Menopause and Constipation: Unlocking the Secrets to Relief

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One common, but often overlooked, symptom of menopause is constipation. Menopause is a completely natural part of aging but it is a time of significant hormonal upheaval in the body.

Changes in hormone levels, particularly a decrease in estrogen, can contribute to a sluggish gut and constipation.

While constipation can be uncomfortable and inconvenient, it is treatable. This article will explore the link between menopause and constipation, discuss common symptoms, and suggest options to help manage if constipation is becoming a problem for you.

Can menopause cause constipation?

Menopause can cause constipation due to changes in hormone levels of estrogen and progesterone. Low hormone levels can affect the digestive tract in several ways:

Reduced muscle tone: Estrogen helps to maintain the tone and strength of the muscles in the digestive tract, as well as the pelvic floor. As estrogen levels decline, passing stool completely can be a challenge due to weakened pelvic floor muscles. Chronic straining can make this worse by further weakening the pelvic floor.

Altered gut motility: Estrogen and progesterone also affects the contractions of the smooth muscles in the gut, which help to propel food through the digestive tract. Slower transit time of stools through the colon can lead to increased drying out, resulting in small, dry, and hard to pass stools.

Changes in gut microbiota: Estrogen has been found to influence the composition of gut microbiota, the trillions of beneficial bacteria that reside in our intestines and play a crucial role in digestion. Alterations in estrogen levels during menopause can impact the diversity and balance of gut microbiota, which can potentially cause digestive issues.

Increased stress hormones: Estrogen plays a role in regulating cortisol, which is a stress hormone in the body. When estrogen levels decline, cortisol levels can increase. Elevated cortisol levels can slow down the digestive process, reducing movement in the colon and potentially leading to constipation.

Increased joint and back pain:  During the menopausal transition, some women may experience increased joint and back pain, which can limit their mobility and hinder regular movement. Since exercise is known to help regulate digestion, this disruption in mobility can also contribute to constipation.

Unfortunately, there is evidence that those who struggled with irritable bowel syndrome (IBS) symptoms prior to menopause may find that their symptoms worsen during the transition.

Symptoms of constipation during menopause

The symptoms of constipation during menopause are like those of constipation in general. These may include:

  • Infrequent bowel movements: Having fewer than three bowel movements per week is considered constipation.
  • Hard stools: Stools that are dry and hard, resembling rabbit pellets.
  • Straining during bowel movements: stool is difficult to pass, requiring significant pressure.
  • Bloating and abdominal pain: Constipation can cause bloating and discomfort in the abdomen due to the accumulation of waste in the large intestine.
Bristol Stool Chart.

Treating menopause constipation

The good news is that there are many options available to help alleviate constipation. One or two small changes to your lifestyle may be all you need.

Diet changes to help constipation

Increasing your intake of fiber and fluids can help to soften stools and make them easier to pass. There are two main types of dietary fiber:

  1. Soluble fiber: This type of fiber dissolves in water and forms a gel-like substance in the gut. It helps to soften the stool and make it easier to pass. Good sources of soluble fiber include oats, beans, lentils, flaxseed, chia seeds, apples, and citrus fruits.
  2. Insoluble fiber: This type of fiber does not dissolve in water and passes through the digestive tract largely unchanged.  It adds bulk to the stool and helps to move it through the digestive tract. Good sources of insoluble fiber include whole grains, vegetables, nuts, seeds, and fruits with edible skins.

It’s best to consume a variety of high-fiber foods with both soluble and insoluble fiber as part of a balanced diet to support digestive health and alleviate constipation.

List of high fiber foods to boost your fiber intake.

Remember to increase fiber intake gradually and drink plenty of water to help prevent digestive discomfort. Recommended intakes of dietary fibre do differ around the world and by age group, but 25-30 g or more daily is widely suggested.

Check out this FREE printable high Fiber foods chart.

You could also try increasing your intake of foods naturally high in sorbitol. Sorbitol is a type of sugar alcohol that can act as a natural laxative due to its ability to draw water into the intestines, resulting in increased stool volume and softer consistency. When consumed in larger amounts, sorbitol can help stimulate bowel movements and relieve constipation.

Dried fruit and fresh stone fruits tend to have the highest amounts of sorbitol: prunes, dates, raisins, peaches, apricots, cherries and plums as well as blackberries.

As well as small study conducted last year found that eating 2 kiwi fruit a day was found to be as effective as taking psyllium fibre(Metamucil) for chronic constipation.

Regular physical activity

Exercise can help to stimulate the muscles in the digestive tract, which can aid in bowel movements. Some of the best exercises for constipation include:

  • Walking: Walking is a low-impact exercise that can help stimulate the natural contractions of the intestines and promote bowel movements. Aim for brisk walks of at least 30 minutes per day, most days of the week.
  • Yoga: Certain yoga poses, such as the Wind-Relieving Pose (Pawanmuktasana), the Child’s Pose (Balasana), and the Cat-Cow Pose (Marjaryasana-Bitilasana), can help stimulate digestion, relieve gas, and promote bowel movements.
  • Abdominal exercises: Exercises that engage the abdominal muscles, such as crunches, leg raises, and pelvic floor exercises (Kegel exercises), can help improve muscle tone in the abdominal area, which can aid in bowel movements.

Over-the-counter medications

There are several over-the-counter medications that can help to relieve constipation including:

  • Fiber supplements: These medications contain natural or synthetic fibers that add bulk to the stool, making it easier to pass. They work by increasing the water content in the stool, which helps to soften it and promote regular bowel movements. Common supplements include Psyllium husk (Metamucil), Methylcellulose (Citrucel)and Wheat dextrin (Benefiber).
  • Stimulant laxatives: Medications such as Bisacodyl (Dulcolax) and Senna (Ex-lax, Senokot) stimulate the muscles in the intestines to contract, helping to move the stool along and promote bowel movements.
  • Osmotic laxatives: Polyethylene glycol (MiraLAX), Lactulose and Magnesium hydroxide (Milk of Magnesia) or magnesium citrate work by drawing water into the intestines, which softens the stool and promotes bowel movements.
  • Stool softeners: Docusate sodium (Colace) or Docusate calcium (Surfak) work by increasing the water content in the stool, making it softer and easier to pass. They are typically used for short-term relief of constipation, especially for those who need to avoid straining during bowel movements.
  • Lubricants: Common stool lubricants are typically classified as mineral oil-based laxatives, such as mineral oil. They work by coating the stool and the lining of the intestines, making it easier for the stool to pass through.

When should I seek medical help?

Having to deal with the occasional bout of constipation is expected during menopause. However it’s important to seek medical advice from a healthcare provider:

  • If it persists for an extended period, such as more than two weeks, despite self-care measures and lifestyle changes.
  • It is accompanied by severe pain or discomfort.
  • If there is blood in your stool.
  • You have a family history of colon cancer or other gastrointestinal disorders.
  • You are taking medications that may affect bowel movements or have recently made changes to your medications.

Annoying as it is, there are effective strategies to manage and alleviate symptoms. By incorporating fiber-rich foods, drinking enough water, exercising regularly, and taking medication if needed, you can take proactive steps towards better digestive health. Don’t suffer in silence, I am here to help you develop a personalized nutrition plan to help you thrive in menopause.

FAQ: Constipation and Menopause

Q: Can menopause cause constipation?

A: Yes, hormonal changes during menopause can disrupt normal bowel movements and contribute to constipation in some women.

Q: Why does menopause affect bowel movements?

A: Menopause can cause hormonal imbalances, such as decreased estrogen and progesterone levels, which can affect muscle tone in the digestive tract, slow down digestion, and impact bowel movements.

Q: What are some common symptoms of constipation during menopause?

A: Common symptoms of constipation during menopause may include infrequent bowel movements, difficulty passing stool, bloating, discomfort, and a feeling of not being able to pass stool completely.

Q: Are there lifestyle factors that can worsen constipation during menopause?

A: Yes, lifestyle factors such as lack of physical activity, low water intake, poor dietary choices low in fiber, high stress levels, and certain medications can worsen constipation during menopause.

Q: What dietary changes can help with constipation during menopause?

A: Incorporating a fiber-rich diet with plenty of fruits, vegetables, whole grains, and legumes, staying well-hydrated, and maintaining regular physical activity can help promote regular bowel movements and relieve constipation during menopause.

Q: Are there any natural remedies for constipation during menopause?

A: Some natural remedies for constipation during menopause include drinking a hot drink such as coffee or warm water with lemon in the morning, consuming prunes or prune juice, and incorporating foods with natural laxative properties such as prunes, dates or kiwi fruit.

Q: Is it important to manage constipation during menopause?

A: Yes, managing constipation during menopause is important for maintaining optimal digestive health, preventing discomfort, and improving overall well-being during this transitional phase of life.

Q: When should I seek professional medical advice for constipation during menopause?

A: If constipation persists despite lifestyle changes and home remedies, or if you experience severe symptoms such as severe abdominal pain, blood in stool, or prolonged changes in bowel habits, it’s important to seek professional medical advice from a healthcare provider.

Q: Can a registered dietitian help with constipation during menopause?

A: Yes, a registered dietitian who specializes in nutrition for menopause can provide personalized dietary recommendations, lifestyle modifications, and support to manage constipation during menopause.

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Sandra Turnbull

Sandra has 30+ years experience as a Registered Dietitian and Certified Executive Coach, and is passionately committed to sharing evidence-based information while helping women thrive during the monumental transition that is menopause.

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Sandra Turnbull

Sandra brings over three decades of expertise both as a Registered Dietitian and a Be Body Positive facilitator. As a fellow midlife adventurer herself, she is committed to providing evidence-based guidance and compassionate support to women navigating the pivotal journey of menopause. For her it’s about nurturing bodies and minds with kindness and understanding, knowing its not just about what is on your plate; it’s also about how you feel in your skin.

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