How Menopause Affects Your Gut and What You Can Do About It
Understanding the connection between hormones and gut health
When we think about menopause, hot flushes and mood changes often come to mind first. But for many women, it is the gut that quietly signals something has shifted. Bloating, constipation, diarrhoea, and shifting digestion patterns are more common during perimenopause and beyond than most people realise, and there is a clear reason why.
How oestrogen and progesterone influence gut health
Oestrogen and progesterone do far more than regulate the reproductive system. Both hormones play an active role in how your gut functions, influencing digestion speed, the balance of gut bacteria, and how hormones are processed and recycled in the body.
Gut motility
These hormones help regulate the muscle contractions that keep food moving through the digestive tract. Higher oestrogen levels tend to speed things up, which can sometimes contribute to looser stools. Progesterone can slow digestion when levels are high, which is one reason constipation is common in the lead up to menstruation. As both hormones change during menopause, digestion can be altered, contributing to bloating and constipation.
Gut microbiome diversity
Oestrogen is linked with the diversity and stability of gut bacteria. During the reproductive years, higher oestrogen supports a more diverse microbiome. As levels decline during menopause, bacterial diversity can shift, sometimes leading to dysbiosis, an imbalance between beneficial and less favourable bacteria, which can affect digestion, inflammation, and gut barrier function.
Hormone recycling
Your gut and liver work together to process and recycle oestrogen through what is known as the gut-liver axis. When the gut microbiome has a higher diversity of beneficial bacteria, this process runs smoothly, supporting more stable hormone levels. As oestrogen declines and gut bacteria shift, this recycling process can be disrupted, further influencing both hormones and digestive health.
What changes during menopause
As oestrogen and progesterone decline, you may notice a range of digestive changes. These vary between individuals but commonly include:
Slower digestion — reduced motility can lead to bloating, constipation, and general abdominal discomfort.
Shifts in microbiome composition — reduced bacterial diversity may contribute to changes in bowel habits and greater sensitivity to certain foods.
Increased gut sensitivity — hormonal changes can make the gut more reactive, with symptoms like cramping and bloating becoming more noticeable.
Why gut health matters in menopause
Your gut influences much more than digestion alone. A healthy gut environment supports hormone regulation, immune function, bone health, and metabolic balance
Changes in gut health during menopause have been linked with:
• Differences in calcium absorption, which may affect bone density
• Variations in how oestrogen is processed and recycled
• Changes in inflammation and cardiometabolic health.
Taking steps to support your gut can improve digestive comfort and have positive effects on overall wellbeing during this transition.
Nutrition strategies to support gut health
Focusing on nutrition is one of the most effective ways to support both gut and overall health during menopause.
1. Prioritise plant diversity
Aim to include a wide range of fruits, vegetables, wholegrains, legumes, nuts, and seeds throughout the week. Research suggests that eating more than 30 different plant based foods weekly is linked with a more diverse and resilient gut microbiome.
2. Include prebiotic and probiotic foods
Prebiotics are fibres that feed beneficial gut bacteria, while probiotics provide live bacteria that may support a balanced microbiome.
Prebiotic rich foods: legumes, onions, garlic, wholegrains, pistachios, cashews
Probiotic rich foods: kefir, yoghurt, kimchi, miso, and sourdough
3. Support Gut Health with Omega 3s
Oily fish like salmon, sardines, and mackerel provide omega 3 fatty acids, which have anti-inflammatory benefits and may support gut balance. For those who do not eat fish regularly, an omega 3 supplement may be an option.
4. Maintain Vitamin D levels
Vitamin D plays an active role in gut health, supporting the gut barrier and a balanced microbiome. It also works alongside calcium to support bone health, which is particularly relevant during menopause. Include fatty fish, eggs, fortified foods, and mushrooms exposed to sunlight, and consider supplementing where needed as deficiency is common, especially through the winter months.
5. Manage stress for gut and overall health
Chronic stress can influence gut function, affect the microbiome, and trigger digestive symptoms. Mindfulness, breathing exercises, journalling, gentle movement and getting professional help can all support both gut health and stress management.
Final Thoughts
Menopause brings changes to the body, and gut health is no exception. Oestrogen plays a key role in gut motility, microbial diversity, and hormone recycling, and lower levels can influence how the digestive system functions.
Supporting your gut through nutrition, stress management, and lifestyle strategies can help improve symptoms, microbiome diversity, and promote overall wellbeing during this stage of life.
If you are experiencing gut symptoms through perimenopause or menopause, working with a dietitian can help you create a personalised plan that supports your gut and overall health.
Book an in person dietitian consultation in Canmore today or option for Telehealth consult for clients based in Alberta: Canmore, Banff, Calgary, Edmonton, Cochrane.
References
Rinninella E, Raoul P, Cintoni M, Franceschi F, Miggiano GA, Gasbarrini A, Mele MC. The gut microbiome and female health. Front Microbiol. 2021;12:591335. doi:10.3389/fmicb.2021.591335
Bridgewater LC, Zhang C, Wu Y, Hu W, Zhang Q, Wang J, et al. Sex differences and hormonal effects on gut microbiota composition in mice. Gut Microbes. 2020;11(5):1246–1261. doi:10.1080/19490976.2020.1733922
Wang J, Chen WD, Wang YD. The gut microbiome is altered in postmenopausal women with osteoporosis and osteopenia. Front Cell Infect Microbiol. 2021;11:631583. doi:10.3389/fcimb.2021.631583
Santos-Marcos JA, Rangel-Zuñiga OA, Jimenez-Lucena R, Quintana-Navarro GM, Garcia-Rios A, Tena-Sempere M, et al. Spotlight on the gut microbiome in menopause: Current insights. Maturitas. 2023;171:1–11. doi:10.1016/j.maturitas.2023.02.006
Kim HJ, Camilleri M. Probiotics and prebiotics: Any role in menopause-related diseases? Climacteric.2021;24(4):343–350. doi:10.1080/13697137.2021.1910921
Bourrie BC, Willing BP, Cotter PD. Kefir and intestinal microbiota modulation: Implications in human health. Front Nutr. 2020;7:63. doi:10.3389/fnut.2020.00063
Lin PY, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol Psychiatry. 2021;89(3):222–231. doi:10.1016/j.biopsych.2020.10.021
Yang J, Ma Y, Wang L, Li Y, Wu Z, Tian H, et al. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. Menopause. 2020;27(4):412–420. doi:10.1097/GME.0000000000001480
Charoenngam N, Holick MF. Exploring the role of vitamin D and the gut microbiome: A cross-sectional study of individuals with IBS and healthy controls. Nutrients. 2021;13(7):2323. doi:10.3390/nu13072323
Foster JA, Rinaman L, Cryan JF. The effects of stress and diet on the “brain–gut” and “gut–brain” pathways in animal models of stress and depression. Nat Rev Gastroenterol Hepatol. 2017;14(9):488–505. doi:10.1038/nrgastro.2017.75
Bailey MT, Dowd SE, Galley JD, Hufnagle AR, Allen RG, Lyte M. Psychological stress and gut microbiota composition: A systematic review of human studies. Brain Behav Immun. 2019;82:55–65. doi:10.1016/j.bbi.2019.07.002
Sudo N. Stress and the gut-brain axis: Cognitive performance, mood state, and biomarkers of blood-brain barrier and intestinal permeability following severe physical and psychological stress. Brain Behav Immun. 2019;80:222–232. doi:10.1016/j.bbi.2019.05.006
Valles-Colomer M, Falony G, Darzi Y, Tigchelaar EF, Wang J, Tito RY, et al. Stress, depression, diet, and the gut microbiota: Human-bacteria interactions at the core of psychoneuroimmunology and nutrition. Nutr Rev.2019;77(3):161–179. doi:10.1093/nutrit/nuy068
