Diabetes tips

How to Navigate Monthly Hormone Cycles on Multiple Daily Injections

February 12, 2024

Reader question: How does Elisabeth navigate monthly hormone cycles using MDI? Are there any nutritional changes she makes during each phase to support/balance certain hormones? Does she make dosage adjustments and/or switch up her exercise routine throughout each phase? Any other helpful tips?

Phase overview

There are four phases in the menstrual cycle and each one is determined by the fluctuation of hormones like estrogen, LH, and progesterone. These hormones have a direct effect on insulin sensitivity. 

Menstrual and Follicular

  • While progesterone is low, you will likely see higher insulin sensitivity and lower blood sugar numbers


  • Progesterone is main cause of increasing insulin resistance, stimulating appetite, and higher blood glucose levels

How insulin sensitive or resistant you become in each phase will vary person to person.

Insulin strategy

For those on insulin pumps, you can create different profile settings for different parts of the month or go into manual mode if on an automated pump. But what about people who use multiple daily injections (MDI)? 

Things to consider on MDI if you are seeing stubborn highs during the luteal phase...
- increasing long acting insulin dose
- increasing IC ratio or correction factor
- adjusting prebolus timing (ie from 15 minutes to 25 minutes)

Nutrition strategy

- consider the luteal phase as the time to lean more heavily on easy-to-bolus-for meals
- experiment with the order in which you eat your food (vegetables, protein, carbs) 
- this is NOT a time to go low carb - your body needs the energy to prepare for menstruation, but it is a time to think about carbohydrate sources (ie whole foods vs packaged, fiber-rich carbs like beans and sweet potatoes vs high glycemic carbs like tropical fruit or white rice)
- incorporate enough healthy fats and protein!

Exercise strategy

- Movement during the luteal phase is great for boosting insulin sensitivity.
- Opt for slow, intentional strength training sessions, pilates, walking, and other low impact activities so as to not add stress to your body during this naturally high-hormone phase.
- Can't get in a structured workout? Don't get stuck in an all-or-nothing mindset. Move throughout the day with walks after meals or even a few sugar squats here and there!


- prioritize sleep (this has a powerful impact on insulin sensitivity)
- hydration (always important). Remember you can play around with different hormone supporting teas to up your fluid intake during this phase! (red raspberry leaf, lemon ginger, dandelion root)
- track any adjustments you make to your insulin or routine and reflect on how it goes so you can remember for next month!