Digestive issues during perimenopause

March 07, 2024.

Medically reviewed by Patricia Shelton, MD

What you will learn in this article

Hormones and gut function
Factors affecting digestion

Is this bloating normal?

Most women expect to experience symptoms like hot flashes during peri, but many aren’t expecting indigestion, gassiness, and bloating. However, it turns out that digestive issues during perimenopause are actually very common. Nearly 40% of women report experiencing issues like bloating, gas, or abdominal discomfort during peri – that’s three times the number of premenopausal women who report these issues.

A perry sister posted recently in the community

Anyone experience more stomach problems I seem to be bloating and so gassy and it causes my stomach to hurt I’m sure the way I’m eating isn’t helping! Just curious how many of you suffer from bloating and stomach also does anyone know if you can become lactose intolerant or have a gluten allergy flare up at our age? Thanks in advance!

recently posted in the perry community

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Of course, every woman’s journey through peri is a little different. But hormones do have an impact on your digestive system, and you might experience some 

Hormones and gut function

Hormones like estrogen and progesterone can definitely impact the function of the digestive system. In fact, many women already know this, because they’ve experienced issues like bloating and gas at particular times in their menstrual cycle.

Estrogen and progesterone are both known to inhibit contraction of the muscles in the intestines. This tends to slow down the movement of food through the digestive system. When levels of these hormones are high, this can lead to symptoms like constipation and bloating. (In premenstrual women, both estrogen and progesterone levels are high in the second half of the menstrual cycle, which is why many women feel bloated just before their period.)

During peri, both estrogen and progesterone levels are fluctuating. This causes a bit of a tug-of-war on the digestive system – as hormone levels rise and fall, the activity of the digestive tract varies along with them. Women may experience a variety of digestive symptoms as a result.

For many of the symptoms of peri, taking hormone therapy (HT) can help by stabilizing hormone levels. However, research has shown that women taking HT are actually more likely to experience digestive symptoms. In fact, if you’re taking HT to address symptoms like hot flashes, you might start to find that you’re experiencing more bloating and indigestion. This is because the higher hormone levels associated with HT can slow down your digestive system and cause symptoms.

Factors affecting digestion

While hormones definitely play a role in the digestive process, they’re not the only thing that matters. If you’re having digestive symptoms during peri, paying attention to certain lifestyle factors can definitely make a big difference in your symptoms.

  • Diet. What you eat plays a major role in the health of your digestive system. When your gut bacteria ferment certain foods, they produce gas, which can lead to bloating. Some examples of foods that may cause this include high levels of fiber, certain types of artificial sweeteners known as sugar alcohols (like sorbitol, mannitol, and xylitol), or certain types of carbohydrates known as FODMAPs. (However, a diet low in FODMAPs can be very restrictive and could lead to nutritional deficiencies, so it’s best to talk with a nutritionist if you’d like to try this option.) For people who have lactose intolerance, consuming dairy products can also lead to bloating.

  • Overeating. When you eat a lot of food at once, it’s difficult for your system to digest, which can lead to bloating. Eating a lot of fats, refined carbs, or salt can also slow down your digestion and cause bloating. Eating smaller meals and limiting refined or fatty foods may help.

  • Hydration. Without enough water, it’s difficult for your body to move material through your digestive system. This can lead to constipation and bloating. Make sure you’re getting enough water throughout the day, especially with meals. However, if you choose a carbonated beverage (like sparkling water), those bubbles can lead to bloating.

  • Stress. The nervous system is strongly connected to the digestive system. When you’re stressed, your body will tend to de-prioritize things like digestion to mobilize your muscles for a crisis – and this can slow down your digestion and lead to bloating. Reducing stress in your life and learning relaxation techniques can be very helpful.

  • Physical activity. Exercise helps to keep things moving through the digestive tract, which helps to prevent constipation and bloating. Make sure to get at least 20 to 30 minutes of exercise each day. If you’re feeling particularly gassy or bloated, taking a walk could help to get things moving in your digestive tract again.

  • Probiotics. The specific balance of bacteria in your gut is very important for your overall health. Some research indicates that taking probiotics, which contain beneficial bacteria, may help. Although the research is mixed as to whether this is effective, it’s something that some people want to try. You can take probiotic supplements, or you can try eating foods that contain probiotics, like sauerkraut, yogurt, or kimchi.

You have control over a lot of these factors. If you’re having digestive issues during peri, focusing on the factors you can control can make a huge difference. Although you can’t change what your hormones are doing to your digestive system, you can still take actions to help make things better and improve your quality of life.

Main takeaways

  1. If you’re experiencing digestive issues during peri, you’re not alone. In fact, women consistently discuss this in our Perry community – bloating, gas, and indigestion are very common.

2. Estrogen and progesterone both cause relaxation of the muscles of the digestive tract, which slows down digestion. This can lead to symptoms like bloating and constipation.

3. The fluctuating levels of both of these hormones during peri explain why digestive issues are so common during this time.

4. HT often doesn’t help with digestive symptoms, and may even make them worse, by raising levels of the hormones that slow down the digestive system.

5. Paying attention to factors like diet, exercise, hydration, and stress can make a huge difference in digestive symptoms. Taking probiotics may also help some women.


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Patricia Shelton

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