Why Gut Health Matters During Perimenopause and Menopause

Your Gut Doesn't Know That You're Going Through Menopause But It Certainly Notices

When we talk about perimenopause and menopause, the conversation tends to revolve around hormones. Hot flushes. Night sweats. Sleep. Mood. Weight changes. All important, of course, yet there is another part of your body that can start behaving rather differently during this stage of life, and it doesn't tend to get nearly as much attention ... and that is your gut.

Bloating that wasn't there before, constipation that suddenly becomes a regular feature, changes in bowel habits, feeling uncomfortably full after meals or even foods that you previously tolerated suddenly seeming to cause problems. If you've experienced this, you are certainly not imagining it.

That doesn't mean menopause is responsible for every digestive complaint you experience, but hormonal changes can be one part of a much bigger picture.

This is why I think gut health deserves a much bigger place in conversations about women's health during both perimenopause and menopause.

What Changes During Perimenopause?

Perimenopause is the transition towards menopause, and hormones don't simply decline in a neat, predictable fashion. Estrogen and progesterone can fluctuate considerably, and those changes can affect much more than your menstrual cycle.

Your digestive system has receptors for hormones, and changes in the hormonal environment can influence gut function. At the same time, perimenopause can bring changes in sleep, stress, appetite, energy and body composition. You might find yourself sleeping badly, feeling more stressed, eating differently and moving less because you're exhausted. Suddenly your digestion is dealing with several changes at once.

No wonder it may start complaining.

What Happens After Menopause?

Once you've reached menopause, estrogen levels remain considerably lower than they were during the reproductive years. Some women notice digestive symptoms settle, while others continue to experience bloating, constipation or changes in their bowel habits. Again, there isn't one universal menopause experience.

This is important because it is very easy to see something online that says, “Menopause causes X,” and assume every symptom must be explained by hormones. Sometimes it is and sometimes it isn't.

Persistent or significant digestive symptoms should always be investigated rather than automatically being attributed to menopause.

Your Gut Is More Than Digestion

Your digestive system doesn't simply process your lunch and send you on your way. Your gut is involved in nutrient absorption, immune function and communication with the rest of your body. The trillions of microorganisms living within the gastrointestinal tract also interact with the environment around them. This is where the gut microbiome comes into the conversation.

The microbiome is influenced by diet, lifestyle, medications, age and many other factors. Research is increasingly exploring the relationship between the microbiome, estrogen metabolism and menopause, but this is an evolving area of science.

That last part matters. There is a tendency online to turn every new gut study into a dramatic statement about what you “must” do. The reality is considerably more nuanced. Your gut is important and your microbiome matters but you don't need to buy an expensive probiotic and start eating seventeen different types of fermented vegetables before breakfast.

What Can You Actually Do?

Start with the foundations.

Drink enough fluid.

Eat adequate protein.

Move regularly.

Pay attention to your bowel habits.

Look after your sleep as much as circumstances allow.

Find ways to reduce your overall stress load.

None of these things is particularly glamorous. There probably won't be a documentary about your impressive hydration habits. They are, however, the foundations that support your health.

The other important piece is individuality. If a huge raw salad leaves you bloated, you don't have to force yourself to eat one every day because someone on Instagram told you it's healthy. Try cooked vegetables instead.

If beans make you uncomfortable, don't immediately assume you can never eat them again. Consider the amount, preparation and your overall tolerance.

If you're constipated, don't simply add enormous quantities of fiber overnight and wonder why your stomach has declared a national emergency. Increase fiber gradually and make sure you're drinking enough fluid.

Your gut doesn't need perfection. It needs appropriate support, consistency and a little attention.

Menopause Is a Good Time to Get Curious About Your Gut

One of the biggest mistakes we can make during perimenopause and menopause is assuming that every change in our body means we've somehow failed. You need to remember your body is changing. That doesn't mean you need to fight it, it means you may need to change how you support it.

Gut health isn't a magic solution to menopause, and it certainly isn't going to fix every symptom. It is simply one important part of the bigger picture.

Sometimes understanding that bigger picture is where things begin to feel a little less confusing.