Can perimenopause cause bloating?

Can perimenopause cause bloating?

In perimenopause, the amount of oestrogen and progesterone produced by your ovaries starts to gradually decline. These hormones are responsible for more than just regulating your menstrual cycle. 

The change in your hormone levels can lead to changes in all your body systems. Feeling like your gut is sluggish, over-full, bloated or your tummy is swollen is common in  perimenopause. The bloating is caused by a buildup of fluid, gas or poo. This can often be quite uncomfortable and might have an impact on your quality of life. 

Generally, perimenopause bloating will come and go. It can change based on what you have eaten, your hormone levels and periods. 

Our gut is reliant on oestrogen and progesterone to keep up its natural rhythm, so when the levels fall in perimenopause, your digestion can slow down¹. The result is often an increase in gas production, and sometimes constipation. This change in gut rhythm can also mean that your gut handles some foods differently than it used to, so your usual treats may be bringing you new and unexpected side effects.

Progesterone also has a diuretic effect (i.e it causes you to lose water). When your progesterone levels fall in perimenopause,  your body holds on to more water, which contributes to you feeling bloated. When our bodies hold on to water, we can also feel that we are gaining weight. 

A lot of women suffer from stomach bloating just before their period (because progesterone tends to be higher and constipation worse at that point in the menstrual cycle), and this can also occur in perimenopause, even if your periods are irregular. Bloating can be an issue in perimenopause whether you are having periods or not. 

To add to the issue, weight gain around the middle is also common in perimenopause (with or without bloating)^2,3. 

Many women in perimenopause who feel that their tummy is bloated or they are putting weight on, have their hormone levels to blame. However, there are also medical conditions that cause bloating. Common things include ovarian cysts, uterine fibroids (non-cancerous growth in the womb), and problems with the gut (such as IBS)⁴. If bloating is not getting better, you should speak to your doctor. You should speak to your doctor urgently if;

• Your tummy is bloated and you are losing weight.
• You have blood in your poo.
• You notice that your bowel habit has changed (i.e you are passing stool more or less often, over the course of a few weeks). 
• You have new or persistent urinary symptoms.

If perimenopausal bloating is slowing you down, there is no reason to feel ‘stuck!’. There are lots of things you can do to help get some relief from perimenopause bloating. 

Tips to reduce bloating during perimenopause 

There is no ‘one-size fits all’ answer to beat the bloating. Usually a combination of lifestyle habits and managing your diet will give you some relief. You could try; 

Exercise

Exercise regularly. When you get your body moving, you get your gut moving too⁵! Exercise in perimenopause can have a range of other benefits too.

Stress

Reduce your stress levels. When we are stressed, levels of a hormone called cortisol rises, which can slow down the gut and worsen perimenopause bloating.

Diet

• Keep a diary of what you are eating each day and when your bloating is at its worst. This can help you find out which foods are triggering the symptoms. You can then avoid these and help avoid kicking off your symptoms.

• Eat smaller meals. This helps to keep your gut moving and stops your digestion feeling overwhelmed. You might find it easier to eat little and often throughout the day. 

• Reduce the salt in the foods that you eat. When we eat foods that are high in salt, our bodies hold onto more water, so can make you feel swollen. 

• Drinking plenty of water is important as it helps your body flush out any excess salt and also helps put a stop to constipation, by making your stools softer⁶ . 

• Water or non-fizzy (non-carbonated) drinks are generally better than fizzy drinks.The gas in the fizzy drinks can make your tummy fill up with air, making bloating worse. 

• Try some foods that are thought to reduce bloating – peppermint, ginger, yogurt, and kefir may be helpful.

• Foods that are high in fibre help the gut contract well and move everything through

• Increasing your fibre intake and using a probiotic may help to keep your gut running smoothly and improve the good bacteria in your gut during perimenopause and menopause. 

Supplements

Magnesium supplements are one of our MUSTS during menopause. It may help with perimenopausal bloating by improving constipation and also reducing water retention. As a bonus, it can help with your sleep, mood swings and headaches⁷. 

Medication

• Hormone replacement therapy (HRT) might be an option for you if none of the above tips are helping. HRT aims to replace your declining hormone levels. Speak to your GP if you would like to consider this. 

• If you are suffering from constipation then you may need to use a gentle laxative. Your local pharmacy can offer advice on these. Examples include senna (which stimulates the gut to contract), or movicol, laxido or lactulose (which help to make the stools softer)

Bloating in perimenopause is very common and there are lots of tips you can try to get you back on track. Remember that if bloating is not improving or you have other symptoms along with bloating, then you should speak to your doctor. Some simple tests can make sure nothing else is going on.