October marks Menopause Awareness Month, and while it is a natural life stage that most women go through, that doesn’t make the changes it brings any easier. Alongside hot flushes, sleep struggles and mood shifts, many women also experience changes in their digestion, with symptoms such as bloating, reflux, constipation, and often unexplained weight gain. If you’re experiencing these, let’s delve into what exactly is going on and how you can empower yourself with science-backed tips to help relieve your symptoms.
We’re thrilled to partner with Dr. Megan Rossi on “The Gut Health Doctor” range, bringing you delicious, plant-packed recipes made with Bio&Me’s live and active culture kefir, designed to support your gut while keeping mealtime tasty and easy.
Written by Dr Megan Rossi (PhD, RD), Founder of The Gut Health Doctor
Sluggish stomach, shifting hormones
Progesterone (one of the main hormones responsible for your menstrual cycle) also plays a key role in how efficiently food moves through your digestive tract. As levels decline during perimenopause and menopause, gut motility often slows. That can mean longer transit times, more bloating, and an increased likelihood of reflux.
The midlife microbiome mix-up
Oestrogen (another key group of sex hormones that supports the menstrual cycle and broader health areas, including bone density) also helps shape the gut microbiome, the trillions of microbes that live in your digestive system. Lower oestrogen is linked with reduced gut bacteria diversity and changes in the balance of anti-inflammatory bacteria found in your gut microbiome. One 2022 study including 2,300 participants found that postmenopausal women had lower gut bacteria diversity compared to premenopausal women, whereas there were no major differences between younger men and older men, highlighting it’s due to the menopause and not age. These shifts may also increase gut permeability, sometimes called “leaky gut”, and play a role in low-grade inflammation.
The metabolism dip
Hormonal changes influence not just the gut itself but also how your body stores energy. Falling oestrogen levels can affect insulin sensitivity (how our body regulates blood sugars) and promote fat storage around the abdomen. This explains why men of all ages tend to gain weight centrally, whereas prior to perimenopause, weight gain tends to occur more so around the hips and thighs in women. An imbalance in the gut microbiome is also likely to be involved, interacting with metabolic pathways and appetite hormones that can promote weight gain (including GLP-1 hormone, the target hormone for the new generation weight-loss drugs like Ozempic and Mounjaro).
The role of estrobolome
But here comes some good news. The gut:hormone connection works both ways, meaning the gut can actually play a key role in supporting you at this stage of your life, too. This is where the estrobolome comes in. When ‘old’ oestrogen reaches the gut after its tour of the body, it is either expelled in poop or a group of gut bacteria (known as the estrobolome) produces an enzyme, beta-glucuronidase that, in effect, reactivates it. This recycled oestrogen then gets pushed back into the blood, where it can get to work again. That’s why, as women enter their 40s and 50s and oestrogen production starts to wane, having a thriving estrobolome may help delay the onset of menopause and, when it does hit, protect against more aggressive symptoms. This is thought to explain why one study showed that women who ate legumes and oily fish daily (both gut-nourishing foods) were likely to reach menopause 4 years later than those who rarely consumed those foods.
With the latest research on our side, here are six science-backed diet strategies I recommend for helping to ease menopause-related symptoms:
- Fill up on fibre: Aim for at least 30g a day from a wide variety of sources across the Super Six (vegetables, fruits, wholegrains, legumes, nuts and seeds, herbs and spices). Not only does a mix of these dietary fibres keep things moving, but when fermented by your gut microbes, short-chain fatty acids are produced, which can help combat a leaky gut and support appetite regulation. You’ll find plenty of inspiration from my fibre-rich Mindful Chef recipes, which all pack over a third of your recommended daily fibre.
- Maximise plant diversity: Different plant foods contain different fibres and phytochemicals. So eating with variety in mind helps to encourage a resilient and diverse microbiome (often used as a marker of good health). Over the next three months, gradually increase your vegetable intake to 5x servings, fruit to 2x servings per day, wholegrains to 3x portions, nuts and seeds to 1-2x portions, and legumes to 1-2x portions daily. ( 1x serving veg = 1/2 cup cooked veg or 1 cup salad. 1x serving fruit = 80g fresh or 30g dried. 1 x serving of wholegrains = ½ cup cooked. 1x serving nuts and seeds = 1-2 tbsp).
- Embrace fermented foods: Yoghurt, kefir, sauerkraut and kimchi provide not only extra live microbes but an array of bioactive chemicals, including blood-pressure-lowering peptides specifically in yoghurt and kefir.
- Add in some oily fish: The long-chain omega-3 found in oily fish has not only been linked with bigger brains, including areas that govern memory (goodbye brain fog!), but is thought to support your gut’s estrobolome, the bacteria that help regulate oestrogen levels.
- Add soy beans daily: research shows that adding just ½ cup per day can help with menopause-related symptoms, including hot flushes. This is thanks to phytoestrogens (plant compounds with mild oestrogen-like effects), which can be found not only in soy beans, but also in flaxseeds and other legumes.
- Be mindful with supplements: research from SMART STRAINS® shows that women going through perimenopause and menopause are spending big on supplements, particularly probiotics, with 20% spending between £351 and £500 annually, and 10% spending more than £500. Yet most report they don’t notice a benefit! Ultimately, that’s not because probiotics don’t work, but choosing a ‘generalised’ product has no real benefit. Instead, research shows it’s important to get specific. For example, if you’re experiencing vaginal imbalance (commonly reported during menopause), the two specific types of bacteria (scientifically known as strains), Lactobacillus acidophilus La-14® and Lactobacillus rhamnosus HN001™, combined with lactoferrin, have been shown in clinical trials to reduce symptoms and recurrence of issues like thrush and bacterial vaginosis. Meanwhile, if your immune system needs additional support during this time, the combination of Lactobacillus rhamnosus, LGG®and Bifidobacterium lactis, BB-12 bacterial strains has been shown to reduce the length and severity of symptoms vs placebo. So when it comes to probiotics, think the right strain, at the right time, in the right way.
Red flags to look out for
It’s always worth being on the safe side, so if you experience any of the below, check in with your GP, who can rule out other, sinister causes of symptoms such as bowel or ovarian cancer:
- Uncomfortable and constant bloating that doesn’t fluctuate across the day.
- Unexplained weight loss (5% of your bodyweight).
- Blood in your stool (which may look red or black).
- Persistent changes in bowel habits (that aren’t usual for you).
- Fatigue or tiredness that doesn’t improve with rest.
For more science-backed advice from Dr Megan Rossi, visit: https://www.theguthealthdoctor.com
You can also find delicious plant-packed & fibre-fuelled recipes from Dr Megan Rossi on the Mindful Chef menu every month. Just look out for The Gut Health Doctor badge.