Menopause is a natural phase of a woman’s life that brings about significant changes in her body and overall well-being. While most people are familiar with common menopause symptoms such as hot flashes and mood swings, there’s one symptom that often goes under the radar: diarrhea.
Yes, you read that right! Diarrhea can be an unexpected and bothersome companion during menopause, causing discomfort and disrupting daily routines.
Let’s delve into the connection between menopause and diarrhea, explore the potential causes, and find effective management strategies.
What is diarrhea?
According to the Canadian Society of Intestinal Research diarrhea is defined as the frequent passage of watery, loose stools, accompanied by an excessive loss of fluid and electrolytes. Generally, this means passing more than three liquid bowel movements daily.
Causes of diarrhea during menopause:
Hormonal fluctuations: Changes in sex hormones can impact the digestive system and contribute to diarrhea during menopause. Interestingly, the gut symptoms you experience during menopause may be like those experienced around your monthly menses, when estrogen and progesterone dipped as part of your menstrual cycle. Those who experienced period poops know what I mean.
Estrogen is known to influence the gastrointestinal tract, affecting gut motility, sensitivity, and inflammation. Fluctuations in estrogen levels during menopause can disrupt the normal functioning of the gut.
Changes in gut bacteria: Menopause can bring about shifts in the composition of gut bacteria, known as the gut microbiome. These changes can disrupt the delicate balance of beneficial bacteria, leading to digestive issues, including diarrhea.
Stress and anxiety: It’s no secret that menopause can be accompanied by increased stress and anxiety. These emotional factors can impact digestion and contribute to gastrointestinal symptoms, including diarrhea. This study was the first to show that stress is associated with an increase in diarrhea severity in menopausal women. This result is in keeping with the literature regarding stress and diarrhea in other populations, where stress has been shown to increase GI permeability, a process that is associated with diarrhea.
Medications and hormone replacement therapy: Certain medications, including hormone replacement therapy (HRT), can have side effects that include diarrhea. HRT, commonly prescribed during menopause, aims to alleviate menopausal symptoms by supplementing declining hormone levels. However, some individuals may experience digestive problems, including diarrhea.
Food Sensitivities and Intolerances: Menopause often coincides with changes gut permeability so that some women may experience an increase in dietary triggers especially with dairy(lactose)foods, artificial sweeteners(mannitol, sorbitol)or alcohol.
Inflammatory Bowel Syndrome (IBS): IBS is a gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. While menopause does not directly cause irritable bowel syndrome (IBS), hormonal changes during menopause can potentially worsen or trigger ibs symptoms in individuals who are already predisposed to the condition. The exact relationship between menopause and IBS is not fully understood and may vary from person to person.
How can I stop menopausal diarrhea?
To help alleviate menopausal diarrhea, consider the following lifestyle changes and strategies:
Add Soluble Fiber:
Increasing your soluble fiber intake can help with stool consistency. Soluble fibers help to absorb water in the digestive tract, forming a gel-like substance. It also acts as a prebiotic, providing nourishment for beneficial gut bacteria. These bacteria ferment soluble fiber, producing short-chain fatty acids. These fatty acids help promote a healthy balance of gut flora and improve the overall health of the gi tract.
Consider adding foods such as oats, barley, legumes (beans, lentils), fruits (pears, apricots, avocado), vegetables (carrots, sweet potatoes, green peas), and chia seeds. Anytime you’re adding fiber to your diet it is a good idea to start low and go slow. Check here for a complete list of high soluble fiber foods. If gradually adding these foods causes your diarrhea to worsen, then you may be dealing with a food intolerance.
Eliminate Food Triggers:
With hormonal changes, you may find that foods you once tolerated well may now be harder for your body to digest. Keeping a food diary for a short period of time may can help you track which foods may be triggering your symptoms. Typical culprits could be lactose, fructose sugar alcohols, fatty foods and alcohol. If avoiding those foods isn’t helpful you may want to consider the FODMAP lite diet.
FODMAP lite diet:
The FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet can be helpful for various gastrointestinal conditions, including diarrhea. While the FODMAP diet is usually recommended for irritable bowel syndrome (IBS), it can also be used as a tool to identify and manage triggers for diarrhea.
The FODMAP diet involves avoiding or limiting certain types of carbohydrates that are poorly absorbed in the small intestine and can ferment in the colon, leading to symptoms such as bloating, gas, and diarrhea. These carbohydrates include fructans, galactans, lactose, fructose, and polyols (sugar alcohols).
This elimination diet is very restrictive, meant to be followed only for a short period of time and really requires the support of a dietitian.
Instead, you may want to try a modified version-the gentle FODMAP – which focuses on reducing only the highest FODMAP foods to see if that helps.
High FODMAP foods include wheat, rye, dairy products(lactose), legumes, apples, pears, dried fruit, stone fruits, watermelon, onion, leek, cauliflower and mushrooms. If symptoms improve after avoiding these foods, then you need to slowly start to re-introduce each food separately to find which ones are causing the problem.
I can’t stress enough how helpful a dietitian can be to ensure your diet remains nutritious if you have many food triggers.
Adequate hydration is crucial for maintaining healthy bowel function. Drink plenty of water throughout the day to prevent dehydration, which can worsen diarrhea. Avoid excessive consumption of caffeinated and sugary beverages as they may contribute to diarrhea. Herbal teas and infused water can be hydrating alternatives.
Menopause can be accompanied by increased cortisol levels leading to increased stress and anxiety. This can exacerbate digestive symptoms. Incorporate stress-reducing techniques into your daily routine, such as deep breathing exercises, meditation, yoga, or engaging in hobbies that promote relaxation. Regular physical activity can also help reduce stress levels.
Probiotics are beneficial bacteria that support gut health. They can help regulate digestion and reduce diarrhea. Consider incorporating probiotic-rich foods into your diet, such as yogurt, kefir, sauerkraut, and kimchi.
Probiotic supplements may be helpful as well however It’s important to note that not all probiotics are the same, and different strains may have different effects. Additionally, the effectiveness of probiotics may vary depending on the individual and the specific cause of the diarrhea.
Over the counter medications:
Over-the-counter medications, include Imodium (loperamide) and Pepto-Bismol or Kaopectate (bismuth subsalicylate). These are meant for short term relief until the cause of the diarrhea can be found.
Psyllium (Metamucil) is generally considered safe and can help with mild to moderate diarrhea. Try 5 grams of psyllium husks, mixed with water or juice, one to two times per day. Be sure to take in extra fluids.
When should I seek help?
If menopausal diarrhea persists or significantly impacts your quality of life, it’s important to consult a healthcare provider.
This is especially true if it is accompanied by other concerning symptoms such as high fever, severe stomach pain, dehydration (excessive thirst, dry mouth, dark urine), or blood in the stool.
Remember, every individual’s experience with menopause and diarrhea is unique, so finding the right management approach may involve some trial and error. By understanding the causes and implementing strategies such as dietary modifications, soluble fiber intake, and probiotics, you can take steps towards finding relief and improving your digestive health. Remember, consulting with a registered dietitian can be immensely helpful in developing a personalized plan specific to your needs and gi issues.