Bloating, abdominal pain and menopause: what you need to know

Many menopausal women experience bloating or have a bloated stomach at various points throughout the day. It's a common and usually harmless symptom of menopause. A bloated stomach feels swollen and tight. It's often accompanied by flatulence (wind), rumbling, constipation, abdominal pain or stomach cramps. Bloating does not necessarily result from menopause, but shifts in your hormones are often a contributing factor.  

Here's why. Levels of oestrogen and progesterone in the body decline in the years leading up to menopause. The drop in progesterone speeds up during perimenopause, causing an oestrogen dominance effect in the body. The excess of oestrogen can lead to decreased bile flow (bile is a fluid that helps with digestion), causing the intestines to become weaker, your digestion to slow down and intestinal gas to build up. This can result in symptoms such as bloating, constipation, or shooting pains and cramps. 

Hormonal changes can also affect the fluid balance in the body. Elevated oestrogen levels increase fluid retention, causing your belly to swell. This can make you feel bloated and gassy, or constipated. 

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

Bloating and abdominal pain can also be caused by less obvious factors, such as stress, swallowing too much air when eating, or a food allergy or intolerance (you can also develop allergies later in life). Also, high levels of cortisol, the stress hormone, can slow down digestion or impact bowel movements, leading to constipation, bloating or abdominal pain. Certain medicines or health conditions can also cause or exacerbate abdominal problems.

Feelings of fullness and a bloated stomach, which is often accompanied by abdominal pain, are typical symptoms of menopause. Your stomach may look bigger, which can make you feel self-conscious, or it can make your clothes fit tighter. All this can make your daily life more challenging. 

Most women will experience digestive issues, such as flatulence, constipation, bloating and abdominal pain, in the two years surrounding their final menstrual period (menopause). This is when hormone fluctuations are most dramatic. In postmenopause, once the body adjusts to a new hormonal environment and hormone levels remain at a constant low level, most symptoms will improve. Mind you, we are all unique, so each person may have slightly different symptoms and their duration and severity may also vary. The good news is there is a lot you can do to prevent or alleviate symptoms yourself. 

The first step towards a solution is to look at what goes into your gut: your diet. Here are some tips to reduce abdominal discomfort: 

• Eat mindfully and slowly. Focus on eating without distractions like smartphones or TV shows. Taking your time will help you swallow less air and reduce flatulence. 
• 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.  
• Make sure your diet includes healthy fats. Healthy fats stimulate bile production, which is good for digestion. Healthy fats can be found in avocados, ghee and nuts. 
• 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 and constipation. A better option is water or herbal tea.  
• Have you ever wondered if you might have an allergy? Have yourself tested. If you have a reaction after eating a particular food on a regular basis, you should see your doctor to determine whether you have a food intolerance or allergy. 
• Consider taking a supplement. High-quality dietary supplements can be a good way to fill any dietary gaps, which can be helpful during menopause. These supplements are essential for menopausal health. 

Here are some lifestyle tips that you can implement to improve gut health:  

• 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. Going for a walk after dinner gives your body the chance to digest your food. Walking after eating is also a proven way to stabilise blood sugar and improve mood. A win-win for everyone!