Stomach and digestive issues during menopause explained
Many women experience stomach and digestive issues during perimenopause and menopause, including bloating, constipation and acid reflux.
In this guide we look at why menopause affects gut health and what you can do manage symptoms and keep your gut healthy throughout your menopause.
Stomach & digestive issues and the menopause
Menopause typically occurs between the ages of 45 and 55 and is officially diagnosed when a woman has gone 12 months without a menstrual period. It is preceded by the perimenopause, which usually starts in the early to mid-40s.
During the menopause, the ovaries gradually reduce their production of estrogen (also known as oestrogen) and progesterone. This results in fluctuating hormone levels can impact the entire body, from brain function to bone health.
Crucially, a study found that 94% of women going through menopause reported experiencing gut issues - 38% of whom experienced gut health symptoms for the first time during perimenopause, suggesting a potential link between hormonal fluctuations and gut health.
The most common gut issues reported were:
- Bloating
- Constipation
- Stomach pain
- Acid reflux
Other gut issues that can be experienced during perimenopause and menopause include diarrhoea, changes/slowing down of bowel movements and increased food intolerances.
Why do digestive issues occur during perimenopause and menopause?
The digestive symptoms experienced during perimenopause and menopause are a result of the fluctuations in estrogen and progesterone. This can impact your gut health in several ways:
Digestion:
Slower gut motility: estrogen and progesterone help regulate gut motility (how quickly food moves through the intestines) and support a healthy balance of bacteria in the gut. Their decline can lead to sluggish digestion and bacterial imbalances.
Inflammation: menopause often results in higher stress levels, which in turn raises the level of cortisol (also known as the “stress hormone”). Increased cortisol can disrupt the gut microbiome, leading to inflammation. It can also cause the digestive system to be more sensitive to certain foods.
Lower stomach acid: stomach acid helps break down food and absorb key nutrients like iron and B12. When levels drop, it can lead to bloating, acid reflux, and nutrient deficiencies.
Slower digestion: The digestive system slows down during menopause. This means food lingers longer in the gut, risk of constipation and weight gain.
The gut microbiome:
The gut microbiome is home to trillions of bacteria and it relies on estrogen to maintain balance. It also plays a central role in the regulation of hormone levels within the body; specific gut bacteria, known as the oestrobolome, are involved in estrogen metabolism.
As estrogen levels fall during menopause, this causes imbalance in the microbiome. This in turn further disrupts estrogen levels, creating a vicious cycle of hormonal and gut health issues, including:
Inflammation: Lower estrogen reduces the number and variety of beneficial bacteria, which are essential to maintaining a healthy gut lining. This can make the gut more prone to inflammation, leading to bloating, irregular digestion, weakened immunity and can even influence vaginal health.
“Leaky gut”: A weakened gut lining can lead to undigested food particles and toxins entering the bloodstream. This can trigger inflammation, immune responses and food sensitivities.
The gut-brain axis
The gut and brain are closely connected through the vagus nerve, known as the ‘gut-brain axis’. Hormonal shifts during perimenopause and menopause can disrupt this communication, leading to mood swings, anxiety, and even depression.
Irritable Bowel Syndrome (IBS)
It is unknown what causes all cases of IBS. However the effects of the drop in estrogen and progesterone, such as disruption to the gut-brain axis and the microbiome, can contribute to IBS symptoms.
When to see a doctor about your gut health during menopause
If you experience new, persistent gut health symptoms you should consult a healthcare professional.
How you can improve your gut health during menopause
There is lots you can do during menopause and perimenopause to manage and minimise the impact on your gut health and restore hormonal balance:
Diet: eating the right foods during the menopause can make a huge difference in improving gut issues, balancing gut bacteria, reducing bloating, improving digestion, and supporting overall health.
Supplements: taking supplements such as probiotics or magnesium can help improve digestive symptoms during menopause and manage your overall gut health.
Pelvic floor exercises: a weak or overactive pelvic floor (the muscles that help support the bladder, bowel and uterus) can contribute to digestive issues, such as constipation and incontinence. A pelvic health physiotherapist can provide tailored exercises to suit your specific needs.
Look after your mental health: by triggering the production of cortisol, stress can lead to weight gain during menopause, as well as having a negative impact on your gut health and overall heath. Prioritise sleep and try stress-reducing activities like yoga and meditation.
Stay active: cardio and resistance training can both help to combat the loss of muscle mass during menopause. By helping with muscle growth, these activities can increase metabolism. Furthermore, regular exercise promotes healthy digestion and improves gut motility, whilst helping to alleviate issues like bloating and constipation.
Have a Gut Reset:
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Need gut health advice during the menopause? Our experts can help
If you are looking for support with managing stomach or digestive issues during your perimenopause or menopause, our expert nutritionists can talk you through your options
With this complimentary, commitment-free session, you will receive actionable, clear advice, empowering you to make informed decisions to help you enjoy good health and a happy menopause.
Frequently asked questions about stomach and digestive issues during menopause and perimenopause
Can menopause cause stomach and digestive issues?
Yes. Due to fluctuating hormone levels, women going through the menopause can experience a range of gut health issues, including bloating, constipation, acid reflux and inflammation of the gut.
Do hormones effect gut health?
Yes. Hormone fluctuations during menopause affect the body’s ability to regulate digestion and microbial balance in the gut (known as the microbiome).