Let's talk gas. 

No one does, right? It's humiliating, and few of us want to talk about embarrassing bodily functions at this stage of life. But digestive issues happen: gas, menopause bloating, irregularity, stomach cramps in older women can all be a whole lot worse in perimenopause and menopause. Even women who've rarely experienced these issues previously can suddenly find there are no "safe" foods anymore, and anything they eat is likely to cause public embarrassment.

Why do digestive issues happen in perimenopause and menopause?

First, we should make it clear that flatulence isn't really a "problem." According to metabolic surgeon, gut expert, and frequent Gennev podcast guest Dr. Erika La Vella, gas is how you know those gorgeous little bacteria are doing their jobs in your gut. Unfortunately, society has turned this process into an embarrassment, so most of us are still pretty eager to keep it under control.

Why does it happen more at this stage of life? Among its many other tasks, estrogen also helps regulate cortisol – the “fight or flight” hormone triggered by stress. So when estrogen starts declining around menopause, suddenly stress becomes a lot more … stressful.

Can hormone imbalance cause digestive problems?

Not only do our reactions to stress become a bit more extreme, our ramped-up cortisol has the add-on effect of slowing down digestion of food. That can lead to a host of digestive disorders like gas, bloating and constipation in menopause.

But like so much of menopause, you don’t have to simply endure the symptoms. Where once there was estrogen, now there are lifestyle changes.

1. Regain your balance with phytoestrogens - Because part of the problem here is a decrease in estrogen, eating phytoestrogens that mimic what’s lost can help relieve the problem. Where to get them: Think soy (tofu, tempeh, miso), veggies (beans, potatoes), fruits (dates, apples), seeds (flax, sesame), grains (oats, barley), mint, ginseng, fennel, and anise, among other sources.
2. Get more magnesium - Magnesium does a lot of good stuff for menopause symptoms, not least of which is helping to relieve digestive issues like flatulence and constipation. (It can also help minimize menopausal mood swings, keep bones strong, support your immune system, and regulate heart beat, so… you know… go get you some.) Where to get it: Don’t go too crazy, since too much magnesium can cause diarrhea, but you can find it in leafy veggies like spinach and beet greens, whole grains, sweet potatoes, peanuts, oat bran, cornmeal, some fish (mackerel), tomatoes, figs, avocados, bananas, peanuts, pumpkin seeds, and (woot!) dark chocolate. Try our magnesium supplement for women in menopause.
3. Boost your happy bacteria - Estrogen and progesterone fuel bacteria in your gut, so a decline in these hormones can disrupt and reduce healthy gut flora. Lots of good gut stuff crowd out the bad stuff, so when you lose the good guys, the bad bacteria can move in and really mess stuff up. Feeding your beneficial flora helps you keep a better gut balance. Where to get it. To support good gut guys, bump up fermented foods (miso, kombucha, sauerkraut) and consider a probiotic supplement.
4. Fiber up - It seems like I type “eat more fiber” a lot, but those of us who live in the West tend not to get enough and it’s really good for us. Fiber tidies up your digestive bits, keeping things moving along and not letting semi-digested matter bog down in your system where it gets bored and starts causing trouble. Where to get it. The best high-fiber foods are split peas, lentils, black and lima beans, artichokes, peas, broccoli, Brussels sprouts, raspberries, and blackberries. Whole grains are also good (popcorn, oatmeal, brown breads and pastas). We also recommend taking some of the best fiber supplements for menopause
5. Go natural - Ginger tea and peppermint tea are good, long-standing, natural remedies.
6. Hydrate, sleep, exercise, quit smoking - Is there any menopause symptom that can’t be made better by drinking more water, sleeping more, moving more, and quitting smoking for your estrogens sake? Maybe, but many symptoms are improved and doing these won’t generally make matters worse!
7. Chew slowly - This may seem silly, but when you’re eating on the go, or in front of your computer, or while distracted by a device, you’re not paying attention. How you eat may be nearly as important as what you eat. Chewing slowly, taking your time, being thoughtful and in-the-moment can reduce stress, keep you from ingesting a lot of air, and help your digestive system by breaking food down right from the start. Side note about chewing gum. You might want to cut back on that. Sorbitol (the artificial sweetener in many sugarless gums) and the extra air you swallow can make digestive problems worse.

When menopause and stomach issues may be more serious

Ovarian cancer symptoms can mimic some of the digestive issues perimenopausal and menopausal women contend with, including bloating, fullness, and abdominal pain. If you have these symptoms frequently (12 or more times a month), if they persist, and if you also have to urinate urgently and often, or experience unexplained weight loss, you need to talk with your doctor.

Additionally, many women become more sensitive to certain foods as they age. Many of us find dairy is harder to digest, meaning cheese, ice cream, etc. can cause more ... concerns than they used to. Some women find carbohydrates more difficult to digest, some believe cutting down on sugar helps (and we're big supporters of cutting down sugar and avoiding other foods in menopause). If you think your food may be causing the problem, try cutting down on the suspect food group for a while and tracking progress.

Another risk of digestive issues may seem trivial, but it's really not — self-isolation and potentially, subsequent depression. Women are particularly vulnerable to perimenopause depression or other emotional issues, and social support can be critical to helping us through them. If you cut back on activities because of a fear of social embarrassment, you're missing out on some very important emotional health. If it's an issue, try fasting a while before meeting people, or carrying Pepto Bismol, or eating lightly when out with friends. Chances are, if your friends are women of a similar age, you're not the only one with this fear.

Digestive troubles can be annoying, and if bad enough, humiliating and isolating. But a few lifestyle changes and informed diet choices can provide considerable relief.  

We can help you manage your digestive issues

• Meet with a Gennev Doctor - our board-certified gynecologists are menopause specialists who can help you understand how your digestive issues may be related to menopause, and prescribe a treatment plan to help you find relief.
• Try Vitality – Support your whole body with Gennev’s nutrient-packed multi-vitamin supplement. It helps to alleviate inflammation and joint pain, lift your mood, increase energy, support stress response and immune health.

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.