Digestive troubles and the menopause — are they linked?

The menopause brings with it many physiological changes, some commonly discussed, others not so much.

We’re all braced to expect hot flushes, night sweats, fatigue, a loss of libido and changes to our periods. However, not as many women tend to share their experiences with how the menopause affects digestion.

You might have made it through life boasting a cast-iron stomach, with no food or drink causing so much as a single episode of indigestion or belly trouble. When our stomachs no longer seem so settled, it can become a cause for concern.

So, can the menopause cause stomach pain? The answer: yes — hormonal changes at the dawn of the menopause can give rise to gut and digestion discomfort.

Here’s how the menopause process causes trouble for our tummies, with some tips to help menopausal women say ‘see ya, sore stomach’.

Morning nausea — the perimenopause can cause a sick stomach

When waking in the morning, many women approaching the menopause begin to report feelings of nausea, often reminiscent of morning sickness experienced when pregnant.

During the stages before the menopause — the perimenopause — hormone levels begin to alter. This can include changes to the follicle stimulating hormone (FSH), which regulates the function of the ovaries. The hormone changes in a similar way as during the initial stages of pregnancy, with this process associated with morning nausea.

In this way, the perimenopause period, which occurs 8–10 years before the menopause (the point at which we no longer have menstrual periods), can also be associated with digestive and stomach problems.

Declining oestrogen levels can cause cortisol to increase, raising blood pressure levels and reducing the production of essential stomach acids. The result is a rather upset stomach.

Thankfully, it’s possible to take action. Try setting your alarm clock 20 to 30 minutes earlier; this gives your morning hormone levels a little bit of extra time to settle; jumping out of bed to immediately rush your way through your morning routine is unlikely to help your tummy feel better.

Once you’re up and about, your breakfast can play a role in combating these pesky perimenopause digestive problems. A balanced breakfast stabilises your blood sugar levels, helping to resolve the nausea as well as get you fuelled up for the day. Needless to say, avoid junk and processed food as much as possible.

It’s not just what you eat, but how you eat it — make sure to chew slowly and thoroughly; this means your body has to work less hard to digest the food. Staying hydrated helps with nutrient transportation, so make sure a glass of water is on hand.

If, like many people, you find it hard to eat so soon after getting up, a breakfast smoothie might prove easier to stomach. A particularly delicious, beneficial recipe involves blending up include yoghurt, oats, frozen berries, chia seed and plant milk!

Gut feelings — our hormone levels can cause menopause digestion problems

Naturally, you may think that your sex hormones are only active within your reproductive area. However, researchers have discovered that cells in the intestine lining also have receptor sites for oestrogen and progesterone.

What this means — the hormones normally regulating your menstrual cycle also have an impact on your digestion.

Oestrogen tends to stimulate the muscle that lines the length of the intestine; progesterone has a more relaxing effect. Working together, these hormones help to support the wave of rhythmic muscular activity within the gut. This activity helps food and the waste products from digestion to move through the gut with ease, and at the right speed.

During the menopause, our hormone levels change and oestrogen levels drop, disrupting this natural rhythm in the gut. The result: indigestion, bloating, wind, constipation and diarrhoea. This process means that the menopause and digestion problems often go hand-in-hand. For some women, this can become a more persistent and prominent health concern.

Anxiety, stress and tension — no good for your gut

There’s an inextricable link between the gut and the brain, so if you’ve got a menopause upset stomach, it’s worth checking in on your tension levels.

Increased anxiety is a very common symptom of the menopause, as is a tendency to get flustered during stressful or high-pressure situations. You may get a sense or feeling that you just aren’t able to cope as well as you used to be able to.

Again, this is down to hormones. Oestrogen keeps the stress hormone cortisol in check; when this hormone runs low — as it does during the menopause — blood pressure rises and your digestion slows down. The calming effect of oestrogen can also cause adrenaline levels to rise, which switches off digestive functioning.

Naturally, this can leave your stomach feeling in knots. You probably don’t need us to remind you of those tell-tale signs of an unhappy belly: stomach pains, acid reflux, abdominal cramps, constipation, bloating and sluggish bowel.

Hot flushes, a quintessential menopausal symptom, can also sometimes feel quite overwhelming. For many women, these progress into panic attacks. The direct link between our mind and our tummy means that any worries, stress or anxiety are mirrored in your stomach, with muscles in the gut becoming tense. 

Fortunately, there are always steps we can take to look after our mental health when life’s stressful situations threaten to get the better of us.

Consider exploring a course of cognitive behavioural therapy (CBT), joining up with a local meditation group or treating yourself to regular relaxation massages — perhaps even all of these!

There are many tools at your disposal to help ease and release the stress and tension which naturally comes with the menopause. By taking time to still the mind throughout this stage in our lives, we can do our tummies a big favour.

Dealing with a menopause upset stomach? Look after your microbiome

All along the intestine, there’s a multitude of bacterial activity collectively known as the microbiome. Getting the right type of friendly bacteria in your microbiome supports gut function and the maintenance of bowel regularity, thereby playing a key role in keeping a menopause upset stomach at bay.

These friendly bacteria even produce B-vitamins which get absorbed into the body, contributing to a normal energy-yielding metabolism — required for all physiological functions and activities of the body, including exercise.

Importantly, some of the B-vitamins, such as B6 and B2, help to support hormone balance.

By getting these vital nutrients, you’ll be able to support your body as much as possible during the menopause.