I was in my mid-40s when my gut went completely downhill. I thought I had a handle on my IBS, but suddenly the bloating, constipation, and random bouts of diarrhoea were out of control. Not to mention the low iron, nausea, sleepless nights, and a constant sense of doom, and life became overwhelming. I woke up one day and I was broken.
Like many women, I searched for answers. I saw multiple doctors and was diagnosed with anxiety, adenomyosis, IBS (again), a sleep disorder, and more. They weren’t wrong, but they all missed the bigger picture: perimenopause. After years of struggle, I eventually connected the dots myself and found a doctor who specialised in menopause. Finally, something worked, and I got the support I needed.
If your gut has become unpredictable in midlife too, you’re not imagining it. Hormonal shifts in perimenopause can directly affect digestion and your gut health also plays a key role in how your body processes oestrogen. When hormones fluctuate, so can your gut.
In this blog, we’ll explore how menopause and gut health are connected, why symptoms like bloating and constipation often flare during this stage, and practical ways to find relief.
The Gut-Hormone Connection:
Think of your gut like a busy highway. Oestrogen and progesterone are the traffic cops. When their levels are steady, traffic (your food) flows smoothly. But during menopause, these traffic cops start taking erratic breaks, causing traffic jams and general chaos.
Hormones are chemical messengers that tell your cells what to do. You might be surprised to find out that we have oestrogen receptors all over our bodies, including in our gut and brain. When hormones fluctuate erratically in perimenopause, the messages get scrambled.
- Oestrogen: This hormone affects everything from pain perception to how fast food moves through your gut. When estrogen levels fluctuate and drop, it can lead to slower gut motility and increased gut sensitivity, causing constipation, bloating and pain.
- Progesterone: When progesterone is high it tends to have a calming effect on the body and can slow down gut motility. However, when levels drop (often in early perimenopause) we are often left feeling anxious and edgy which results in faster moving digestion.
- The Estrobolome (your gut-hormone axis): This is a collection of bacteria within your gut microbiome that helps regulate how your body metabolises and processes oestrogen. When this community is imbalanced, it can impact how estrogen circulates in your body, potentially contributing to symptoms and hormonal fluctuations.
- Gut Microbiome Changes: Research shows that postmenopausal women tend to have aless diverse and less abundant gut microbiome compared with premenopausal women. This suggests that the drop in hormones during and after menopause doesn’t just affect your periods or hot flushes, it also reshapes the gut microbiome itself. In other words, the relationship is two-way: your gut influences hormones, and hormones influence your gut.
- The Gut-Brain Axis:Your brain has oestrogen and progesterone receptors too. That’s why anxiety, low mood and depression are so common in perimenopause. Fluctuating hormones and related anxiety raise cortisol (the stress hormone) and throw off the gut brain axis, both of which make IBS symptoms like bloating and diarrhoea worse. Read more about the relationship between stress, the gut brain axis and IBS here.
My Journey: From Dismissed to Empowered
Since that frustrating experience, I’ve found a team of experts who helped me navigate this transition. I also educated myself and trained as a menopause coach because I am passionate about making sure other women get the support I wish I’d had.
I am living proof that you can get your gut back on track and feel in control again. My gut is now much healthier with the right combination of diet, lifestyle, medication, and supplements. And Im not just living with menopause, I’m thriving.
Simple Steps to Support your gut in menopause
Here are a few actionable, evidence-based tips you can start with today to support your gut microbiome, your estrobolome and help manage your perimenopause and menopause journey. You could build your habits by choosing one to focus on each week:
- Eat more plants: Diversity is everything. The more colours and types of fruits, veggies, nuts, seeds, legumes, grains, herbs, and spices you eat, the happier and more resilient your gut microbiome (and estrobolome) will be.
- Feed your gut with fibre & prebiotics: Think of fibre and prebiotics as fertiliser for your gut. Prebiotic foods like oats, chia, kiwi, firm bananas and low FODMAP serves of legumes, garlic, onion and asparagus nourish your gut garden.
- Hydrate, hydrate, hydrate: Fibre only works well when there’s enough water. Keep a water bottle nearby and sip throughout the day to keep things moving
- Add something living: Probiotic foods like yoghurt, kimchi, kefir, and miso give your gut friendly bacteria. Supplements tend to be hit and miss, helping some but not others. Food sources are a nutritious and tasty place to start.
- Move your body: Movement isn’t just good for your heart and bones; it literally helps your gut move food along. Walk, dance, lift, stretch, do whatever keeps you strong and makes you smile.
- Guard your sleep: Erratic hormones can wreak havoc on rest. Keep a regular bedtime routine, dim the lights and wind down with calming rituals to signal to your body it’s time to switch off.
- Rest before you digest: Take a few deep breaths before meals. Calming your nervous system tells your gut it’s safe, so it can focus on digesting rather than fighting or fleeing.
- Stay socially connected: Isolation feeds anxiety. Even if you don’t feel like it, spending time with friends, family or a community boosts mood and supports resilience.
- Consider MHT: Modern menopause hormone therapy isn’t what it used to be. Today, there is a whole menu of options to choose from. There are many safe and effective options that ease symptoms and reduce risks of heart disease, osteoporosis, dementia and more. Whether you choose to use MHT or not, you deserve to understand your options so you can make an informed choice.
Key takeaway: A diverse, fibre-rich diet + daily movement + stress management = a stronger gut and smoother menopause transition. Small changes add up.
Ready to Stop Guessing and Start Healing?
It’s time to stop guessing and start healing. With my combined expertise as a dietitian and registered nurse, I’ll help you understand what’s happening in your body so you can feel in control again.
Ready to find relief? You can work with me one-on-one to create a tailored nutrition and lifestyle plan. Or, for a comprehensive resource you can access anytime, my ebook “The Hot Girl’s Guide to Perimenopause and Menopause” is packed with practical strategies to help you thrive.
P.S. Use code IMAHOTGIRL for 50% off my ebook at checkout!
