Bloating in perimenopause is very common. Very unwelcome, but very common. It can happen at different points in your menstrual cycle, especially before your period starts. Although some people may experience bloating only sporadically. You may also experience bloating daily, where you wake up with a flat stomach and by 6 pm you look like you’re five months pregnant. Not fun.
What Is Bloating?
As with many perimenopause symptoms, the bloating experience varies from person to person. A swollen stomach is typical, often with a sensation of tightness or heavy pressure. For some it’s just uncomfortable. Other people may also experience pain or cramping that can range from mild to severe. Some people may not have any stomach swelling and just experience a feeling of heaviness or fullness.
Bloating is the result of ‘too much’. As in too much gas, air, or water. And yes, poop. You may also experience increased belching and farting. Delightful. And sometimes funny?
What Causes Bloating in Perimenopause?
As your estrogen levels fluctuate and eventually decline, various digestive issues can become more pronounced. This is because estrogen helps regulate fluid retention and the functioning of your gastrointestinal tract. These symptoms may be new to you, or they may become more frequent and intense than what you’ve experienced in the past as you transition to menopause.
You may find that bloating only happens after your meals, or with certain foods. (Lentils anyone?!) It could also be that your symptoms may have nothing to do with food. Stress and fatigue, which are often magnified during perimenopause, may also contribute to symptoms like bloating.
These symptoms can be managed through lifestyle changes, dietary adjustments, and possibly medical intervention if required.
Certain medical conditions can cause digestive symptoms. If you’re experiencing new and/or persistent symptoms, see your doctor to rule out any other potential causes. And remember, perimenopause is not about getting through. It’s about understanding what’s going on with your body so that you can find the care and solutions you need to thrive.
Bloating Triggers
Bloating in perimenopause can be influenced by various factors, from diet to underlying health conditions. Understanding these causes can help you address symptoms more effectively.
Diet
Your food choices play a critical role in managing bloating. Specific foods can contribute to increased gas production:
- Beans and lentils: High in fiber, but can cause gas.
- Cruciferous vegetables: Such as broccoli and cabbage are known for causing bloating.
- Onions and/or garlic: Can trigger bloating in some individuals.
Women need 25g of fiber a day. Most of us aren’t getting enough and when we do add in more fiber-rich foods, we often get the unwanted side effect of gas and bloating. What to do?
Try eliminating potential triggers like the foods mentioned above, as well as spicy foods, carbonated water, caffeine, and alcohol. A food diary can help you track your symptoms and see if there is a connection to the foods your consuming. If the healthy veggies are the culprits, try reintroducing them slowly to give your body a chance to adapt to the fiber increase.
Air
There are several food choices and habits that can introduce excess gas into the digestive system:
- Carbonated beverages
- Gum
- Smoking
- Eating too quickly
Consider giving up the first three to help ease the bloat and gas. Particularly the smoking as it is not only bad for your overall health, it can exacerbate other menopausal symptoms like hot flashes. See you doctor to create a plan to quit smoking.
When it comes to eating too quickly, there are multiple steps you can take. Try to take the time to eat and focus on the act of eating. Rather than scarfing down lunch at your desk or eating dinner while you’re driving to hockey practice. Take the time to eat small bites and chew properly. Not only will this help reduce the bloat, it can also help you build a mindfulness practice. Being more mindful can help reduce stress and anxiety. Taking small moments daily to be mindful, like when you’re eating, can make a difference to your outlook and overall health.
Stress
Most would agree that perimenopause can be a very stressful life stage. It’s a time when physical and emotional changes due to fluctuating hormones collide with the stress of mounting work and family obligations. For all of these reasons you’re more likely to struggle with anxiety and depression during this phase of life. One of the ways your body handles stress is to increase your cortisol, the stress hormone. When this happens your digestive system slows down leading to bloating and other unwanted symptoms.
Constipation
Bloating and discomfort is often caused by constipation. And your hormones in perimenopause can make constipation a ‘regular’ fact of life. (See what we did there?) Add in pelvic floor issues due to aging, giving birth, and/or symptoms of GSM, and pooping can become a real problem.
Indeed, problems with your pelvic floor can lead to pain, prolapses, and incontinence, both urinary and anal. Yes, anal incontinence. Yikes! If you suspect you’re having pelvic floor issues, speak to your doctor and/or a pelvic floor physiotherapist for treatment.
Health Conditions
If your bloating is sudden, severe, or persistent, and disrupting your life, you should consult with a healthcare professional to get help. It’s also important to rule out any potential underlying conditions. Some of the medical conditions that can cause digestive symptoms include:
- Irritable bowel syndrome or IBS: is a common disorder that causes a multitude of digestive symptoms like cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. This is a chronic condition that can often be managed with diet and lifestyle changes, as well as stress reduction. In severe cases, medications and counselling may be required to manage symptoms.
- Small intestinal bacterial overgrowth or SIBO: characterized by a concentration of bacteria in the small intestine that is too high, SIBO can cause a multitude of digestive issues, including diarrhea. It can also cause malabsorption and weight loss.
- Gastroesophageal reflux disease or GERD: occurs when stomach acid repeatedly flows back into the esophagus. Treatment options include lifestyle and dietary changes, medications, and/or surgery.
- Celiac Disease: is a digestive problem that damages your small intestine. This illness is caused by an immune reaction to eating gluten. Symptoms include bloating, chronic diarrhea, constipation, gas, nausea, vomiting and abdominal pain that can be quite severe. Celiac disease is managed with a strict, gluten-free diet.
Managing Bloating in Perimenopause
Ruling out new, sudden, and/or severe digestive symptoms with your healthcare provider is paramount. For most people, lifestyle adjustments can significantly alleviate symptoms.
Adjusting Diet
You might find relief by reducing your intake of processed foods, which can contribute to bloating. Instead, concentrate on incorporating high-fiber foods, which aid in digestion and gut health. As noted above, if fiber rich foods are causing gas try eating them in smaller quantities so that your system can adapt to the increase in fiber. You may also want to keep a diary and see what symptom and food patterns emerge. There may be some foods that you just can’t eat, even if they are healthy. (Hello, lentils!)
Eating smaller meals more frequently can prevent the stomach from becoming overly full, thereby reducing bloating. And remember to slow down and chew well.
Consistent hydration is vital; ensure you hydrate with water to help with digestion and the reduction of bloating. Is sounds counterintuitive, but if you are bloated due to water retention, drinking more water can help flush out the excess fluid in your body. You’ll also want to limit your intake of salty foods as this can lead to water retention. Foods like yogurt or supplements that contain probiotics may be also beneficial.
Increasing Physical Activity
Engaging in regular physical activity, such as walking or yoga, can enhance gastrointestinal function and reduce the severity of bloating. Ensure that your weekly routine includes sufficient exercise that elevates the heart rate and improves overall circulation.
Stress Management
Stress can have a significant impact on your body, including exacerbating bloating. Techniques such as deep breathing, meditation, or yoga can be effective for managing stress levels.
According to the Centre for Disease Control and Prevention, adults need 150 minutes of moderate-intensity physical activity and 2 days of muscle strengthening activity weekly. Not anywhere near there? That’s okay. Start slow with a walk around the block everyday and build from there.
Medications
Sometimes lifestyle and diet adjustment aren’t enough to ease bloating in perimenopause. For mild bloating, over-the-counter (OTC) solutions like diuretics can provide temporary relief by helping to reduce water retention. Anti-gas medications may also help ease your discomfort.
If you’re taking birth control pills, talk to your doctor about their impact on bloating since some birth control methods can affect water retention and hormone levels. Similarly, bloating can be a side effect of hormone replacement therapy (HRT). And although not indicated for digestive symptoms, some patients report benefits to their digestive symptoms after starting HRT.
It’s important to discuss the potential risks and benefits of any medication with your doctor.
Disclaimer
The intent of this information is to provide the reader with knowledge to support more efficient and effective communication with their medical providers. This information is not intended as medical advice.
