Menopause and Digestive Issues


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Bloating, indigestion, and intestinal gas are common problems during menopause. They often go away after menopause, but many women experience these symptoms throughout their lives.

If you’ve experienced any of these issues yourself, then you know how frustrating they can be. But there are ways to get rid of these uncomfortable symptoms once and for all.

This article covers menopause and digestive issues, explains why these issues happen, how to help you overcome bloating, indigestion and intestinal gas, and how you can prevent them from happening again.

The Connection Between Menopause and Digestive Issues

Many women claim that all their digestive issues started when they were in their perimenopausal years. Many women don’t realize they’re experiencing menopausal symptoms until they’re in their mid to late for­ties, years after their body has officially entered menopause.

Menopause and digestion issues are intimately connected. One of the main reasons for excessive bloating, gas, and general digestive problems in women between the ages of 45 and 55 is hormonal imbalance. Women are actually twice as likely to have digestive disorders, aka dysbiosis or gastrointestinal (GI) problems, as men.

As a woman gets older, her digestive system slows down, which can cause menopausal symptoms including bloating, gas, and constipation.

Cortisol: Hormonal Disruption and Digestive Disorder

Cortisol affects the way other hormones act, including insulin and thyroid hormones.

Cortisol helps regulate blood sugar levels, and is involved in synthesizing proteins and the body’s immune response. It also plays a part in REM sleep, bone turnover rate, and thyroid functioning.

Women’s adrenal glands control the body’s response to stress, so they’re important for women’s health. The stress from constant fatigue and other menopause stressors from hormone changes can have serious effects on those adrenal glands. 

Hormonal fluctuations can disrupt cortisol levels. The abnormal cortisol levels can then impact menopausal symptoms. Symptoms of cortisol level disruption include fatigue, depression, insomnia, weight gain, and cravings for salt and sugar.

Estrogen helps to maintain healthy cortisol levels. As estrogen levels drop during perimenopause and menopause, cortisol levels may increase, which can cause blood sugar and blood pressure to rise. The release of stomach acids and the emptying of stomach contents into the small intestine are delayed, causing digestive system problems such as bloating, gas, and constipation.

Hormone fluctuations during perimenopause and menopause cause women to experience a wide range of menopausal symptoms including:

  • Digestive problems
  • Disinterest in sex
  • Fatigue
  • Forgetfulness
  • Headaches
  • Hot flashes
  • Insomnia
  • Joint pain
  • Mood swings
  • Night sweats
  • Weight gain

Understanding the Digestive Process

To understand how digestive enzymes can help ease the digestive disorder that sometimes accompanies perimenopause and menopause, it’s necessary to get a sense of the various factors necessary for healthy digestion.

Digestive Enzymes

Digestion begins in the saliva, where carbohydrates and fats are broken down into smaller molecules. Chewing starts the production of digestive enzymes in the stomach.

Digestive enzymes help break down food into nutrients that your body can absorb. Once food enters the stomach, various enzymes begin digesting the food. Proteins, carbohydrates, and fat are broken down into smaller molecules, so they can be absorbed by the body.

The food then moves into your small intestine, which is where most of the absorption takes place. Additional enzymes are produced in the intestines to help break down fats, carbohydrates and proteins. The pancreas and liver produce enzymes and bile, respectively, to help break down fats.

The end result of this process is that food becomes sugar, fat, and protein – the fuel that your body runs on. After absorption, the remaining nutrients stay in the large intestine (colon) until they’re expelled in the form of stool.

Hydrochloric Acid (HCl)

Enzymes aren’t the only substance a body requires to process food. The stomach needs a mixture of hydrochloric acid and digestive enzymes to break down food into nutrients. Pepsin – an enzyme produced by our bodies – needs an extremely acidic pH level in order to do its job.

As we get older, a variety of factors, including over-use of medications, poor diet, and stress, can result in low stomach acid (low levels of HCl).

Without enough HCl, the digestion of carbohydrates, protein, and fat cannot be properly completed. The stomach needs HCl to help protect it from bacterial overgrowth.

HCl also helps the body to efficiently absorb essential vitamins and minerals.

Intestinal Flora

Intestinal flora is also referred to as gut flora or the intestinal microbiome. It helps break down carbs, fat, and protein into usable nutrients.

Gut bacteria populations consist of both good and bad types of bacteria. A balanced population of these bacteria is necessary for optimum health. They help with digestion and detoxification, they ensure balanced immune responses to potential allergens, and they help with metabolic processes.

Bad bacteria include those that cause diseases, such as Salmonella and Clostridium. They become problematic only when they grow large and uncontrollable compared to the number of good bacteria. Even yeast such as candida can be healthy in small amounts.

Good bacteria include Lactobacillus bulgaricus, Lactobacillus acidophilus, Bifidobacterium bifidum, and others. They help digest food, provide nutrients and vitamins, maintain a healthy gut, and protect against bad bacteria. Good bacteria can be added by taking probiotic supplements. 

Healthy gut flora helps prevent bloats, gas, and yeast infections by maintaining a healthy acidic pH level in the intestines. They produce certain vitamins, help prevent diseases by depriving unwanted bacteria from obtaining nutrients, and secrete acid that bad bacteria have trouble dealing with.

For pre-menopausal and menopausal women, good bacteria helps to metabolize and recycle hormones like estrogen, phytoestrogens, and thyroid, which fosters hormonal balance and helps to minimize menopause symptoms.

Learn more in this Probiotics Guide.

Symptoms of Digestive Disruption

If digestion is disrupted, or there isn’t enough digestive enzymes, a variety of symptoms can occur:

  • A false urge to have a bowel movement
  • Bloating and flatulence
  • Constipation
  • Cramps
  • Diarrhea
  • Fatigue
  • Food sensitivities
  • Headaches
  • Heartburn and acid reflux
  • Irritable bowel syndrome (What is IBS?)
  • Lowered immune response
  • Nausea and motion sickness

Menopause-Related Digestive Disorder Solutions

Dietary and lifestyle changes, taking prebiotic and probiotic supplements, and adding digestive enzymes to your diet may be helpful for optimizing digestion during peri­menopause and menopaus­e.

Learn more about the Differences Between Probiotics and Digestive Enzymes.

Daily Digestive Enzymes to Ease Menopause-related Dysbiosis

Enzymes are complex proteins produced by the body’s cells, which stimulate specific biochemical reactions in the body. Digestive enzymes stimulate digestion, breaking down food into energy. To digest food properly, your body needs a variety of different enzymes.

Digestive enzymes are classified into three main categories:

  • Carbohydrases (including amylase, maltases and sucrose) – Found in saliva, and pancreatic and intestinal juices, carbohydrases break down carbohydrates.
  • Proteases and Peptidase – They are present in pancreatic and intestinal juices, breaking proteins down into amino acids.
  • Lipases – They are found in the stomach and pancreatic juices, splitting fat into fatty acids

As we age, the production of enzymes in our body slows down. Furthermore, the enzymes themselves become inactive. It’s no coincidence at all that as women reach menopausal age, their enzymes become less effective.

Digestive enzyme supplements can help the body digest food better, and ease the effects during menopause when the body produces less digestive enzymes.

Look for digestive enzyme supplements that include,

  • Amylase
  • Bromelain
  • Lactase
  • Lipase
  • Papain
  • Peptidase
  • Protease

Digestive enzymes should be taken during or after each meal. If taken on an empty stomach, they’d just be absorbed into the bloodstream and have little effect. It makes sense to take digestive enzymes with food because they’re secreted naturally when we digest our meals.

Probiotics

We’ve discussed intestinal flora and the importance of probiotics above.

Health care specialists recommend taking probiotics as part of any daily health routine, especially for women in the perimenopausal and menopause stages of life.

Lactobacillus acidophilus

Lactocbacillus acidophilus is an acid-loving milk-bacterium that is a component of probiotics.

It helps relieve chronic constipation, and intestinal and gas pain. It also helps restore beneficial bacteria in the gut to healthy levels.

Lactobacillus acidophilus can be found in some yogurts and probiotic supplements. 

Colon Cleansing

Another strategy for dealing with digestive issues during menopause is to keep the digestive tract moving. If your colon is slow at eliminating waste, you may experience sluggishness, fatigue, or other health issues.

Complications can arise from the type and number of toxic substances that our bodies contain. For example, there are environmental estrogens – chemicals that can mimic the body’s natural estrogens. That can disrupt the hormonal balance and confuse the body’s estrogen receptors. 

Toxins from environmental and dietary sources put pressure on the limits of our body’s immune system. Our bodies must constantly fight against harmful, toxic substances in the environment. If your body’s resources are constantly taxed by toxins during menopause, then it will be harder for your body to deal with menopausal stress.

Psyllium seed husks are another healthy way to keep waste moving through the colon. The husks are coated with mucilage that swells as intestinal fluids are absorbed, lubricating the gut wall. The extra bulk helps stimulate the intestinal wall to contract, which encourages bowel movements.

Herbal Remedies for Digestive Ailments

Herbal remedies tend to work slowly, but over time they can strengthen the digestive system and help you feel better overall. Herbs known to help with digestion include fennel seeds and fenugreek seeds.

Berberine – Effective against bacterial/viral infections, Candida albicans, fungal infections, human parasites, and yeast. Berberine is an alkaloid that’s found in the herb barberry, Oregon grape root, goldenseal, and Chinese goldthread.

Ginger – Aids digestion and prevents gas. You can take it as a tea or in capsules. Learn more about Ginger for Diarrhea Relief and Ginger for IBS Relief.

Dandelion – can be taken for an upset stomach, and congestion and inflammation of the liver and gallbladder.

Herbal Relief for Low Estrogen

There are various herbal supplements that are believed to help alleviate low estrogen levels and, as a result, reduce menopause symptoms:

  • Black cohosh
  • Chasteberry
  • Dong quai
  • Evening primrose oil
  • Licorice root
  • Red clover
  • Siberian ginseng
  • Wild yam

Other supplements that may relieve menopausal symptoms include omega 3, calcium, magnesium, B vitamins, and vitamin E. Multivitamins can help simplify the process of ensuring that you’re getting enough of all these important vitamins every day.

Lifestyle and Dietary Changes

Various simple lifestyle changes may help relieve and prevent menopausal digestive disorders.

  • Avoid eating when stressed
  • Avoid junk and processed food
  • Avoid overeating
  • Chew food well
  • Drink plenty of water
  • Exercise for 30 minutes each day
  • Implement a high fiber diet
  • Increase omega-3 fatty acid intake by eating oily fish, such as salmon 
  • Lower wheat and bread to minimize bloating and weight gain
  • Minimize alcohol intake
  • Minimize caffeine intake
  • Reduce intake of hydrogenated fats, refined carbohydrates, and sugar 

Phytoestrogen, also known as dietary estrogen, occurs naturally in some foods, and has the ability to act like natural estrogen on the body. It produces effects similar to natural estrogen.

There are two main phytoestrogen types — isoflavones and lignans.

Isoflavones are found in chickpeas, soybeans and soybean products, fava (broad) beans, and other legumes (alfalfa, beans, carob, clover, lentils, lupins, mesquite, peanuts, peas, and soy sauce). Most processed foods that are manufactured from legumes (tofu, for example) retain their isoflavone content.

Lignans are found in beans, some berries, broccoli, nuts, oilseeds (i.e. flax, sesame), soybeans, pumpkin seeds, whole grain cereals (barley, oat, rye, and wheat), and some legumes, fruits, and vegetables.

Other foods known to contain phytoestrogens are apples, anise, carrots, dried beans, fennel, ginseng, linseed (flax), mung beans, pomegranates, rice, rice bran, soy beverages, tempeh, wheat germ, and yams. 

Menopause and Digestive Issues Final Thoughts

Menopause and Perimenopause can be a very challenging time for women, especially when they experience uncomfortable side effects such as digestive problems.

However, there are many natural, easy ways to help minimize and alleviate digestion problems and, by extension lessen and even eliminate many of the many symptoms associated with menopause.

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Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.