Why Your Digestion is Changing in Perimenopause & Menopause
Bloating. Constipation. Heartburn. Nausea. Really? Now?
In the middle of all of the other challenges that come during both perimenopause and menopause, digestive changes can be one more added challenge that women also have to try to manage. And for so many, these changes aren’t recognized as being part of this significant hormonal shift that’s happening. Which makes this feel even more concerning and confusing!
So let’s talk about why this is happening and some easy first steps you can take to start feeling better.
Why & How Does Digestion Change During Perimenopause?
Your digestive health can change significantly as both estrogen and progesterone drop. This is why for some women digestive issues only come on prior to their period, but as they move through perimenopause these symptoms become more consistent and often, more intense. One thing to keep in mind is that, like a lot of perimenopausal symptoms, these changes may stabilize as a woman moves into menopause, as her hormones are no longer fluctuating and instead are now consistently low (or fairly stable if a woman is on bioidentical hormones or hormone replacement therapy).
How Estrogen & Progesterone Impact Digestion During Perimenopause
For so many reasons, the balance of estrogen and progesterone is fundamental when it comes to supporting a woman’s hormonal health. This is no different when we’re looking at a woman’s digestion. Where estrogen increases the rate of digestive activity, progesterone slows it down.
In perimenopause progesterone is starting to decline but estrogen can be incredibly erratic, spiking and dropping at unpredictable times. This can lead to periods of time (weeks, months, or years) where a woman has more estrogen circulating through her body than she has progesterone to help keep this in balance. While this happening she’s more likely to experience the following:
Diarrhea (loose stool and/or more frequent bowel movements)
Nausea
Urgency
When both estrogen and progesterone start to drop a woman is more vulnerable to the slow down of her digestive function as estrogen is no longer driving digestive activity. As a woman moves closer to menopause she’s more likely to experience the following:
Constipation (hard stool and/or infrequent bowel movements)
Bloating
Gas
Estrogen also helps to control inflammation in the body and the digestive tract - the presence of estrogen has been shown to reduce tissue damage in the esophagus and when this decreases research has found that this change can cause a reduction in the gut’s mucosal defenses . When estrogen is present in the body a woman’s cells are better able to have an antioxidant effect on tissue, helping to control changes and damage that could otherwise cause inflammation. When estrogen drops in menopause she’s more likely to notice problems because inflammation is increasing. In the gut this means the protective mucosal lining can start to be damaged and intestinal inflammation can increase. Which can lead to more bloating, more gas, and even an increased risk of developing heartburn and stomach ulcers.
So what can you do to support digestion during perimenopause?
Boost your water intake - it’s not sexy and it’s not new but this is fundamental to digestive wellness and so many of us are significantly under-hydrated.
Increase your fibre intake but don’t just add in fibre supplements - lean into fibre sources you can get from foods like ground flax, soaked chia seeds, and high intake of vegetables.
Consider swapping your magnesium bisglycinate for magnesium citrate - magnesium citrate is going to be more effective for those struggling with constipation and can make a marked difference in digestive function. Remember to always check with your Naturopathic Doctor before changing your supplement regimen.
Incorporate ginger - cold or hot ginger tea is great for digestion but even more effective when it comes to helping lower inflammation and inflammatory symptoms in the gut.
When should you go for further investigation?
If you’re not sure whether or not you’re in perimenopause, get your hormone levels tested. If you’re in perimenopause or menopause and your digestive symptoms have been persistent or are worsening, make sure you look into this as a digestive change before writing it off as purely due to hormones. Talk to your doctor about a colonoscopy if you’re experiencing any of the following symptoms (especially if you have a family history of GI cancer):
A persistent or abrupt change in bowel regularity, stool quality, or ease of bowel movements
Rectal bleeding or black stool (this includes stool with black spots)
Unintentional weight loss
A persistent increase in abdominal girth (extreme bloating)
A Final Word
As women become more aware of what can happen in perimenopause and menopause it can become much easier to determine what the cause of her digestive symptoms are. This will ultimately allow for more choices around effective treatment and prevention.
If you have questions or concerns about digestive changes during perimenopause and menopause, and how Naturopathic Medicine can help, book a complimentary consult with me to learn more!
Ready to make a change?
If you're searching for more guidance and understanding of how you can support your (peri)menopausal transition with naturopathic medicine, you can book a complimentary consult with me here.
Yours in health,
Dr. Hayhlee Clarence, ND