Supporting Digestive Health Through Menopause: Tips and Insights

As some of the more common menopause symptoms, such as hot flashes or mood swings begin to affect you, you might notice a correlation between menopause and an upset stomach. Digestive issues and lower gastrointestinal discomforts may also become more frequent. Digestive issues experienced during menopause can include acid reflux (“heartburn”), constipation, diarrhea, bowel cramping, bloating and excessive gas. 

But can menopause cause stomach issues?

Unfortunately, the answer is complicated. Most, if not all these digestion-specific problems are not as conventionally discussed when the topic of menopause arises. So let’s dig in here to clarify some of the connections clinical studies have made between menopause and digestive health.

Can Menopause Cause Stomach Issues? 

If you’re already on your menopause or perimenopause journey and are experiencing digestion issues, you might be wondering if menopause is causing your upset stomach. The quick answer: the jury is still out. More research needs to be done to fully understand the impact of estrogen and progesterone on gastrointestinal (GI) symptoms.  But there is evidence that suggests the decline of these hormones during menopause can affect digestion and the GI tract—at least indirectly.

For example, as the body’s output of estrogen slows down, the hormone cortisol, which is routinely produced as a response to stress, is freer to irritate your GI tract. Increased stress levels, which are particularly common during perimenopause due to external factors like relationship changes, finances, aging parents, etc., in addition to disrupted sleep from hot flashes and hormonal changes, which can also increase cortisol production. Unchecked cortisol, often connected to increased stress levels, can contribute to all sorts of digestive problems, like indigestion, diarrhea, or constipation.¹

Menopause and IBS

Irritable Bowel Syndrome (IBS) isn’t lethal, but it has the potential to cause distress, discomfort, and interfere with quality of life especially when accompanied by painful cramping, frequent diarrhea, or constipation. It’s possible for women who never experienced IBS in their younger years to find themselves struggling with the condition in perimenopause and throughout the menopausal transition.

There is research indicating IBS in women may be influenced by estrogen and progesterone. Receptors for both have been located on gastrointestinal cells, and fluctuations in these hormones (which are common leading up to and during menopause) appear to influence the onset and severity of IBS symptoms.² However, more research needs to be conducted to better understand the relationship.

IBS during midlife may have more to do with challenges and changes that often occur during this time, rather than just menopause. It’s true that the changes and symptoms happening during menopause can influence stress, which in turn can trigger IBS symptoms. But as mentioned, plenty of other stressors are common during this stage of life too, including increased job responsibilities, marital or parental challenges, and illness or death among aging family members.  Such causes of stress, along with low-quality diet, inadequate sleep, and lack of exercise can contribute to IBS symptoms and GI issues.³

Menopause and Bowel Irregularity

As you go through menopause, you may notice that your bowel habits suddenly are not as regular as they used to be. Perhaps you now go twice a week (constipation is defined as having no more than 3 bowel movements a week) and have more bouts of diarrhea. This is not abnormal for women in perimenopause or menopause.

Progesterone during this time isn’t as plentiful as when you were menstruating, and as a result, the colon’s activity is slowed, increasing the time it takes for your food to digest and turn into stool for elimination. Stool that hangs around longer than it should dries out, making it difficult to pass and leading to constipation.

Another potential cause of difficulty in moving the bowels is weakened pelvic floor muscles, which can occur in some postmenopausal women,⁴ and is most often due to childbirth, genetic factors or aging. If you suspect this may be the case, your gynecologist can confirm and provide guidance on how to manage the symptoms.

Finally, cortisol and stress can both impact bowel regularity. Whether caused by the changes of menopause, or by non-menopausal factors related to the demands of midlife, cortisol and stress can result in diarrhea or constipation.⁵

Can Digestive Problems Cause Hot Flashes?

Looking at the relationship between menopause and digestion from another angle, you may be wondering if digestive problems can trigger menopause symptoms, such as hot flashes. Though there is more research to be done, digestive issues related to dietary intake could be more likely to impact hot flashes than the digestive issues themselves.⁶ Additional research in this area is still underway.

What Helps With Digestive Problems During Menopause?

There are certain lifestyle adjustments you can consider to support your digestion and bowel function during menopause:

• Make adjustments to your diet: Think about reducing red meats and packaged foods, which can have a lot of chemicals and preservatives. You could consider adding a probiotic to your diet which may have digestive benefits. Also try eliminating fried foods and reducing alcohol. Increasing your plant consumption, fiber, and good fats (such as extra virgin olive oil) can help, too. The Mediterranean diet includes many of these recommendations and is a great option for women in menopause.
• Stay hydrated: Thirsty? Water not only quenches, but it also hydrates and gets things moving smoothly along the GI tract. Functional beverages that contain probiotics, such as kombuchas, can be both healthy and satisfying.
• Practice mindful eating: When eating, chew food slowly, deliberately and savor each bite. Doing so activates the release of the critical digestive enzyme amylase. Chewing well also prevents you from overeating and stuffing your stomach, stressing your digestive system.
• Kickstart a manageable exercise routine: As with cardiovascular health, exercise is also important to maintaining digestive function.
• Get your checkups: Don’t forget to schedule preventive care. Newer guidelines suggest that adults should screen for colon cancer starting at age 45.⁷

As you journey through menopause remember, keep your GI on your mind. By making some simple lifestyle changes to your routine, you can manage your digestive health during menopause and beyond.

If you feel that you are enduring frequent bouts of severe constipation, cramping, more frequent and intense IBS or an increase in acid reflux, consider consulting with your healthcare provider, as they could be indicative of health conditions unrelated to menopause.

Resources

1. https://www.everydayhealth.com/wellness/united-states-of-stress/how-stress-affects-digestion/
2. https://www.med.unc.edu/ibs/wp-content/uploads/sites/450/2017/10/IBS-and-Hormones.pdf
3. https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-021-00064-5
4. https://www.mind-body-health.net/ibs.shtml
5. https://www.cancer.columbia.edu/news/45-year-olds-should-now-get-routine-colorectal-cancer-screenings-q-james-church-md
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9581385/
7. https://www.cancer.columbia.edu/news/45-year-olds-should-now-get-routine-colorectal-cancer-screenings-q-james-church-md