Many women encounter a whole host of undesirable symptoms during menopause, such as mood swings, hot flushes and night sweats. If you’re suffering from bloating, trapped wind or constipation, these aren’t uncommon either. This is because menopause can cause stomach issues as a result of declining hormones affecting your digestive system.
However, you can also experience menopause and stomach issues at the same time, without them being linked. If you’re having digestive problems in menopause, it’s important to rule out any possible underlying causes. Understanding menopause’s impact on your physical and emotional well-being, and the symptoms it can create is beneficial in ensuring you get the right support.
How the menopause can cause stomach issues
During menopause, fluctuations of the hormones oestrogen and progesterone occur due to the loss of ovarian function and the stopping of menstrual cycles. While these hormones play a key role in the reproductive system, they also influence functions throughout the entire body. The changes in hormones that occur during menopause can influence:
- Your perception of pain: During menopause, hormonal changes can make individuals more sensitive to pain, potentially amplifying the discomfort of gastrointestinal issues like bloating and cramps.
- The movement of food through the gut: Menopause can slow down digestion, causing issues like constipation and bloating as food moves more slowly through the gut and more water is reabsorbed into the bloodstream.
- Intestinal permeability: Fluctuating hormone may increase intestinal permeability (leaky gut), allowing toxins or bacteria to pass through the intestinal lining, potentially leading to inflammation and digestive discomfort.
- Immune and inflammatory processes: Menopause can trigger changes in the immune system, increasing inflammatory responses in the gut, which may exacerbate symptoms like bloating, gas, and abdominal pain.
Why it happens: the gut microbiome and hormones
Your gut microbiome is an ecosystem composed of trillions of microorganisms, including bacteria, viruses and fungi. It plays an important role in your body and overall well-being, affecting not only your digestive system but also your immune, nervous, and endocrine systems.
Your gut microbiome is unique to you and is influenced by many factors including your diet, toxins, bowel movements and hormones. This is why it can be impacted by menopause.
Research suggests that declining oestrogen and progesterone during menopause leads to a lower gut microbiome diversity and results in the microbiome of postmenopausal women resembling the microbiome typically found in men.
The emotional impact of menopause on your stomach
Changes to your digestive system can also be a result of the emotional impact of this significant life transition. Hormones impact the brain-gut connection, meaning heightened stress or anxiety during menopause can worsen gastrointestinal (GI) symptoms.
Further, life circumstances, such as managing career changes, caring responsibilities, or shifts in identity in conjunction with navigating menopause can intensify emotional stress, leading to increased cortisol production. This stress hormone can affect gut motility and digestion, making stomach issues more pronounced.
What’s more, your emotional and mental health during menopause can impact your appetite and the foods you are eating. This, in turn, can lead to digestive issues. For example, if you are dealing with fatigue and begin eating highly processed meals rather than cooking from scratch, the increase in fats and sugar may lead to diarrhoea and stomach discomfort.
Common gastrointestinal symptoms
Digestive problems in menopause can significantly impact your quality of life yet they are not recognised in international and UK guidelines. This is despite 91% of women saying they experience changes in their gut health during menopause.
Gastrointestinal menopause symptoms include:
- Constipation
- Diarrhoea
- Nausea
- Vomiting
- Bloating
- Cramps
- Wind or trapped wind
- Heartburn
- Indigestion
- Acid reflux
- Mild or severe IBS
- Faecal incontinence
Can menopause make existing stomach issues worse?
45% of people have chronic digestive and gut health problems, such as:
- Irritable bowel syndrome (IBS)
- Inflammatory bowel disease (IBD)
- Gastroesophageal Reflux Disease (GERD)
- Crohn’s disease
- Coeliac disease
Research has found that for some women, going through menopause can exacerbate existing symptoms. For example, one study found that postmenopausal women had more severe IBS symptoms than premenopausal women while another found that 38% of postmenopausal women reported altered bowel function.
However, as some symptoms of menopause and digestive disorders are the same, it can be difficult to determine whether it is menopause or the condition itself that is responsible for any changes.
Things that can help with digestive problems in menopause
Exercise
Regular physical activity improves gut motility, helping to relieve constipation and bloating, common during menopause. Exercise also reduces stress, which can calm the digestive system by lowering cortisol levels, supporting overall gut health and reducing discomfort.
Diet changes
Adopting a nutrient-rich menopause diet can not only help alleviate digestive discomfort, but it can also contribute to overall wellness and better management of other physical menopause symptoms. It can be beneficial to:
- Learn your trigger foods
- Increase your fibre
- Reduce alcohol consumption
- Limit caffeine and fizzy drinks
- Include prebiotics and probiotics
- Eat smaller, more frequent meals
- Eat more slowly
Sleep
Quality sleep is essential for maintaining a healthy gut. Poor sleep disrupts the gut-brain connection, which can lead to slower digestion, increased inflammation, and heightened sensitivity to stomach pain. A regular sleep schedule supports better hormonal balance and gut function.
Stress reduction
Managing emotional stress is key during menopause, as the gut is sensitive to stress signals, which can exacerbate bloating, cramps, and other GI symptoms. Techniques such as mindfulness, yoga for menopause, or deep breathing can help lower cortisol levels, reducing stress-related digestive issues.
Medication
Hormone replacement therapy (HRT) can help regulate symptoms by balancing hormone levels, thus improving gut motility. However, digestive issues can also be a side effect of treatment and research indicates there is a slightly higher risk of developing gastroparesis after taking HRT.
There is also a range of over-the-counter and prescribed medications that can help manage digestive symptoms including:
- Antacids
- Probiotics
- Laxatives
- Loperamide
- Antispasmodics
Natural treatments and remedies
Herbal remedies for menopause digestive issues may also be worth considering if you cannot take HRT or other medications, or don’t want to use a hormone-based treatment.
Natural treatments for constipation include senna, ginger, buckthorn, psyllium and rhubarb.
If experiencing diarrhoea temporarily, eating a BRAT (banana, rice, applesauce and toast) diet can help your stool to firm up. Herbal tea, such as chamomile, green and lemongrass can help relieve an upset stomach and replenishing electrolytes and fluids are also important.
Other natural treatments and remedies include:
- Slippery elm: For stomach ulcers and gastrointestinal symptoms
- Ginger: For heartburn and nausea
- Turmeric: Can aid digestion and has anti-inflammatory properties
- Liquorice root: Used to relieve digestive symptoms and can also alleviate other menopause symptoms
- Fennel, coriander, anise and caraway: Are all natural remedies for bloating and gas
When to see a doctor about menopause and stomach problems
Dealing with menopause symptoms isn’t something you have to do alone. If you are struggling, then speaking to a professional can ensure you get the right treatment. However, you should consult with a doctor if you have a family history of GI cancer or are experiencing:
- A change in bowel habits
- Rectal bleeding
- Unintentional weight loss
- Extreme bloating
- Problems swallowing
- Black stool
- Pain when you touch your stomach
At Menopause Care, our doctors are experienced in helping women effectively manage the symptoms of menopause. They use evidence-based guidance to empower you to make the right choices for your own well-being. If you’d like tailored support delivered with kindness and understanding, book a consultation with a menopause doctor.
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