Hi, I'm Dr. Bianca!


I’m a menopausal woman. I write about what it's like to get through the hormonal transition we’ve come to know as menopause. My intent is to help us all age together in the best and healthiest way possible. Let’s not suffer in silence. Let’s normalize the conversation. 


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Menopause and digestion are intricately linked.

Which marks a pivotal transition in a woman's life.

Fluctuating estrogen and progesterone (and testosterone) levels not only bring about various menopause symptoms but also significantly influence the digestive system.

This blog post is about the relationship between menopause and digestion.

It emphasizes how hormonal changes influence gut health and offers strategies to mitigate these effects.

Understanding the Menopause Transition and its Effects on Digestion

Understanding Menopause and its Impact on Women's Health

Menopause: the word every woman over a certain age knows all too well but is still completely confused by. 

It's the stage in life when our bodies decide to play a hormonal game of musical chairs.

Often leaving us to deal with hot flushesmood swings, brain fog, and the occasional urge to throw our computers out the window.

But did you know that menopause doesn't just mess with our emotions?

It can also wreak havoc on our digestion.

You know that belly bloat and excess gas you've been dealing with...yup, it could be hormones!

The Relationship between Hormones and The Digestive System

So, how exactly do hormones and digestion connect?

Our hormones (estrogen, progesterone and testosterone) are more connected to our digestive system than we might think. 

They can have a significant impact on everything from gut motility (how quickly and efficiently food moves through our intestines) to the balance of bacteria (gut bugs) that cohabitate within us. 

The lining of our digestive tract is filled with cells that stimulate our immune system. 

In fact, the National Institute of Health reports that 70-80% of our immune cells are housed in the gut.

And a good amount of the serotonin (our happy hormone) is also made there!

In other words, when our hormones go haywire, our digestion can go haywire too.

Personally, I often notice that when I'm feeling sad or down, it coincides with my gut not feeling too good either. 

Chicken or the egg? 



Understanding HOrmonal Changes During Menopause

Overview of the menopausal transition

Buckle up, ladies, because we're about to take a ride on the hormonal roller coaster.

The menopausal transition, also known as perimenopause, is the period leading up to menopause when our ovaries start to slow down their estrogen production.

This can last anywhere from a few months to several years, and during this time, our hormones can go as wacky as a toddler on a sugar rush.

Read more about Perimenopause vs Menopause here.

Fluctuations in Estrogen, Progesterone and Testosterone Levels

Estrogen, progesterone, and testosterone – these three hormones are what I like to call, our "super powers".

But during the menopausal transition, they can turn quickly into kryptonite.

Estrogen levels can fluctuate wildly, leading to those infamous hot flashes and night sweats.

Progesterone, the peacemaker hormone, starts to decline, leaving us feeling like we've lost our calm.

And testosterone, the hormone responsible for our sex drive, can take a nosedive, leaving us with the va and no longer the voom.

hormones and gut health

The Impact of Hormonal Changes On Digestive Health

Effects of Hormonal Imbalances on Digestive Function

Hormonal imbalances can lead to a host of confusing digestive issues, including bloating, gas, constipation, and diarrhea even without an exact cause.

In fact, some women discover new food sensitivities and weird IBS symptoms that creep up during menopause.

Fatty foods are often no longer tolerated. 

There goes indulging in the occasional french fry or scoop of ice cream!

Acid production in the stomach can often lead to GERD or "reflux" which in some instances can be "silent" and present like sinus pressure, a sore throat or allergies.

Role of Hormones in Gut Motility and Digestion

Gut motility is how quickly and efficiently food moves through our intestines.

Hormones exert a significant influence on gut motility and digestion.

Estrogen, for instance, plays a crucial role in regulating the contractions of our intestines.

During menopause, when estrogen levels undergo fluctuations, it can disrupt the normal pace of digestion, leading to either slow or rapid movements of food through the digestive tract.

On the other hand, progesterone has a relaxing effect on the muscles of the gut, but excessive decreases in its levels can result in constipation.

This delicate hormonal balance within the digestive system highlights how hormonal changes during menopause can directly impact gut symptoms. 

Common Digestive Issues Experienced During Menopause

Menopause-Related Digestive SymptomS

As if hot flashes and mood swings weren't enough, menopause can also throw us many digestive curveballs.

The link between menopause and digestion is not always as widely discussed even when you seek medical guidance.

Yet, many women during this transitional phase experience noticeable changes in their digestive health.

Why is it so hard to get your GYN, GI and Endocrinologist to work together as a team? 

No, you don't need to be put on antidepressants or antacids if your funk is coming from your gut which leads back to your hormonal roller coaster! 

Here are some common digestive symptoms experienced during menopause (in most experienced to least experienced order): 

  • Bloating
  • Gas
  • Acid reflux or heartburn
  • Constipation
  • Diarrhea
  • Abdominal pain or cramping
  • Changes in appetite
  • Nausea
  • Gallbladder issues (e.g., gallstones)
  • Dry mouth or changes in saliva production

So, if you seek help for these GI issues, make sure to tell your practitioner that you are in the menopause transition and hopefully you can get a team approach to calm your chaos!

poor gut health leads to dysbiosis in menopause

Digestive Disorders 

Common Digestive Disorders and Menopause

It is not uncommon for women transitioning through menopause, to find themselves grappling with other health-related challenges

Among these challenges, digestive disorders such as irritable bowel syndrome (IBS) and acid reflux become increasingly prevalent.

This uptick in the incidence of digestive issues can be attributed, in part, to the hormonal fluctuations that we've been discussing. 

Recent research has shed light on the connection between menopause and the gut microbiome.

Revealing that menopause-related changes in the gut microbiome are associated with adverse cardiovascular risk in postmenopausal women. 

This finding underscores the pivotal role of the gut microbiome in influencing cardiometabolic health during menopause.

In addition to IBS and acid reflux, here are several other common digestive disorders that are frequently encountered during menopause. 

Constipation - Can't Poop?

Estrogen, plays a role in maintaining the normal function of the GI tract, including the coordination of smooth muscle contractions that move stool through the intestines.

As estrogen levels decrease, this results in slower and less coordinated contractions of the intestines, leading to a delay in the transit of stool = constipation.

Adequate water absorption is essential for the formation of soft, easily passable stools.

Unfortunately, a decrease in estrogen levels can disrupt this balance, potentially leading to drier and harder stools that are more difficult to pass.


Fluctuating hormone levels, particularly estrogen (again), can lead to diarrhea in some women.

Estrogen influences the smooth muscles in the digestive tract, affecting their contractions and tone.

When estrogen levels fluctuate, it can result in hyperactive contractions, causing food to move too quickly through the intestines.

This rapid transit may prevent the intestines from adequately absorbing water from stool, resulting in loose and watery bowel movements, or diarrhea.

Increased stress and anxiety, commonly experienced during menopause, can further exacerbate diarrhea.

Stress triggers the "fight or flight" response, stimulating rapid bowel movements. 

Bloating and Gas

Estrogen and progesterone, in particular, play a role in regulating the composition and activities of the microbiome. 

During menopause the balance of "gut bugs" can become disturbed.

Gas-producing bacteria in the gut, responsible for fermenting dietary components, may become overabundant.

Consequently, larger quantities of gases like hydrogen and methane are produced during digestion.

These excess gases can accumulate in the digestive system, leading to bloating, a sensation of fullness, and the passage of excess gas, causing discomfort.

Additionally, excessive gas production can influence gut motility, potentially resulting in irregular bowel movements


Indigestion, also known as dyspepsia, is a common issue exacerbated by hormonal changes during menopause.

Estrogen helps in stomach acid production, which is vital for proper digestion.

Lower estrogen levels can lead to reduced stomach acid, resulting in inefficient food breakdown and discomfort.

Gastroesophageal Reflux Disease (GERD)

GERD is a chronic condition characterized by the backflow of stomach acid into the esophagus, resulting in heartburn and discomfort.

Hormonal changes during menopause, particularly the decline in estrogen, can contribute to the development or exacerbation of GERD.

Estrogen plays a role in maintaining the strength and integrity of the lower esophageal sphincter (LES), a muscular ring that separates the esophagus from the stomach.

As estrogen levels decrease, the LES may weaken, allowing stomach acid to flow back into the esophagus more easily.

This weakened LES can lead to more frequent and severe episodes of acid reflux and heartburn. 

Lactose Intolerance

Lactose intolerance is a common digestive disorder characterized by the inability to fully digest lactose, a sugar found in dairy products.

During menopause, hormonal changes, particularly the decline in estrogen, can influence lactose intolerance.

Estrogen is known to promote the production of lactase, the enzyme responsible for breaking down lactose.

As estrogen levels decrease, the body may produce less lactase, making it more challenging to digest lactose.

This reduction in lactase digestive enzyme activity can result in symptoms such as bloating, gas, diarrhea, and abdominal discomfort when dairy products are consumed.

Food Sensitivities

Food sensitivities refer to adverse reactions or discomfort experienced after consuming specific foods.

During menopause, hormonal changes, including the decline in estrogen, can influence food sensitivities.

Estrogen plays a role in regulating the immune system and maintaining the gut lining's integrity.

As estrogen levels decrease, the immune response may become more reactive, potentially triggering food sensitivities.

Women in menopause may find that foods they previously tolerated without issue now lead to symptoms like bloating, gas, diarrhea, or abdominal pain.

These symptoms can be indicative of food sensitivities, such as gluten or certain FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).

Hormonal fluctuations can make the digestive system more susceptible to irritation by specific food components.


Gallstones are hardened deposits that form in the gallbladder, a small organ that stores bile produced by the liver.

During menopause, hormonal changes can impact gallstone development.

Estrogen influences the composition of bile, which aids in fat digestion.

As estrogen levels decline in menopause, changes in bile composition can occur, potentially leading to the formation of gallstones.

These gallstones can vary in size and may obstruct the gallbladder or bile ducts, causing symptoms such as intense abdominal pain, nausea, and vomiting.

Hormonal fluctuations during menopause can also affect gallbladder motility, making it less effective at emptying bile, which can contribute to gallstone formation.

Small Intestinal Bacterial Overgrowth (SIBO)

SIBO is another digestive disorder that can affect menopausal women.

It's a medical condition characterized by an abnormal increase in the number and/or types of bacteria in the small intestine.

Normally, the small intestine contains a relatively low level of bacteria compared to the large intestine (colon).

However, in cases of SIBO, bacteria that are typically found in the colon migrate or overgrow into the small intestine.

GI Inflammation in Menopause

Strategies for improving Gut Health During Menopause

ImpOrtance of a healthy gut 

Maintaining a healthy gut is always important, but it becomes even more crucial during menopause.

A healthy gut can help alleviate digestive symptoms and can also support hormonal balance and overall well-being.

In The Meno Method 30 - Day Program, week 3 is dedicated to teaching you about the Gut Microbiome and sustaining a healthy gut. 

One of the biggest take aways is the importance of diversifying your gut bacteria at this time. 

Varying the types of fruits and vegetables is key for keeping the gut bugs healthy, happy and living in harmony within you.

Implementing probiotics and prebiotics

One way to improve your gut health is by incorporating probiotics and prebiotics into your diet.

Probiotics are beneficial bacteria that can help restore the balance of gut microbiota.

They can be found in fermented foods like yogurt, kefir, and sauerkraut.

Prebiotics, on the other hand, are the food for these good bacteria.

They can be found in foods like bananas, onions, and garlic.

By adding more probiotic and prebiotic-rich foods to your diet, you can promote the growth of healthy bacteria in your gut, supporting digestion and hormonal balance.

The Role of Exercise in Maintaining a Healthy Gut

Exercise is not just great for your overall health, but it can also benefit your gut health.

Regular physical activity has been shown to increase the diversity and abundance of healthy gut bacteria.

So, get moving!

Whether it's going for a walk, attending a fitness class, or bouncing on a rebounder 5 minutes per day, find activities that you enjoy and make them a part of your routine.

Diet and Lifestyle Modifications 

Adopting a hormone Friendly Diet

When it comes to managing digestive symptoms during menopause, adopting a hormone-friendly diet can make a big difference.

This means incorporating foods that support hormonal balance and gut health.

Focus on whole, unprocessed foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats.

Limiting your intake of sugar, processed foods, and alcohol can also help reduce digestive discomfort.

Managing Symptoms through Diet Adjustments

Certain foods can trigger digestive symptoms like bloating and gas.

However, food sensitivities can also show up in skin conditions, sleep issues and many other tissues or organs of the body.

Pay attention to how your body reacts to different foods and make adjustments accordingly.

For example, if you notice that dairy, gluten, wheat or any food chemicals worsen your symptoms, you may want to reduce or eliminate them from your diet.

Keeping a food diary can help you identify potential trigger foods and help you make informed dietary choices.

If you are aware that coffee creates bowel symptoms, you might want to consider drinking peppermint tea instead. 

I personally drink Yogi Tea's "Stomach Ease" when my belly is feeling "off".

It is a blend of Indian Ayurvedic herbs combined with peppermint and licorice root.

Or, if you're a coffee lover like me, you can choose a low histamine and low acid coffee like Purity.

Stress management Techniques 

Stress can wreak havoc on your gut health and digestive system.

Finding effective stress management techniques can help alleviate digestive symptoms.

Whether it's through meditation, deep breathing exercises, finding a yoga teacher, or making simple changes, prioritize stress reduction in your life.

Your gut will thank you.


The intricate relationship between menopause and digestion is undeniable.

Hormonal changes during this transformative phase of life exerts a profound influence on digestive health. 

As estrogen levels decline, the digestive system undergoes a series of shifts, impacting everything from stomach acid production to gut motility. 

Therefore, understanding these connections empowers women to take proactive steps to manage their digestive health during menopause.

Through dietary adjustments, stress management, exercise, and, when necessary, consultation with healthcare providers, women can mitigate the discomfort and distress that often accompany menopausal digestive symptoms.

Prioritizing gut health during menopause is not just about alleviating physical discomfort; it's about enhancing overall well-being and quality of life.

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Hormones, Menopause and Digestion: How Gut Health Is Affected

menopause and digestion


October 26, 2023


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Dr. Bianca Beldini

I’m your Doctor of Physical Therapy, Acupuncturist, Master Dry Needler, and Triathlon and Running Coach. I’ve been in the health, wellness and fitness industry for over 25 years, and I’m here to help you reach your optimal health.