During perimenopause and menopause, beyond the well-known symptoms like hot flashes, insomnia, and vaginal dryness, many women also experience digestive issues. These issues affect 40 to 50% of women in perimenopause or menopause. Studies indicate that 80% of these women had never been diagnosed with these issues before, suggesting that menopause may play a significant role in their development.

The most common digestive symptoms include:

• Constipation: Defined by a decrease in the frequency of bowel movements combined with difficulty in evacuating. Constipation is the most common symptom among menopausal women. You can learn more about how menopause impacts digestive transit here.

• Diarrhea: This involves the rapid passage of overly liquid stools (less common during menopause, except in cases of increased intestinal permeability).

• Bloating: (see our article about bloating) Caused by the accumulation of intestinal gas, leading to abdominal discomfort. It’s essential to determine the cause, which could be food intolerances, gluten sensitivity, chronic candidiasis, or intestinal inflammation. 

• Abdominal Pain: This can be caused by bloating or by painful periods during perimenopause.

• Gastroesophageal Reflux Disease (GERD): Occurs when part of the stomach contents rise back into the esophagus, causing a burning sensation. It’s related to the malfunction of the muscle that closes this part of the digestive tract (a sort of valve). Overweight, alcohol consumption, smoking, and large meals can exacerbate GERD.

The Link Between Menopause and Digestive Transit

1. Hormonal Influence

You may have noticed during your menstrual cycle that hormones have a significant impact on digestive transit. During menopause, the drop in estrogen and progesterone levels affects the digestive system, although the exact mechanism is not fully understood. Research has mainly focused on transit issues in non-menopausal women.

However, it is known that at the beginning of the menstrual cycle, the increase in hormonal levels can cause diarrhea in some women. It is, therefore, logical to assume that this phenomenon persists during perimenopause when menstrual periods become irregular, and that it reverses during menopause as estrogen and progesterone levels drop, leading to constipation.

Menopause is a change of life created by hormonal changes, if you want to know more about that read our article about hot flashes and hormones.

2. Age

Age directly influences the severity of constipation and diarrhea in women. As women age, the prevalence and severity of constipation increase, while diarrhea becomes less common.

This can be explained by the aging of the colorectal apparatus. Additionally, reduced physical activity (which naturally massages the organs), poor diet (lacking sufficient protein and fiber), and inadequate hydration (some people lose their sense of thirst as they age) can all contribute to constipation during perimenopause.

3. Stress Levels

Stress levels are closely linked to constipation. Several studies have shown that tension and anxiety reported by patients are positively associated with the severity of constipation (i.e., the higher the tension and anxiety, the more severe the constipation).

During periods of stress, the body tightens its sphincters to prioritize cardiac function and send blood quickly to vital organs (this is the basic principle of stress). You've probably noticed that during intense stress, your heart races, you lose your appetite, you sweat, and physiological functions change to cope with the stress and enable your body to defend itself. Learn more about how stress affects menopause in this article.

Moreover, at menopause, mood-related symptoms (anxiety, mood swings, depression) can appear and impact digestive transit. The gut and brain are intimately connected through the vagus nerve (hence the term "second brain" for the gut).

Possible Solutions

If you suffer from constipation or bloating during menopause, several solutions can help.

1. Hydration

Maintaining good hydration is essential (1.5 to 2 liters of water per day). Proper hydration helps soften stools, making them easier to pass.

2. Diet (Fiber, Fruits…)

Consuming fiber can increase stool mass and volume, thereby improving frequency. Fiber is found in fruit skins, vegetables, legumes (lentils, chickpeas), and whole grains. However, some of these can be hard to digest and cause bloating. To reduce this effect, soak lentils overnight before cooking, or opt for semi-whole grains instead of fully whole grains. (more on diet tips on our Diet Tips for Managing Menopause Symptoms article)

3. Reduce Salt and Alcohol Consumption

Salt and alcohol can cause bloating and water retention, leading to a swollen abdomen. Avoid processed foods, chips, mustard, and other condiments, and choose either cooking salt or table salt, but not both. For alcohol, the health ministry recommends women limit themselves to one drink per day, and not every day.

4. Physical Activity

Physical activity helps strengthen abdominal muscles and naturally massages the organs during movement, aiding in the fight against constipation. Check out our Exercise and Menopause: Keeping Fit During Menopause article for tips on staying active.

5. Potassium Intake

Potassium is an effective mineral for combating bloating. It’s found in abundance in bananas, avocados, berries, dried fruits, and legumes.

However, if you have heart problems, water retention, or hypertension, be mindful of the sodium-potassium ratio and consult your doctor before increasing potassium intake.

6. Toilet Positioning

Did you know that when using the toilet, it’s better to position your feet elevated (knees closer to your chest) rather than flat on the floor? This posture promotes better alignment of the digestive tract.

So consider adding a small stool in your bathroom—your intestines and belly will thank you!

7. Chew Slowly

Digestion begins in the mouth through chewing. Proper digestion can’t happen if you don’t chew your food thoroughly.

Chewing slowly helps your body digest better and absorb nutrients that contribute to improving digestive transit.

8. Stress Reduction

As discussed, stress significantly impacts constipation. Try to reduce stress by engaging in physical activity, going for walks, or practicing meditation. The effects of stress on the body extend beyond constipation, so it’s beneficial to work on reducing stress for your overall happiness and well-being. Yoga often called as a major stress reduction technique is detailed in our Yoga for Menopause: Benefits and Poses article.

9. Abdominal Massage

You can also massage your abdomen in the natural direction of your digestive transit to help ease discomfort. Massage in a clockwise direction. Essential oils like basil or tarragon are great allies for soothing your stomach as they have antispasmodic properties.

Apply 3 to 5 drops in a tablespoon of hazelnut oil, for example, and use this mixture to perform gentle circular massages in a clockwise direction.

If, despite all this, you continue to experience digestive issues that affect your daily life, consult your doctor. These digestive problems may require treatment or could have underlying pathological causes.

How Amira Can Help You

Amira offers a natural and innovative solution to support women during menopause, especially when dealing with digestive issues. Terra, one of the flagship products in the Amira range, is specifically designed to help alleviate menopause-related symptoms, including digestive issues such as constipation and bloating.

Terra works by rebalancing the hormonal system and supporting gut health, both of which are essential for maintaining regular transit. By incorporating natural and proven ingredients, Terra helps to reduce digestive discomfort, allowing women to navigate this phase of their lives more smoothly.

The Amira team understands the importance of natural solutions that respect your body’s balance while being effective. Amira’s products, such as Terra, are designed to easily integrate into your daily routine and enhance your overall well-being.

Don’t hesitate to explore the solutions offered by Amira to regain better digestive comfort and an improved quality of life during menopause.

Based on Sandrine Mathez expertise, Pharmacist