Bloating and menopause: what you need to know

Bloating a symptom experienced by women going through perimenopause and menopause. It’s usually harmless, but it can be very annoying. A bloated stomach feels tight, full and swollen. It may or may not be accompanied by flatulence, rumbling, constipation, stomach cramps or stomach pain, and it can be uncomfortable, even painful. Although menopause is not always the culprit, hormones play a huge roll in your overall health, and thus also your gut health.  

Many women experience a host of symptoms as they go through menopause, such as hot flashes, sleep problems and mood swings. 

During perimenopause and menopause, fluctuating oestrogen levels result in decreased levels of bile. Bile is a fluid that is made in the liver and stored in the gallbladder. It helps with digestion by breaking down fats. It also keeps the intestines lubricated.  

Levels of oestrogen and progesterone in the body decline during the menopausal transition. The drop in progesterone speeds up during perimenopause, causing an oestrogen dominance effect in the body. This excess of oestrogen can lead to reduced bile production, causing the intestines to become weaker, your digestion to slow down and intestinal gas to build up, resulting in symptoms such as bloating, constipation, or shooting pains and cramps. 

Hormonal changes can also disrupt your body’s water balance. Since oestrogen helps control water balance, the drop in oestrogen can lead to holding onto more water, making you look and feel bloated. 

Bloating can also be caused by other factors, such as stress, swallowing too much air when eating, or a food allergy or intolerance, such as hypersensitivity to lactose. Research has shown that while most people are born with the ability to digest lactose, 75 percent of all adults lose this ability at some point. Hence, many women claim to find relief from their symptoms when they avoid lactose.

Abdominal pain is often caused by a problem in the digestive tract, but it may also have to do with menstruation (heavy periods). Do you have persistent abdominal pain? Then talk to your doctor. Severe menstrual or pelvic pain can be a sign of endometriosis and should be examined.

Many menopausal women experience bloating or have a bloated stomach at various points throughout the day. These symptoms usually start somewhere around perimenopause when the level of oestrogen is relatively high compared to the level of progesterone. They can linger into postmenopause or they can first appear after the menopause. First, you need to figure out whether menopause or other factors are to blame. Then you can look for a solution that works.

The first step towards a solution is to look at what goes into your gut: your diet.  

• Eat unprocessed foods and avoid processed foods (canned, preserved or packaged foods). Processed foods have added salt and sugar, which can worsen bloating. 
• Eat more fibre. Fibre helps your digestion. Make sure your diet is rich in vegetables, fruit, whole grain products, nuts and seeds.  
• Cut back on coffee and alcohol. Caffeine and alcohol irritate the stomach and gut. They are also diuretics: they cause your body to expel lots of water, which may lead to dehydration. Dehydration can contribute to constipation which, in turn, can contribute to bloating. A better option is water or herbal tea. 
• Do you have a sedentary job? Get up from your desk every hour. Or ask for a standing desk. Sitting down can cause your abdomen to compress, which slows down digestion. By getting up every hour and walking, you stimulate your intestines. 
• Being physically active improves digestion. Get at least 30 minutes of physical activity a day in addition to your normal activities.  
• Take a walk after dinner. Going for a walk after dinner gives your body the chance to digest your food. Walking after eating has also proven to stabilise blood sugar and improve mood. A win-win for everyone!