Q: I’ve got diarrhoea, could this be due to menopause?
A: Yes, it could be.
If you’re in pre-*, peri- and post-menopause and you’ve got gut issues going on you’re not alone.
In fact, it’s one of the common signs and symptoms and can include acid reflux, bloating, constipation, diarrhoea and gas.
Two things that can move the needle for you is optimising stomach acid (hello, digestive enzymes!) and eliminating potential food sensitivities. As a result of this scenario, I’ve seen women become free of symptoms, lose weight and sleep better.
Why does your digestion change at menopause?
It all comes down to the declining levels of estrogen and increases in cortisol that begin during perimenopause. Subtle signs can start early.
How does the digestive system work?
As you know, your digestive system’s role is to process the food you eat.
You put it in your mouth, chew it and swallow. And off it goes down the gastrointestinal (gah-stro-in-test-i-nal) tract to the stomach and intestines. From there, it gets broken down so the nutrients can be absorbed.
NB: The GI tract is also known as the gut
That’s one reason why dietary fibre is so important. It helps to move the food through your digestive system so you can comfortably poop what you can’t use.
The gut is also the home of what’s known as the gut microbiome or gut flora.
You have trillions of bacteria, fungi and viruses in the gut, far more than you have cells in the body. This bacteria is made up of both good and bad guys. The key to optimum health is keeping both of them happy so they live in harmony. When they fall out (as friends sometimes do) they get out of balance. This discord leads to gut dysbiosis which can be behind conditions such as weight gain, bloating and irritable bowel syndrome (IBS).
What gut changes occur at menopause?
- Once you head into perimenopause the entire digestive process begins to slow down. What’s more, your HCL (stomach acid) and digestive enzymes reduce. And that’s important because they’re what make up the gastric juices that break down food and kill unwanted bacteria.
- Another digestive fluid that diminishes during menopause is bile. Made by the liver (see image above) and stored in the gallbladder, bile helps to digest fat. As a result of less bile, you can’t digest fats (or fat-soluble vitamins) as well.
- Subsequently, all of a sudden you may find you can’t tolerate some foods like you used to.
- Dairy, gluten, refined sugars and carbohydrates and meat can all become more difficult for your body to process.
- Because your gut can’t break down food like it once did you won’t be able to absorb the same amount of nutrients. Therefore, you can become deficient in some key players.
- Coupled with that, estrogen balance, adrenal function, optimal thyroid health all depend on specific vitamins, minerals, amino acids and essential fatty acids. These include zinc, vitamin C, vitamin D, magnesium, calcium, iron, selenium, folate and vitamin B6 and 12.
Basically, poor nutrition leads to imbalances in gut flora and if you add a diet heavy in processed foods and sugar into the mix you’ve got the perfect storm for weight gain, the symptoms we talked about above and hormonal imbalance.
Photo by Sarah Chai from Pexels
Let’s talk about stress, gut health and menopause
Did you know that one of the biggest killers of healthy gut bacteria is stress?
It can be a surprise to many people that emotional and psychological reasons also play havoc with our digestive processes.
And this gets magnified at menopause. (And in pandemics!)
When you’re under stress, your adrenal glands release the stress hormone cortisol. A little cortisol is a good thing, too much is not. Unfortunately, more than is necessary is common in today’s world.
One of estrogen’s many tasks is to regulate cortisol and because estrogen levels lower during menopause it doesn’t do it as efficiently. One reason it’s difficult to cope with stress in midlife. It’s not you, it’s your hormones!
So cortisol puts you into fight or flight mode and increases the amount of glucose in your bloodstream. There’s a sound biological reason for this: to give you the energy to run for your life. (Cortisol doesn’t differentiate between being chased by a tiger or a fight with your partner.) Additionally, it de-prioritises your digestive processes while it focuses on survival.
Ultimately, this can lead to digestive imbalances and slow GI motility meaning food takes longer to travel through the gastrointestinal tract.
Signs of a healthy gut
- No bloating
- Zero flatulence
- No indigestion
- Zero heartburn
- Regular pooping
- Soft/ well-formed poop
- Poop with no visible undigested food
What can you do to heal your gut?
- Avoid sugar, dairy and wheat
- Ensure you eat plenty of fibre – fruit and veg skin, oats
- Drink lots of water
- Chew well – 30 times is optimum
- Try adding fermented foods such as sauerkraut or kimchi to your day (avoid this if you’re histamine intolerant)
- Don’t underexercise or overexercise
- Move your body with moderate exercises such as yoga, swimming or walking
- Avoid stressful situations as much as possible
- Incorporate more phytoestrogens, protein, fat and fibre (PPFF) in your diet. Read more about PPFF in 5 Ways Your Diet Should Change As You Enter Perimenopause
- Consider helping your digestive system with VitaminKIWI which is packed with soluble fibre and digestive enzymes.
- Take 55+. It contains vitamin D3 as well as magnesium which – among other things – helps with stool formation. And the Enzogenol pine bark extract in 55+ is very high in proanthocyanidins which are extremely beneficial for the gut.
All in all, ‘gut instinct’ is far from a misnomer.
The gut speaks and it’s vital we learn to listen to it.
Especially when you’re in pre-, peri- and post-menopause.
* We mention premenopause because if you can optimise your gut health early you’ll be in good shape for the upcoming shifts.
NB: It can get confusing because these signs can be caused by things other than menopause. For example medications (including antibiotics, HRT and birth control) and how active you are.
Also, certain medical conditions such as liver and bowel disease, diverticulitis and some cancers can manifest in a similar way to menopausal digestive issues. Chrohn’s, coeliac disease, IBS and SIBO also need a professional diagnosis.
If you are having persistent problems it’s important that you see your GP or gastroenterologist.