Perimenopause and Blood Sugar: Why Am I Craving Sugar and Carbs?

Have you noticed that your cravings seem to have changed during your 40's?

Perhaps you find yourself reaching for chocolate in the afternoon, craving something sweet after dinner, or feeling as though you could eat carbohydrates all day.


You may also be experiencing energy dips, feeling hungry again shortly after eating, or finding it harder to stop once you start eating something sweet.

If this sounds familiar, you're not alone.


Perimenopause can be a time when appetite, energy levels and food cravings change. Hormonal fluctuations are one part of the picture, but sleep, stress, changes in muscle mass, activity levels and blood sugar regulation can all play a role too.


Understanding what's happening can help you move away from the idea that your cravings are simply a lack of willpower.


What is blood sugar?

Blood sugar, or blood glucose, is the amount of glucose circulating in your bloodstream.


Glucose is an important source of energy for your body. Your brain, muscles and other tissues all need a steady supply.


When you eat carbohydrate-containing foods, your digestive system breaks some of those carbohydrates down into glucose. This glucose is absorbed into your bloodstream, causing your blood glucose level to rise.


Your body then needs to move that glucose from the bloodstream into your cells.


This is where insulin comes in.


What is insulin?

Insulin is a hormone produced by your pancreas.


One of its main roles is to help glucose move from your bloodstream into your cells, where it can be used for energy or stored for later.


Think of insulin as helping to open the door that allows glucose to move from your blood into your cells.


After you eat, particularly when you eat carbohydrate-containing foods, insulin is released to help your body manage the resulting rise in blood glucose.


This is a normal and necessary process.


The problem arises when the body becomes less responsive to insulin.

What is insulin resistance?

Insulin resistance means that your cells don't respond to insulin as effectively as they should.


Your pancreas can compensate for this by producing more insulin to try to keep blood glucose within a healthy range.


Insulin resistance is influenced by many factors, including genetics, body composition, physical activity, diet, sleep and other aspects of metabolic health.


It can also become more common with age.


Importantly, insulin resistance doesn't mean that you have diabetes. However, it can increase the risk of developing type 2 diabetes and other metabolic problems, so it's something worth taking seriously.


What does this have to do with sugar cravings?

This is where things become interesting.


Blood sugar naturally rises and falls throughout the day. However, large fluctuations can sometimes leave you feeling hungry, tired or craving quick sources of energy.


For example, you might have a breakfast that is mainly carbohydrate with relatively little protein or fibre.


You feel energised initially, but a couple of hours later you become hungry, tired or distracted by thoughts of food.


You reach for something sweet.


You get a quick boost of energy.


Then the cycle begins again.


Of course, this isn't the only reason people experience cravings. Cravings are influenced by many factors, including habits, emotions, stress, sleep, hunger and the palatability of certain foods.


But supporting more stable blood glucose can be one useful part of the bigger picture.


Why can cravings change during perimenopause?

Perimenopause is a time of significant hormonal change.


Oestrogen and progesterone fluctuate, sometimes dramatically, before eventually declining.


Oestrogen has effects throughout the body, including on energy metabolism and insulin sensitivity. As hormone levels change during the menopausal transition, some women may experience changes in how their bodies regulate blood glucose.


However, hormones aren't working in isolation.


Several other changes often happen at the same time.


1. You may be sleeping less well


Sleep problems are extremely common during perimenopause.


Hot flushes, night sweats, anxiety, changes in mood and hormonal fluctuations can all interfere with sleep.


Poor sleep can affect appetite regulation and insulin sensitivity, and being tired can make highly palatable foods much harder to resist.

When you're exhausted, reaching for a quick source of energy is a very understandable response.


2. Stress may be higher


Midlife can be a particularly demanding period.


You may be balancing work, children, caring responsibilities, relationships and the physical and emotional changes of perimenopause.


Stress triggers the release of hormones such as cortisol and adrenaline. These hormones help make energy available when your body perceives a challenge.


Short-term stress is a normal part of life.


However, ongoing stress combined with insufficient recovery can affect sleep, appetite, food choices and blood glucose regulation.


3. Muscle mass may be changing


Muscle is an important site for glucose disposal.


As we age, muscle mass can gradually decline if we don't actively work to maintain it.


This can affect metabolic health and is another reason why resistance exercise becomes particularly valuable during midlife.


4. Your eating patterns may have changed


Busy lifestyles can make it easy to skip meals, eat on the go or rely on convenience foods.


You might unintentionally go several hours without eating, become extremely hungry and then find yourself craving foods that provide quick energy.

This isn't a failure of willpower.


It is often your body responding to being very hungry.


Does eating sugar cause insulin resistance?

It's tempting to look for one food or ingredient to blame, but the reality is more complicated.


Eating sugar does cause blood glucose and insulin levels to rise, but that doesn't mean that eating sugar automatically causes insulin resistance.


Insulin resistance is influenced by a combination of factors, including genetics, physical activity, body composition, overall dietary pattern, sleep and other aspects of metabolic health.


A diet consistently high in energy-dense, highly processed foods can make it easier to consume more energy than your body needs, and excess body fat – particularly visceral fat around the organs – is associated with insulin resistance.


This is why focusing on your overall dietary pattern is much more useful than labelling one food as "bad".


How can you support more stable blood sugar?

You don't need to completely remove carbohydrates or live on salads.

Instead, think about how you combine foods.


Start with protein


Try to include a source of protein at each main meal.


For example:

  • Eggs
  • Greek yoghurt
  • Fish
  • Chicken
  • Lean meat
  • Tofu or tempeh
  • Beans and lentils
  • Cottage cheese


Protein can help you feel fuller and is important for maintaining muscle.


Add fibre


Fibre slows digestion and can help meals feel more filling.


Good sources include:

  • Vegetables
  • Fruit
  • Beans and lentils
  • Oats
  • Wholegrains
  • Nuts and seeds


Increasing fibre gradually is usually best, particularly if you're not currently eating much fibre.


Don't be afraid of carbohydrates


Carbohydrates are not inherently unhealthy.


Choose mostly minimally processed, fibre-rich sources such as oats, potatoes, sweet potatoes, beans, lentils, wholegrains, fruit and vegetables.


Combining carbohydrates with protein, fibre and healthy fats can make a meal more satisfying and can help moderate the rise in blood glucose compared with eating carbohydrate on its own.


Don't skip meals if it makes you ravenous later


If you regularly reach the afternoon feeling shaky, exhausted and desperate for something sweet, consider whether you're simply not eating enough earlier in the day.


A balanced lunch containing protein, fibre-rich carbohydrate, vegetables and healthy fats may help you avoid the "3pm crash".


Move after meals


Physical activity helps your muscles take up glucose.


You don't necessarily need an intense workout.


A short walk after a meal can be a simple way to incorporate more movement into your day.


Prioritise resistance training


Resistance exercise helps maintain and build muscle, which is particularly valuable during midlife.


It can also support insulin sensitivity and overall metabolic health.


If you're new to resistance training, start gradually and seek appropriate professional guidance if needed.


Don't underestimate sleep


If you're constantly exhausted, it's much harder to make balanced food choices and manage cravings.


Prioritising sleep and addressing the causes of poor sleep can therefore be an important part of supporting healthy appetite and blood sugar regulation.


What should you eat when you have a sugar craving?

First, don't panic.


Having a craving for chocolate or something sweet doesn't mean you've done anything wrong.


Instead, ask yourself:


Am I actually hungry?


If you are, have something that combines protein, fibre and carbohydrate.


For example:

  • Greek yoghurt with berries and nuts
  • Apple with peanut butter
  • Oatcakes with cottage cheese
  • A piece of fruit with a handful of nuts
  • Greek yoghurt with a small amount of dark chocolate


And if you simply fancy some chocolate, you can have some chocolate.


Healthy eating doesn't require perfection.


The goal is to develop a way of eating that supports your health while still allowing enjoyment and flexibility.


What if I crave sugar constantly?

Persistent cravings can be frustrating, particularly if you feel that you're constantly thinking about food.


Rather than trying to suppress the cravings through willpower alone, look at the bigger picture.


Ask yourself:

  • Am I eating enough?
  • Am I getting enough protein?
  • Am I eating enough fibre?
  • Am I skipping meals?
  • How well am I sleeping?
  • How much stress am I under?
  • Am I exercising regularly?
  • Am I relying heavily on highly processed foods?
  • Have my cravings changed alongside other perimenopause symptoms?


These questions can often provide much more useful information than simply asking, "How can I stop eating sugar?"


When should you speak to your GP?

If you're experiencing persistent symptoms such as excessive thirst, frequent urination, unexplained weight loss, significant fatigue or other concerning changes, speak to your GP.


If you're concerned about blood sugar or insulin resistance, your GP can assess your symptoms and determine whether blood tests or further investigation are appropriate.


Nutrition can support metabolic health, but it shouldn't replace medical assessment where this is needed.

The bottom line

Sugar cravings during perimenopause are not necessarily a sign that you've lost your willpower.


Hormonal changes can occur alongside changes in sleep, stress, muscle mass, appetite and blood sugar regulation – all of which can influence how hungry you feel and what foods you crave.


Rather than completely eliminating carbohydrates or following a highly restrictive diet, focus on the basics:


Eat enough protein.

Choose plenty of fibre-rich foods.

Combine carbohydrates with protein and healthy fats.

Move your body regularly.

Build and maintain muscle.

Prioritise sleep.

Look after your stress levels.


And most importantly, look at the whole picture rather than blaming yourself for having cravings.


Want help understanding your cravings?

If you're experiencing increased sugar cravings, changes in appetite, weight gain or energy dips during perimenopause, personalised nutrition can help you look at the underlying factors and develop a practical approach that's right for you.

https://www.oxfordclinicfornutrition.co.uk/contact


Published 4th September 2026


About the author

Megan Oliver – Nutritionist

Megan is a UK-based nutritionist specialising in female health, with a particular interest in supporting women through perimenopause, menopause and midlife.


She holds a BSc (Hons) in Nutritional Science and a Diploma in Personalised Nutrition, and is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and the Complementary & Natural Healthcare Council (CNHC).


Her approach focuses on understanding the individual rather than following a one-size-fits-all diet, with nutrition and lifestyle strategies tailored to each woman's needs, goals and circumstances.


Find out more about Megan’s approach here


This article is for educational purposes and is not intended to replace individual medical advice or diagnosis. If you have persistent, new or concerning symptoms, please speak with your GP or another appropriately qualified healthcare professional.

The Oxford Clinic for Nutrition

24 Barley Close, WallingfordUnited Kingdom

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