Perimenopause, menopause and your digestion: what you need to know

Have you noticed changes in your digestion in your 40s or 50s — more bloating, constipation, or bouts of heartburn? These gut symptoms often show up during perimenopause and menopause, and it’s no coincidence. Your digestive system and hormones are closely linked.

How hormone changes in midlife affect your digestion

Perimenopause is the transition phase leading up to menopause, when your periods stop for good. It usually starts around age 45 and can last 4–7 years. As oestrogen and progesterone levels start to fluctuate, you might experience new symptoms like hot flushes, anxiety, brain fog, poor sleep and changes in your digestion. This could look like bloating, constipation, indigestion or heartburn for you.

Your gut contains trillions of microbes (known as your gut microbiota) that regulate everything from immunity to how you digest food. It is also lined with hormone receptors. Your digestive system and hormones are closely linked this way, through a connection called the gut–hormone axis.

One group of gut bacteria, called the oestrobolome, plays an important role in managing your oestrogen levels. It recycles oestrogen back into the bloodstream for your body to reuse. This is important during perimenopause.

Common gut changes in midlife

Many women notice gut changes during perimenopause and menopause. Digestive system issues and symptoms include:

• Sluggish digestion: Falling oestrogen and progesterone levels can slow down the movement of food through your gut, leading to indigestion, bloating or nausea.

• Fluctuating IBS symptoms: If you have irritable bowel syndrome (IBS), you may notice that your symptoms flare up during this time of your life.

• Bloating: This is the number one symptom I see in clinic, with my female clients talking about both stress and hormone changes.

• Imbalance in gut bacteria: A diverse range of gut microbiota is important for your overall health and your digestion. However, gut bacteria diversity declines post-menopause. I'll explain what you can do, later in this article.

• Weakened gut barrier: Hormonal shifts can weaken the protective barrier of your gut, increasing inflammation and digestive discomfort.

  
  

Stress and your gut

Midlife can be stressful. You might be experiencing work or financial pressure, health issues or juggling family demands (or all of them). Stress affects digestion through the gut–brain axis, a two-way communication system between your digestive system and brain just like the one between your gut and your hormones.

High levels of the stress hormone cortisol can trigger bloating, stomach discomfort and IBS symptoms. When you’re in pain, your stress levels increase and you can get caught in a difficult cycle. Add changing hormone levels to the mix from perimenopause or menopause, and your digestion may feel like it’s gone off track.

Try to practice regular self-care to help you manage stress or to bring some calm to your daily life. My series of recipes, called The Sunlight Sets, each feature a three-part meal that is light and easy to digest and a relaxing ritual to help you take care of yourself. I'm writing more menus every week to support you, so keep an eye on the pip speaks blog on my website.

My two top tips for supporting your gut in perimenopause and menopause:

1. Eat a diverse diet: A plant-based diet, rich in vegetables, fruit, wholegrains, legumes, nuts, seeds, herbs and spices, feeds a wide range of gut microbes. That will boost the diversity of your gut microbiota. Foods like garlic, onion, fennel, almonds or lentils contain prebiotic fibre, which your good gut bacteria love. Introduce them gradually to avoid wind and bloating.

2. Drink more water: When increasing fibre in your diet, up your fluid intake too. Aim for 6–8 cups of water or herbal tea daily to support your digestion and prevent constipation.

When to seek support

Always speak to your GP if you notice changes in your bowel habits, blood in your stool or weight loss, or need support with your hormones during midlife. If digestive problems are interfering with your daily life, seek personalised advice from a clinical nutritionist. You don’t need to put up with pain or discomfort, help is available.

Author: Kym Lang. Photography: Wix.