The Impact of Sugar on Inflammation in Perimenopause
As a clinical nutritionist working closely with women in their 40s and 50s, I hear this question a lot:
“Isn’t some sugar better than others?”
The short answer? It’s complicated — but also, not really.
Let’s unpack it.
How Sugar Affects Your Body During Perimenopause
Whether it’s honey in your tea, coconut sugar in your baking, or a “no added sugar” label on your cereal — your body breaks it all down into glucose. That’s the fuel your cells run on.
Even the so-called “natural” sugars — maple syrup, agave, fruit juice concentrates — end up as glucose. And once glucose hits your bloodstream? Insulin steps in to move it into your cells. When there’s more than your body needs, it gets stored — often as fat.
This process becomes harder to manage during perimenopause, when declining oestrogen makes blood sugar regulation more erratic and inflammation more likely.
Why Too Much Sugar Triggers Inflammation
So, how does sugar actually cause inflammation?
When you eat high amounts of sugar, especially the refined, rapidly absorbed kind, it causes sharp spikes in blood glucose. This triggers the release of inflammatory compounds and increases oxidative stress, which damages your cells.
Over time, excess glucose can also lead to the formation of advanced glycation end-products (AGEs) — harmful compounds that interfere with normal cell function and accelerate ageing.
High sugar intake can also disrupt your gut lining, making it more permeable (“leaky”) and allowing inflammatory molecules to enter the bloodstream. Add insulin resistance into the mix — another consequence of chronic sugar exposure — and you’ve got a cascade of inflammatory signals at play.
For women in perimenopause, whose oestrogen is already declining (and with it, its natural anti-inflammatory support), this creates the perfect internal storm.
Your Body Isn’t Broken — It’s an Evolutionary Mismatch
Here’s a reframe: your biology is doing exactly what it was designed to do. It’s just living in the wrong environment.
For most of human history, sugar was rare and seasonal — a piece of fruit, a handful of berries, or a spoonful of honey. Our brains evolved to crave it because it meant survival.
Now we live in a world where sugar is everywhere. Hidden in sauces, cereals, dressings, “healthy” bars, and snacks — our modern foodscape doesn’t match the design of our metabolism.
That’s what we call an evolutionary mismatch: your ancient biology in a hyper-processed world. During perimenopause, this mismatch is magnified, as blood sugar and inflammatory responses become more sensitive.
Types of Sugar and Their Impact on Inflammation
While all carbohydrates eventually break down into glucose, some sugars are gentler on your system than others. Here’s how different types compare:
Refined sugars
Found in: lollies, soft drinks, pastries
These hit your bloodstream fast, causing a sharp blood sugar spike and triggering inflammation.
Blood sugar impact: Very high
Inflammatory effect: High
Natural sweeteners
Found in: honey, maple syrup, coconut sugar
Although less processed, they still cause moderate blood sugar spikes and can contribute to inflammation when overused.
Blood sugar impact: Moderate
Inflammatory effect: Moderate
Whole fruit sugars
Found in: apples, berries, citrus
These come packaged with fibre, water, and antioxidants — helping to slow glucose release and reduce inflammation.
Blood sugar impact: Low
Inflammatory effect: Low
Complex carbohydrates
Found in: oats, sweet potato, legumes
They break down slowly, providing steady energy and supporting metabolic and hormone health.
Blood sugar impact: Slow and steady
Inflammatory effect: Can be anti-inflammatory when balanced with fibre and whole foods
Fibre is the game-changer. It slows glucose absorption, supports gut health, and reduces inflammation.
Is Fruit Bad for Blood Sugar During Perimenopause?
Short answer? No.
Whole fruit contains natural sugar, but it also provides water, fibre, antioxidants, and phytonutrients that protect against inflammation and help stabilise blood sugar.
An apple ≠ apple juice. One feeds your body, the other spikes your glucose.
Unless you’re juicing everything or eating a whole bunch of high-sugar tropical fruits daily, fruit is not the enemy — it’s usually part of the solution.
The Truth About Artificial Sweeteners and Sugar-Free Foods
Artificial Sweeteners and Hormonal Health
Common artificial sweeteners include aspartame, sucralose, acesulfame-K, and saccharin.
Concerns for perimenopausal women:
They may disrupt the brain’s hunger and satiety signals
Some research suggests they alter gut microbiota and potentially worsen insulin sensitivity
They might save you calories, but that doesn’t mean they support your hormones.
Sugar Alcohols and Digestive Health
Found in keto snacks and sugar-free products, sugar alcohols (like xylitol, erythritol, sorbitol) are known for their laxative effect.
Pros:
Minimal blood sugar impact
Fewer calories than sugar
Cons:
Can trigger bloating, gas, and diarrhoea — especially in sensitive guts
Some studies suggest high erythritol intake may affect cardiovascular health (research is ongoing)
If you’ve got IBS or a sluggish digestive system, proceed with caution.
Is Stevia a Healthy Sweetener?
Stevia is derived from a plant and is one of the better-tolerated non-nutritive sweeteners.
Benefits:
No blood sugar spike
May support glucose and blood pressure regulation
Minimal gut impact
Things to watch:
Many products mix stevia with erythritol or other additives — read your labels
It has a strong aftertaste that some people dislike, especially in baking
Used occasionally in its pure form, stevia can be a useful stepping stone when cutting back on sugar.
How to Reduce Sugar Without Feeling Deprived
Perimenopause is not the time to starve yourself or fear food — but it is the time to get strategic.
Here’s how to reduce sugar without feeling like you’re missing out:
Check labels — sauces, crackers, and “healthy” mueslis are often full of hidden sugar
Balance your plate — aim for protein, fibre, and healthy fats with every meal
Drink smarter — swap fruit juice or diet soft drinks for herbal tea or sparkling water with citrus
Keep fruit in — stick to 2 serves/day of low-GI fruits like berries, apples, and citrus
Stop chasing “sugar-free” everything — real food trumps fake sweeteners every time
Final Word: What Sugar Really Means for Women in Perimenopause
This isn’t about demonising sugar or banning birthday cake.
It’s about supporting your body through one of its most significant transitions — and knowing that the modern food landscape isn’t built with your hormones in mind.
Small, consistent changes — like swapping sweet drinks, eating more fibre, and using natural sweeteners sparingly — can make a huge difference to your energy, mood, skin, and metabolism.
You don’t need to be perfect.
Just a little more informed, and a lot more kind to your body.
Start Feeling Like You Again
Ready to reduce inflammation, stabilise your energy, and feel more in control of your body again?
Book a free 10-minute wellness chat to find out how personalised nutrition support can help you feel like yourself again — without the overwhelm.
