How Menopause Affects Your Gut (and Simple Ways to Feel More Comfortable)

Menopause brings many changes, not least of which is a shift in gut health. The decline in oestrogen and progesterone during menopause can bring about new or worsened digestive symptoms, such as bloating, constipation, and changes in gut microbiome diversity. Here, we’ll explore why these changes occur and what steps you can take to support a healthy, balanced gut during and after menopause.

How Hormones Change During Menopause

Menopause leads to a reduction in oestrogen and progesterone levels, which significantly impacts gut health - women experience a noticeable decrease in beneficial bacteria like Lactobacillus and Bifidobacteria, alongside an increase in harmful bacteria such as Enterobacter [1]. Oestrogen helps regulate the motility of the digestive system, and with lower levels, gut transit time tends to slow down [2]. Progesterone also declines, which may disrupt the balance of gut microbiota that has been supported by oestrogen's stabilising effects on the microbiome.

Common Digestive Symptoms During Menopause
Menopause can bring about a variety of digestive symptoms:

• Bloating and Constipation: With oestrogen levels dropping, the gut may move more slowly, leading to a build-up of gas and constipation [2].
• Microbiome Shifts: Post-menopause, studies show that the diversity of the gut microbiome decreases, resulting in lower levels of beneficial bacteria like SCFA (short-chain fatty acid) producers. SCFAs are crucial for supporting the gut lining and reducing inflammation, so this drop can lead to increased discomfort and bloating [3,4].
• Gut Lining Integrity: Declining oestrogen can affect gut lining integrity, which may increase gut permeability [4]. A permeable gut lining allows more inflammatory substances to cross into the bloodstream, contributing to discomfort and bloating.

Strategies to Support Gut Health During Menopause
While you can’t stop menopause, you can adjust your diet and lifestyle to better support digestive health during this transition:

• Increase Fibre Intake: Foods high in fibre, like fruits, vegetables, legumes, and whole grains—support a healthy microbiome, promote motility, and can help alleviate constipation.
• Eat Phytoestrogen-Rich Foods: While the research is inconsistent, foods like soy, flaxseeds, and chickpeas contain plant oestrogens that may help balance hormone levels and provide some support to the gut lining [5].
• Incorporate Fermented Foods and Prebiotics: Adding foods with live beneficial bacteria (like yoghurt) along with prebiotic fibre (found in onions, garlic, and asparagus) can support microbiome diversity.
• Manage Stress and Prioritise Rest: Cortisol, the stress hormone, can also affect gut motility and microbiome composition. Engage in stress-relieving activities like meditation, stretching, or gentle exercise to help maintain balance.
• Hydrate and Move: Staying well-hydrated and incorporating regular physical activity are essential for gut motility and overall digestive health.

A Final Word
As your body adapts to hormonal changes, supporting your gut health can be a powerful way to manage symptoms and maintain digestive comfort. By prioritising fibre, probiotic foods, stress management, and hydration, you can keep your gut healthy and thriving through menopause and beyond. With the right strategies in place, you can experience smoother digestion and a better sense of balance in this new phase.

References

[1] Meng Q, Ma M, Zhang W, Bi Y, Cheng P, Yu X, Fu Y, Chao Y, Ji T, Li J, Chen Q, Zhang Q, Li Y, Shan J, Bian H. The gut microbiota during the progression of atherosclerosis in the perimenopausal period shows specific compositional changes and significant correlations with circulating lipid metabolites. Gut Microbes. 2021 Jan-Dec;13(1):1-27. doi: 10.1080/19490976.2021.1880220. PMID: 33691599; PMCID: PMC7954427. 

[2] Aytuğ N, Giral A, Imeryüz N, Enç FY, Bekiroğlu N, Aktaş G, Ulusoy NB. Gender influence on jejunal migrating motor complex. Am J Physiol Gastrointest Liver Physiol. 2001 Feb;280(2):G255-63. doi: 10.1152/ajpgi.2001.280.2.G255. PMID: 11208548.

[3] Peters BA, Santoro N, Kaplan RC, Qi Q. Spotlight on the Gut Microbiome in Menopause: Current Insights. Int J Womens Health. 2022 Aug 10;14:1059-1072. doi: 10.2147/IJWH.S340491. PMID: 35983178; PMCID: PMC9379122.

[4] Mayneris-Perxachs J, Arnoriaga-Rodríguez M, Luque-Córdoba D, Priego-Capote F, Pérez-Brocal V, Moya A, Burokas A, Maldonado R, Fernández-Real JM. Gut microbiota steroid sexual dimorphism and its impact on gonadal steroids: influences of obesity and menopausal status. Microbiome. 2020 Sep 20;8(1):136. doi: 10.1186/s40168-020-00913-x. PMID: 32951609; PMCID: PMC7504665.

[5] Domínguez-López I, Yago-Aragón M, Salas-Huetos A, Tresserra-Rimbau A, Hurtado-Barroso S. Effects of Dietary Phytoestrogens on Hormones throughout a Human Lifespan: A Review. Nutrients. 2020 Aug 15;12(8):2456. doi: 10.3390/nu12082456. PMID: 32824177; PMCID: PMC7468963.