The Gut-Menopause Connection: How Hormonal Changes Affect Digestion

April 09 2025, by Tatianna Gerard, 15 min reading time

Menopause is a natural phase in every woman's life, but the hormonal changes that come with it can bring about more than just hot flashes and mood swings. For many women, one of the less-discussed impacts of menopause is its effect on digestion. As oestrogen levels decline, women often experience digestive issues like bloating, IBS-like symptoms, and food sensitivities. These changes can make daily life uncomfortable and leave many wondering what’s causing these disruptions.

We’ll explore the gut-menopause connection and explain how hormonal shifts, particularly the drop in oestrogen, affect gut health and digestion. We’ll also discuss why symptoms like bloating and food sensitivities become more common after menopause and offer practical advice on how to support your digestive health during this time.

How oestrogen affects gut bacteria and digestion

Oestrogen, one of the primary female sex hormones, plays a crucial role in maintaining overall health, and its influence extends to many systems in the body, including the digestive system. During menopause, as oestrogen levels decrease, many women begin to notice digestive changes. One of the most significant ways that oestrogen impacts digestion is through its effect on gut bacteria, which can lead to disruptions in digestion and gut health.

The role of oestrogen in gut health

Oestrogen is essential for maintaining a healthy balance of gut microbiota—the trillions of bacteria, viruses, and fungi that live in the digestive tract. These microorganisms help regulate many functions, including digestion, immune response, and even mood. Oestrogen has been shown to have a protective effect on the gut by supporting the growth of beneficial bacteria, which in turn help with nutrient absorption, digestion, and maintaining a balanced gut environment.

When oestrogen levels are high, as they are during a woman's reproductive years, the gut microbiome tends to be more diverse and balanced. Beneficial bacteria like Lactobacillus and Bifidobacterium thrive, helping to break down food, absorb nutrients, and prevent harmful bacteria from growing. This helps ensure efficient digestion and supports overall gut health.

How oestrogen decline affects gut bacteria

As oestrogen levels decline during menopause, there can be a noticeable shift in the composition of the gut microbiota. Research has shown that lower oestrogen levels can lead to an imbalance in the gut microbiome, where harmful bacteria may proliferate, and beneficial bacteria may decrease. This shift can have a direct impact on digestion and gut health.

Decrease in beneficial bacteria: As oestrogen declines, there’s often a reduction in the number of beneficial bacteria that help keep the digestive system functioning properly. This can lead to slower digestion, decreased absorption of nutrients, and an increase in inflammation in the gut.
Increased gut permeability: Lower oestrogen levels have also been linked to an increase in gut permeability, sometimes referred to as "leaky gut." This occurs when the lining of the digestive tract becomes damaged, allowing harmful substances like toxins and undigested food particles to pass through into the bloodstream. This can trigger an immune response and lead to chronic inflammation, contributing to digestive issues such as bloating, gas, and food sensitivities.
Imbalance in gut flora: With a shift in the balance of gut bacteria, some women may experience an overgrowth of pathogenic bacteria that can irritate the gut lining, disrupt digestion, and even lead to conditions like irritable bowel syndrome (IBS)-like symptoms.

Why some women experience bloating, IBS-like symptoms, and food sensitivities after menopause

In addition to affecting gut bacteria, oestrogen also plays a role in the normal functioning of the digestive system. One way it impacts digestion is by influencing gut motility—the movement of food through the digestive tract. Oestrogen helps to regulate the muscle contractions of the intestines, ensuring that food moves through the digestive system at a healthy pace. When oestrogen levels drop, these contractions can become less efficient, leading to symptoms such as:

Constipation: Slower gut motility can result in constipation, a common issue during menopause. When food moves more slowly through the intestines, it can lead to harder, drier stools and difficulty passing them.
Bloating and discomfort: With slower digestion and changes in gut bacteria, bloating and abdominal discomfort may increase. Gas can build up in the intestines, leading to a feeling of fullness, distension, and discomfort.
Indigestion and acid reflux: Lower oestrogen levels can also affect the production of stomach acid and the function of the lower esophageal sphincter, which keeps stomach acid from flowing back up into the esophagus. This can result in acid reflux or heartburn, especially after meals.

Hormonal fluctuations and food sensitivities

As the balance of gut bacteria shifts and gut motility slows down during menopause, many women begin to notice an increase in food sensitivities. Foods that were once easily tolerated may start causing discomfort, such as bloating, gas, or diarrhoea. This is partly because the gut’s ability to break down certain foods becomes compromised as the microbiome shifts.

Intolerance to dairy or gluten: Some women find they become more sensitive to certain foods like dairy or gluten during menopause. This could be due to the reduced ability to digest lactose or gluten properly, as a result of imbalances in gut bacteria or changes in enzyme production.
Increased sensitivity to high-fat or spicy foods: Hormonal changes can also affect how the stomach responds to certain types of food. Some women may find that foods that were once enjoyed—especially those high in fat or spice—can now trigger symptoms like heartburn, nausea, or discomfort.
The role of gut inflammation: Chronic inflammation in the gut, which may arise from a disrupted microbiome, can further exacerbate food sensitivities. Inflammation can impair the gut lining and make it more difficult for the body to process and tolerate certain foods.

Best foods and probiotics for digestive health during menopause

1. High-fibre foods

Fibre plays a vital role in digestive health by promoting regular bowel movements, preventing constipation, and helping to maintain a healthy gut microbiome. Including fiber-rich foods in your diet can help keep things moving smoothly.

Whole grains: Oats, quinoa, and brown rice are excellent sources of fibre that help support digestion and keep you feeling full longer.
Fruits and vegetables: Apples, pears, berries, carrots, and broccoli are rich in soluble and insoluble fibre. These help to add bulk to stool and improve gut motility.
Legumes: Beans, lentils, and chickpeas are also fibre-rich and can support healthy digestion while providing plant-based protein.

2. Anti-inflammatory foods

Inflammation in the gut can contribute to discomfort during menopause, including bloating and indigestion. Anti-inflammatory foods help to soothe the digestive tract and reduce inflammation, promoting better digestion and overall gut health.

Fatty fish: Salmon, sardines, and mackerel are rich in omega-3 fatty acids, which have anti-inflammatory properties and support gut health.
Olive oil: A great source of healthy fats, olive oil has been shown to reduce gut inflammation and promote a healthy balance of gut bacteria.
Turmeric: The active compound in turmeric, curcumin, has powerful anti-inflammatory effects. Adding turmeric to dishes or drinking turmeric tea can help soothe inflammation in the gut.

3. Fermented foods

Fermented foods are an excellent source of probiotics—beneficial bacteria that support a healthy gut microbiome. Since hormonal changes during menopause can disrupt gut bacteria, incorporating fermented foods into your diet can help restore balance and improve digestion.

Kefir: A fermented dairy drink that is rich in probiotics, kefir supports the growth of beneficial bacteria in the gut and can help with bloating and digestion.
Sauerkraut and kimchi: These fermented vegetables are packed with beneficial bacteria that can enhance gut health and improve digestion. Just be mindful of portion size, as they can be salty.
Yoghurt: Look for plain, unsweetened yoghurt with live and active cultures to get the most probiotic benefit.

4. Prebiotic foods

Prebiotics are non-digestible fibres that feed beneficial bacteria in the gut. Eating foods rich in prebiotics can help nurture the healthy bacteria that support digestion and improve gut function.

Garlic and onions
Bananas
Asparagus and leeks

5. Water-rich foods

Staying hydrated is crucial for maintaining proper digestion and preventing constipation, a common issue during menopause. Eating foods that have a high water content can also help keep the digestive system functioning smoothly.

Cucumbers
Watermelon
Celery

Probiotics for digestive health during menopause

While incorporating probiotic-rich foods into your diet can be beneficial, sometimes these foods alone may not be enough to restore gut balance or alleviate digestive issues. In such cases, supplementing with probiotic capsules can provide an additional boost to support digestive health. Here are some probiotics strains to look for:

Lactobacillus

This is one of the most common and well-researched strains of probiotics. Lactobacillus helps support the growth of beneficial bacteria in the gut and can improve symptoms of bloating, gas, and constipation. It is commonly found in fermented foods like yoghurt, kefir, and sauerkraut.

Bifidobacterium

Bifidobacterium is another beneficial strain of probiotics that plays a key role in gut health by supporting the balance of good bacteria and improving digestion. It has been shown to help reduce symptoms of IBS and other digestive disorders that may become more prevalent during menopause.

Saccharomyces boulardii

This probiotic strain is a beneficial yeast that has been shown to help with diarrhoea, bloating, and other digestive discomforts. It can also help restore gut balance during times of hormonal fluctuations.

Lifestyle tips for supporting digestive health during menopause

Managing digestive health during menopause involves more than just eating the right foods and taking probiotics. Lifestyle factors play a significant role in how your digestive system functions. Hormonal changes during menopause can slow down gut motility, increase bloating, and cause discomfort, but adopting healthy lifestyle habits can help mitigate these effects and promote a healthier digestive system. Here are some essential lifestyle tips to support your digestive health during this transitional phase:

1. Stay hydrated

Hydration is key to maintaining proper digestive function, especially during menopause when women often experience constipation and slower digestion. Drinking enough water throughout the day can help soften stools, improve digestion, and reduce bloating.

2. Regular exercise

Physical activity is an excellent way to boost gut motility. Certain yoga poses, such as twists and forward bends, can help stimulate digestion and relieve bloating. These exercises not only benefit the gut but also promote relaxation, which can reduce stress and further support digestive health.

3. Manage stress effectively

Stress is a major factor that can negatively affect digestive health, and menopause itself can bring about mood changes, anxiety, and stress. Stress increases the production of cortisol, which can disrupt digestion and cause gut-related issues such as bloating, constipation, and indigestion. Techniques like deep breathing, meditation, and mindfulness can help reduce stress and support digestive health by calming the nervous system.

4. Prioritise sleep

Sleep allows your body to repair and regulate various systems, including digestion. Poor sleep can contribute to an imbalance in the gut microbiome and may even worsen symptoms like bloating and indigestion. Aim for 7-9 hours of sleep each night. Establish a consistent sleep schedule, limit screen time before bed, and consider relaxing activities like reading or a warm bath to help improve sleep quality.

5. Avoid eating large, heavy meals late in the day

Eating large meals, particularly those high in fat, spice, or sugar, can overwhelm your digestive system, leading to indigestion, bloating, and discomfort. During menopause, when gut motility may already be slower, it’s even more important to be mindful of meal timing and portion sizes.

6. Limit processed foods and sugar

Processed foods, high in refined sugars and unhealthy fats, can disrupt your gut health, increase inflammation, and contribute to digestive discomfort, particularly during menopause when your body’s digestive capacity is already shifting. Incorporate more fresh fruits, vegetables, lean proteins, and healthy fats into your meals.

Conclusion: Prioritise your gut health during menopause

Menopause brings many changes to a woman’s body, and digestive health is often one of the areas affected by hormonal fluctuations. As oestrogen levels decline, it’s not uncommon for women to experience symptoms such as bloating, constipation, and food sensitivities, making it important to understand the connection between hormones and gut health. By taking steps to support your digestive system through a balanced diet, regular exercise, stress management, and proper hydration, you can help alleviate many of these discomforts.

It’s important to listen to your body and make adjustments as needed. Every woman’s experience with menopause is unique, and what works for one person may not work for another. If you’re struggling with persistent digestive issues, it’s always a good idea to consult with a healthcare provider for personalised advice and treatment.

With the right approach, you can manage menopause-related digestive changes and feel more comfortable and in control during this transitional phase of life.