Feeling bloated during menopause? You’re not alone. Bloating is a really common, often very uncomfortable symptom during menopause. It’s caused by a variety of factors, including hormone changes. Fluctuating estrogen and progesterone can lead to changes in digestion and fluid retention. Keep reading to discover the common causes of bloating and more importantly what you can do to get some relief.
What does menopause bloating feel like?
I hear a lot of women complain about their menopause belly or ‘menno-belly.’ It is important to distinguish between the normal body composition changes that happen – gaining additional fat around our middle- with that of bloating.
Weight gain around our middle may make us feel unhappy or uncomfortable but it is not the same as bloating.
Common symptoms of bloating:
- Abdominal fullness or tightness
- Distended stomach
- Increased burping
- Increased flatulence
Everyone experiences bloating a bit differently, but most common is a sensation of fullness or actual physical swelling(distention) in the abdomen, accompanied by discomfort or pain. The duration and intensity really vary. Some women complain of constantly feeling full while others notice a gradual build up through the day. Some struggle for a day or two or after certain meals while others experience months of distress affecting their quality of life..
Differences even seem to exist among racial/ethnic groups. A 2021 study found that Asian women experiences less severe and lower number of GI symptoms than non-Hispanic White women during the menopause transition.
Why does bloating happen in menopause?
During the menopause transition, the levels of estrogen and progesterone fluctuate, sometimes wildly. These changes have a big impact on our digestive functions:
- Increased water retention
- Decreased bile production
- Slowed digestion
- Increased gas
- Increased visceral pain sensitivity
Increased water retention
Fluid retention can cause swelling in various parts of the body, including the abdomen, leading to a feeling of bloating. Often hormonal factors and sodium intake are at play.
Estrogen plays a powerful role in our body fluid regulation. It impacts our thirst, fluid intake, and sodium (salt) cravings.
Progesterone acts as a natural diuretic which helps to relieve excess fluids from the body. As our levels fall this again leads to bloating due to water retention.
A 2020 study found that a high sodium intake promotes water retention in our bodies which can lead to bloating.
Decreased bile production
Higher levels of estrogen and a lack of progesterone can lead to decreased bile production which can cause the digestive system to slow down.
Estrogen also influences the production of bile, and this acts as a lubricant in the intestines. When this process becomes less efficient, fats are less thoroughly digested, and bloating can occur.
Estrogen and progesterone have an influence on peristalsis, which is the regular muscular movement of our intestines. This affects how quickly (and smoothly) food travels through the digestive tract. When estrogen levels fluctuate unpredictably, gut motility decreases, slowing down the whole digestive process.
A gut that moves more slowly will feel fuller longer and may result in constipation. It can also lead to a build up of gas, contributing to bloating.
Increased intestinal gas
Beyond a gas retention due to a slowed gut, changes in our microbiome during menopause can lead to increase gas production. The gut is home to trillion of bacteria that play a vital role in digestion. Menopause can alter the composition of these bacteria, leading to an imbalance that can contribute to increased gas.
Increase pain sensitivity
Fluctuations in estrogen and progesterone appear to increase visceral sensitivity, i.e., the sensitivity to pain of our organs.
While mild bloating may have not bothered us before, the sensation becomes much more noticeable in the menopause transition.
Hormone Replacement Therapy( HRT)
While use of HRT is meant to help stabilize hormone levels and reduce many symptoms of menopause, it appears that it won’t help with bloating. Studies have found that oral HRT users have longer transit times (i.e., the amount of time it takes food to travel through the gut) This may cause both gas and water retention, leading to bloating symptoms.
How do I get rid of menopausal bloating?
Figuring out how to reduce bloating can be tricky and ultimately it comes down to figuring out why you are experiencing bloating in the first place. Here are some lifestyle changes and strategies to try:
Drinking plenty of water can help keep your digestive tract to keep moving in a healthy way throughout the day. Drinking more to help with fluid retention may seem counterintuitive, but it helps. Adequate hydration can minimize constipation and the feeling of bloat that accompanies. Aiming for at least 8 cups of water per day, may be wise, especially as our natural thirst cues may be disrupted with hormonal fluctuations.
Reduce your salt.
Salt reduction can help to decrease bloat caused by water retention. Surprisingly, more than 70 percent of our daily sodium consumption comes from packaged foods rather than the saltshaker or packet. As a registered dietitian, I encourage women to limit their total sodium to 1500-2000 mg per day. Apart from reading food labels, there are many free sodium tracker apps available.
When it comes to enhancing the flavor of your meals without relying on salt, try experimenting with lemon juice or vinegar to add a tangy twist to your dishes. I routinely double the amounts of spices and herbs in recipes to boost the flavor.
A diet rich in fiber can help improve overall digestion and reduce bloating and constipation. But too much fiber, too fast or inconsistent intake can lead to bloating. It’s important to go slow when increasing the fiber in your diet. Start off with one higher fiber meal and wait for symptoms to subside before you add more.
Rule out trigger foods.
I routinely suggest that my clients keep a food journal to help them sort out exactly what might be causing their discomfort. Foods you previously ate with no problem may now be giving you grief. Some people may be more sensitive to certain foods that can cause gas.
Food that can cause gas:
- Beans (Presoaking reduces the gas-producing potential of beans if you discard the soaking water and cook using fresh water)
- Vegetables such as artichokes, asparagus, broccoli, cabbage, Brussels sprouts and cauliflower.
- Whole grains and bran (Adding them slowly to your diet can help reduce gas forming potential)
- Fizzy drinks
- Milk and milk products, such as cheese and ice cream
- Foods containing sorbitol, such as sugar-free candies and gums
Be very wary if someone is recommending you cut out whole food groups or banish gluten or sugar. It’s rarely as simple as that and you can be unnecessarily avoiding foods that are highly nutritious and pleasurable.
When we exercise, our body gets moving, and this movement stimulates the muscles in our digestive system. This can help to regulate digestion and prevent food from sitting in our intestines for too long, which can contribute to bloating. Additionally, exercise can promote the release of trapped gas in the digestive system, providing relief from bloating discomfort. Regular physical activity can help improve digestion and reduce bloating. Light to moderate activities like walking, swimming, or cycling can be effective in reducing bloating. Aim for at least 30 minutes of exercise most days of the week.
Practice stress management techniques.
Stress levels can have a significant impact on digestion and contribute to bloating. When we experience stress or anxiety, our body’s natural response is to activate the “fight or flight” mode, diverting resources away from digestion. Try a few of these techniques to help:
Deep Breathing: Deep breathing exercises can help activate the body’s relaxation response, counteracting the effects of stress. Take slow, deep breaths, inhaling through your nose and exhaling through your mouth. Focus on filling your belly with air, allowing it to rise and fall with each breath. Deep breathing can help calm your nervous system and promote relaxation.
Meditation: Regular meditation practice can help reduce stress and anxiety levels. Find a quiet and comfortable space, close your eyes, and focus on your breath or a specific calming visualization. Allow thoughts to come and go without judgment. Even a few minutes of daily meditation can have a positive impact on stress management and digestion.
Mindfulness: Practice being present and fully engaged in the moment. Mindfulness can help shift your attention away from stressors and promote a sense of calm. When eating, for example, pay attention to the taste, texture, and aroma of your food. Chew slowly and savor each bite. Being mindful during meals can enhance digestion and reduce the likelihood of bloating.
Over the Counter Medications:
There are several over-the-counter (OTC) medications available that can help alleviate bloating symptoms. However, it’s important to note that OTC medications may not address the underlying cause of bloating and should be used as a short-term solution. Here are some common OTC medications for bloating and how they work:
Antacids: Antacids are commonly used to relieve bloating associated with indigestion or acid reflux. They work by neutralizing stomach acid, reducing gas buildup, and providing temporary relief from bloating and discomfort. Examples of antacids include Tums, Rolaids, and Maalox.
Simethicone: Simethicone is an often used for bloating caused by excessive gas in the digestive system. It works by breaking down gas bubbles, making them easier to eliminate. Simethicone is available in various forms, including chewable tablets, capsules, and liquids. Some popular brands include Gas-X, Phzyme and Ovol.
Digestive Enzymes: Digestive enzyme supplements can aid in the breakdown and digestion of carbohydrates, proteins, and fats, potentially reducing bloating associated with poor digestion. These supplements contain enzymes such as amylase, protease, and lipase.
Lactase Supplements: Lactase supplements are helpful for individuals who have lactose intolerance and experience bloating after consuming dairy products. Lactase is an enzyme that helps break down lactose, the sugar found in milk and dairy products. By taking lactase supplements before consuming lactose-containing foods or beverages, bloating and other digestive symptoms can be reduced.
Natural remedies for perimenopause bloating:
There are several natural remedies that may help alleviate bloating:
Peppermint: Peppermint is known for its soothing properties and can help relax the muscles of the gastrointestinal tract, reducing bloating and discomfort. You can drink peppermint tea or take enteric-coated peppermint capsules to help relieve bloating symptoms.
Ginger: Ginger has been used for centuries to aid digestion and alleviate bloating. It can help stimulate the digestive system, reduce inflammation, and relieve gas. You can consume ginger by drinking ginger tea, adding fresh ginger to meals, or taking ginger supplements.
Chamomile: Chamomile tea has anti-inflammatory and calming properties that can help soothe the digestive system and reduce bloating. Drinking a cup of chamomile tea after meals may help relieve bloating and promote relaxation.
Fennel: Fennel has carminative properties, meaning it can help reduce gas and bloating. Chewing on fennel seeds or drinking fennel tea can provide relief from bloating symptoms. Fennel seeds can also be added to meals as a natural spice.
Probiotics: Probiotics are beneficial bacteria that promote a healthy gut microbiome. They can help improve digestion and reduce bloating. You can incorporate probiotics into your diet by consuming fermented foods like natto, kefir, sauerkraut, and kimchi. Alternatively, you can take probiotic supplements containing Lactobacillus acidophilus or Bifidobacterium lactis.
When to seek medical help:
While bloating is a common symptom during the menopause transition, it’s important to speak with a healthcare provider if it persists or is disrupting your daily life or causing significant discomfort.
Some symptoms that may warrant a visit to the healthcare provider include:
- Persistent bloating that does not go away after trying self-care measures.
- Abdominal pain or discomfort that is severe or worsening.
- constipation lasting more than three months.
- Unexplained weight loss
- Loss of appetite
- Persistent nausea or vomiting
- Chronic joint pain
It will be important for your medical provider to rule out other chronic medical conditions such as:
SIBO. Small intestinal bacterial overgrowth is a too-high concentration of bacteria in the small intestine which can be the underlying cause for many digestive symptoms. A breath test can help you determine if this is causing your digestive issues.
IBS. “Irritable bowel syndrome” refers to a group of symptoms that generally cause abdominal pain and changes in bowel movements. Studies have shown that women experience a worsening of symptoms during menopause.
GERD or “gastroesophageal reflux disease” is a condition in which the stomach contents flow backward up the esophagus. GERD can cause an increase in both belching and bloating.
Celiac disease is an autoimmune disorder in which the presence of gluten causes the body to attack its own small intestine. Subsequent damage to the villi, the lining of the small intestine, can keep nutrients from being absorbed correctly.
Menopause bloating is a common symptom that many women experience during the menopausal transition. It can be triggered by various factors such as dietary choices, food intolerances, gastrointestinal disorders, hormonal changes, or even stress. Identifying the root cause is crucial in determining the most effective approach to manage and alleviate bloating symptoms. Consulting a dietitian can be invaluable.
Let’s work together to create a personalized plan that will have you feeling confident and comfortable. Book your appointment today.