A woman reaches menopause when she has gone 12 consecutive months without a menstrual period, but menopause is often spoken about as a transitional process rather than a singular event. Perimenopause is when you have menopause symptoms, but your periods have not stopped, although they may be irregular.
Perimenopause and menopause can cause symptoms such as hot flushes, night sweats, brain fog and low mood. However, they can also impact your digestive system, leading to a variety of gastrointestinal (GI) symptoms including nausea, constipation, reflux and bloating.
Most of us know what it’s like to feel bloated, perhaps after a large meal or when experiencing constipation, but it’s actually a common symptom of menopause, with over 40% of reporting bloating during perimenopause and postmenopause.
Understanding the link between menopause and stomach bloating is the first step in helping you tackle this uncomfortable symptom.
Why menopause can cause bloating
During perimenopause and menopause, the amount of oestrogen and progesterone in your body declines due to the loss of ovarian function. These hormones play a pivotal role in the menstrual cycle, which is why it eventually stops, but they also impact other areas and functions in the body.
Decreasing amounts of oestrogen and progesterone during menopause can affect peristalsis, the movement of the muscles that line your GI tract. This causes food to pass through your GI system more slowly and more water to be reabsorbed back into the bloodstream, which can lead to constipation, a buildup of gas, and bloating.
Oestrogen influences cortisol, which is often referred to as the ‘stress hormone’. There is a strong connection between our brains and our gut, so when cortisol levels are elevated, they can disrupt your gut microbiome, decrease the flow of oxygen and blood to the stomach, and cause inflammation, all of which can lead to bloating.
In addition, hormone fluctuations can also lead to food intolerances. You may find you are more sensitive to certain foods like dairy, gluten or high-fibre products, resulting in digestive discomfort.
Changes to your hormones aren’t the sole cause of menopause bloating. Many women find menopause and its symptoms difficult and are often facing other challenging life circumstances at the same time, such as balancing a full-time job with caring for ageing parents. This can lead to:
- Overeating
- Dietary changes, such as increased salt intake
- Eating too quickly and swallowing air
- Not drinking enough water
- Increased alcohol consumption
- Reduced exercise
- A lack of sleep
- Stress
All of these lifestyle factors can impact your digestive system and result in bloating during menopause.
What does menopause bloating feel like?
Menopausal bloating is characterised by abdominal tightness, heaviness or pressure where your belly feels full and uncomfortable and can be accompanied by a visibly enlarged stomach. Menopause bloating can come with other symptoms including:
- Belly rumbling or noises
- Burping or passing wind more often than usual
- Nausea
- Abdominal cramping
- Temporary weight gain
How long does menopause bloating last?
The duration and severity of menopause symptoms are different for everyone. For some women, menopause bloating is intermittent and temporary, lasting just a few weeks or months, while for others it’s a chronic condition that lasts for years.
According to research, digestive issues are more common in postmenopause, with 38% of women experiencing symptoms compared to 14% in perimenopause. However, as hormone fluctuations begin in perimenopause, you may experience bloating at any stage throughout menopause.
How to stop menopause bloating
Many symptoms of menopause can be alleviated with hormone replacement therapy (HRT). However, bloating is a side effect of HRT so you may find that this symptom gets worse before it gets better as your body acclimatises to the introduction of the hormones that HRT provides. Usually, you’ll be asked to persevere with HRT for three months to allow your body to adjust and for side effects to settle.
In many instances, small, easily implemented lifestyle changes are key to managing menopausal bloating and reducing digestive discomfort.
Menopause bloating relief, remedies and treatments
You may not necessarily be able to stop menopause bloating altogether but there are many options you can try to help ease discomfort and improve your digestive function:
- Stay hydrated: Drinking plenty of water helps flush out excess salt and reduce water retention. It also helps to soften your still to make it easier to pass and prevent constipation.
- Eat smaller, frequent meals: Instead of large meals, aim for smaller portions throughout the day to ease digestion and prevent bloating.
- Limit salt intake: Bloating is one of the most common short-term effects of consuming too much salt. Reducing your salt intake can help minimise water retention and bloating.
- Incorporate fibre gradually: Adding more fibre-rich foods like vegetables, fruits, and whole grains can aid digestion, but increase fibre slowly to avoid excess gas.
- Avoid trigger foods: Identify and reduce foods that may cause bloating, such as dairy, high-fat foods, carbonated drinks, and artificial sweeteners.
- Stay active: Regular exercise, like walking, menopause yoga, or Pilates, can help keep your digestive system moving and reduce bloating.
- Manage stress: Practice relaxation techniques like deep breathing, meditation, or mindfulness to help alleviate stress-related bloating.
- Take probiotics: Probiotics can support a healthy gut microbiome, which may reduce bloating and improve digestion.
- Try herbal teas: Ginger, peppermint, and chamomile teas can soothe the digestive tract and relieve bloating.
- Eat slowly and mindfully: Chew food thoroughly and avoid eating too quickly to reduce the amount of air you swallow.
- Limit sugar and refined carbs: Reducing sugar and processed carbs can help decrease gas and bloating.
- Consider digestive enzymes: Supplements with digestive enzymes may support your body's ability to break down food, reducing bloating, although evidence is limited.
- Wear loose clothing: Opt for loose, non-restrictive clothing to avoid putting pressure on your abdomen. This won’t stop bloating but can make you feel more comfortable.
- Try over-the-counter remedies: Antacids, simethicone, laxatives or other over-the-counter medications can provide relief from gas, constipation and bloating.
When to see a doctor
Menopause bloating is a common symptom of this natural transition and while you may be able to manage it successfully on your own, it's important to know when it might be a good idea to seek some professional advice.
You should see your GP to discuss your symptoms and rule out other causes of bloating if:
- Your bloating is affecting your ability to move or complete your usual day-to-day activities
- You regularly feel bloated (more than 12 times a month)
- You’ve changed your diet, but bloating is still persistent
- You have a swelling or lump in your abdomen
- Your bloating is accompanied by vomiting or diarrhoea
- You have blood in your stool
- You have unexplained weight loss
At Menopause Care, we have a team of specialists who are experienced in supporting women to navigate menopause and its symptoms. You can discuss your symptoms and medical history with one of our menopause doctors and they’ll provide tailored, evidence-based treatment and relief recommendations.
In addition, our menopause dietician can give you personalised nutritional guidance so that you can adopt a menopause diet that will help reduce your symptoms and get your gut feeling back to its best.
If menopause bloating is affecting your overall well-being and you’re ready for this to change, book a consultation with a menopause doctor.
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