Not just hot flashes: a family doctor explains why the gut 'rebels' during menopause

During perimenopause and menopause, bloating, cramping, a feeling of pressure or tension often appear unexpectedly, and sometimes it becomes a challenge to digest previously usual food. According to Rita Simonaitytė, a family doctor at the 'Rezus' clinic, during this period of life, women's digestive tract can be particularly sensitive to hormonal changes. Therefore, it is important to take care not only of nutrition and physical activity but also of emotional health - the gut is rightly called the 'second brain'. 

How hormonal changes affect the gut

According to Dr. R. Simonaitytė, during perimenopause (4–10 years before menopause), the balance of the main sex hormones - estrogen and progesterone - in a woman's body begins to change. These hormones affect not only mood or sleep but also the digestive system and overall body condition. Hormonal changes during perimenopause and menopause often affect the digestive system, so women may experience various unpleasant symptoms. Fluctuations in estrogen and progesterone slow down metabolism, change bowel motility, so bloating, a feeling of heaviness or fullness in the intestines, constipation, belching after meals, or even changes in appetite often occur.

During this period, it is especially important to take care of the balance of gut microbiota. Probiotics, prebiotics, and fibers play an important role. Probiotics are live beneficial bacteria that help maintain a healthy gut microflora, reduce bloating, and strengthen immunity. Prebiotics are nutrients that feed good bacteria and promote their multiplication. They are abundant in garlic, onions, leeks, asparagus, as well as bananas, apples, and oats. Fibers, found abundantly in vegetables, fruits, legumes, and whole grain products, ensure regular bowel function, reduce the risk of constipation, and help stabilize blood sugar levels. Regular consumption of these nutrients can not only improve digestion but also positively affect mood and overall well-being during this sensitive period of life.

It is very important to monitor your body if constipation, abdominal pain, or other symptoms that were not present before start to persist, as these are signals to consult a doctor.

What to eat to feel better?

During perimenopause and menopause, it is worth including quality sources of good fats in your diet, such as olive oil, avocados, nuts, fatty fish, and cod liver. 'Good fats help maintain cell elasticity, improve metabolism, and contribute to detoxification processes. They are also essential for the functioning of sex hormones', says R. Simonaitytė.

It is very important to ensure an adequate amount of protein during this period. Proteins are extremely important because they help slow down the natural loss of muscle mass, which occurs faster during this life stage due to hormonal changes. In addition, proteins contribute to a longer feeling of satiety, thus helping to control weight and reduce the likelihood of emotional overeating. An adequate amount of protein ensures higher energy levels and better daily well-being.

The World Health Organization (WHO) recommends getting at least 1.0–1.2 g of protein per kilogram of body weight daily to maintain muscle mass, bone strength, hormone function, and the immune system. Meanwhile, women who are physically active, exercise, or aim to preserve and restore muscles are advised to increase their protein intake to 1.2–1.5 g/kg of body weight per day.

'During perimenopause and menopause, it is important to eat more protein, reduce simple carbohydrates and saturated fats. We should consume a larger portion of the day's food early in the day, and enjoy desserts until 14–15 hours. Moreover, alcohol can enhance various symptoms associated with hormonal changes, so its consumption should be limited or completely avoided,' advises the doctor.

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