So you’re in perimenopause or menopause, and you’ve noticed some extra pounds have appeared. You tell yourself, “I know one way to take care of that. I’ll switch to artificial sweeteners instead of sugar, save lots of calories, and lose weight!” Great idea, right?

It sounds good, but it’s so wrong for several reasons. Let’s count the ways!

Artificial sweeteners and cardiovascular disease

Declining estrogen levels beginning in perimenopause place women at increased risk of cardiovascular disease since this hormone has a protective effect on cardiovascular health and metabolism. Therefore, women need to take steps to guard their health.

A new study published in September 2022 that involved more than 100,000 participants found a potential link between use of artificial sweeteners and a greater risk of stroke and coronary heart disease. More specifically, people who consumed aspartame showed an increased risk of stroke, while those who used acesulfame potassium and sucralose showed an increased risk of coronary heart disease.

Read about 7 reasons artificial sweeteners are terrible for us

The authors looked at commonly used artificial sweeteners-- aspartame (Equal, NutraSweet), acesulfame potassium (Sunett, Sweet One), and sucralose (Splenda), which are found in thousands of baked goods, soft drinks, snack bars, cereals, flavored yogurt, syrups, canned fruit, and more. They also evaluated cyclamates, saccharin, and a few other less common sweeteners.

Overall, the authors concluded that their “results indicate that these food additives…should not be considered a healthy and safe alternative to sugar.” Earlier studies have also found an association between artificially sweetened beverage use and cardiovascular events, including the Women’s Health Initiative, the Nurses’ Health Study, the Framingham Offspring cohort, and more.

Artificial sweeteners and diabetes

Can’t the use of artificial sweeteners instead of sugar help ward off diabetes? Insulin resistance and the development of type 2 diabetes is common among women in menopause, so turning to artificial sweeteners may seem to be helpful. However, another recent study found that using sugar substitutes can change the microbes in your gut and also raise blood sugar levels. 

Did you know that your tongue can’t tell the difference between read sugar and artificial sweeteners? When you eat something that contains fake sugar, the pancreas still reacts by sending insulin into the bloodstream, just as if sugar were entering the body. 

Over time, if this type of response continues, the pancreas may stop responding to these false alarms, even when you do eat sugar. At the same time, a woman’s control over blood sugar weakens as estrogen levels decline. This combination can lead to high blood sugar levels and the development of prediabetes and, ultimately, diabetes. 

Read about 5 artificial sweeteners that are (probably) making you fat

Artificial sweeteners and weight loss

So you think you’ll lose that extra menopausal weight if you use artificial sweeteners instead of sugar? Not so fast. In fact, they may promote the opposite result. In a review and meta-analysis that included data from more than 407,000 individuals and 37 trials and studies, the authors found that use of artificial sweeteners resulted in an increase body mass index (BMI). 

According to the study’s lead author, Mathilde Touvier, a research director at the French National Institute for Health and Medical Research, her research team defined a large amount of artificial sweetener to be about 77 milligrams daily, which translates to slightly less than two packets of sweetener.

Soft drinks headed the list of items consumed that contained artificial sweetener, while slightly less than one third were attributed to tabletop sweeteners. Less than 10 percent were associated sweetened dairy food such as fruited yogurt. 

What should women do about artificial sweeteners?

One word: avoid them, along with added sugars. The best alternative to these sweet things is natural fresh and frozen fruits. To satisfy your sweet beverage desires, still or carbonated pure water with slices of fruit may do the trick. 

Bottom line

Artificial sweeteners are in thousands of foods, and we are bombarded with messages about how they are a great alternative to sugar. More and more research, however, is showing us that they are detrimental and can contribute to our most serious health issues, including cardiovascular disease, diabetes, and obesity, which are also significant concerns among women in menopause.