectomy, with metabolic data at age 47, not taking insulin/medications for hyperglycemia; mean fasting insulin 10.117 µIU/mL (SD 6.711), body mass index (BMI) 27.0 (SD 6.6), mean age at final menstrual period 51.0 years (SD 2.3)of 3302 SWAN participants
- Participants
- 704 women
- Exposure
- Higher vs lower fasting insulin at age 47
- Outcome
- Vasomotor symptom timings and durations, and trajectories of E2, FSH and testosterone across the menopausal transition
Methodological detailscommunity-based, secondary analysis of SWAN data
- Community-based
- Secondary analysis of SWAN data
Main finding
As reported in the abstract
Vasomotor symptoms and reproductive hormone trajectories · menopausal transition
- Higher insulin at age 47 predicted younger onsets of hot flashes and night sweats
- Higher insulin at age 47 predicted longer durations of hot flashes and cold sweats
- Higher insulin at age 47 predicted greater testosterone rise
- Cox models: elevated age-47 insulin associated with increased likelihood of hot flashes; remained significant with BMI and glucose as covariates
Observational data: associations, not effects.
Further findings
- BMI associations with vasomotor symptoms paralleled those of insulin
- BMI more closely linked to slower E2 decline and blunted follicle-stimulating hormone (FSH) rise
Original publication
Insulin Levels Early in Perimenopause Inform Vasomotor Symptom Incidence Across the Menopausal Transition. J Clin Endocrinol Metab. Published 3 January 2026. doi:10.
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