Menopause? Here’s How Your Digestion Might Be Affected

  • 5 mins read
  • Health Conditions
  • Written by: Dr. Pramod Mane
going through Menopause

Every lady stepping into her 40s goes through an upheaval of uncontrolled emotions. She experiences hot flashes which makes her body feel warm; however, there may be times when she may break into a sweat at night and feel cold. The crankiness which she never knew existed suddenly makes an appearance out of nowhere.

There are those sudden bursts of sadness, increased anger and irritation at the slightest triggers, heightened anxiety for no specific reason, erratic mood changes, aggressiveness, and difficulty in concentrating, all combined with continual fatigue.

If you are experiencing any of these frequently, your body may be drawing up a retirement plan for your ovaries. By this we mean that there’s every chance that all these emotions are pointing towards impending menopause.

Why the emotional chaos? Understanding menopause symptoms

As a lady reaches her late 40s or early 50s, her body undergoes numerous hormonal changes which are a part of the normal process of ageing. Her ovaries, which have been relentlessly active all throughout, start slowly shrinking, decreasing the amount of hormones i.e, the estrogen and progesterone which they produce.

These are the very hormones that control her monthly menstrual cycles. A woman’s ovaries are a safe vault for her eggs which are released one at a time every month starting from her puberty, with estrogen and progesterone being the principal controllers of this entire process leading to her monthly periods.

With a gradual decrease in hormonal levels, at a particular point in time, the ovaries would pause and cease to release the egg. This marks the end of the menstrual cycle, leading to menopause, or a time when her periods completely stop.

Menopause sets in gradually

Menopause progresses gradually, in three stages:

Perimenopause

Is the first stage which generally starts at 40 years of age, in fact, 8 to 10 years before menopause. Ovaries slowly decrease the production of estrogen.

Menopause

Occurs at approximately 51 years of age and is the stage wherein the ovaries have completely stopped releasing the eggs and producing most of the estrogen.

Postmenopause

Is the stage wherein the menstrual cycle has not occurred continuously for a period of one year. The estrogen levels are extremely low and the risk of various health conditions substantially increases.

Estrogen the master modulator

The estrogen produced by the ovaries has a varied role to play. It helps regulate body fat, female reproductive function, cardiovascular health, bone health, and brain function (including memory).
Menopause, which is characterized by very low estrogen levels may hence increase health-related risks that never existed before, due to the protective nature of estrogen.

Does your gut health really matter?

Yes, it does. Your gut is the second brain. It even plays a role in immunity. Practically every system in our body is regulated by our gut and so are the levels of estrogen. You must have noticed how your mood swings can affect your appetite, digestion and in turn your gut. So, it is an obvious that menopause will affect digestion.

How do those tiny gut residents control your estrogen levels?

You’ll be surprised to know that gut health and menopause are interlinked. Here’s how. There exists a diverse community of bacteria in our gut (gut microbiome). It is they who metabolize and modulate the body’s circulating estrogen. Hence this bacterial community is named the ‘estrobolome’.

The gut microbiome (estrobolome) is responsible for regulating a number of hormones in our body. A healthy estrobolome regulates estrogens through the secretion of β-glucuronidase, an enzyme that activates estrogens. When the estrobolome is disturbed (gut dysbiosis), due to lower microbial diversity, it affects the secretion of β-glucuronidase, in turn further reducing the number of circulating estrogens. This alteration in circulating estrogens may contribute to weight gain, hormonal imbalance, heart diseases or mood disturbances in females.

The drop in estrogen levels at menopause is normal. However, if gut dysbiosis is also present, any decrease in beta-glucuronidase activity it causes may make things worse, further increasing the risk of various chronic diseases.

How menopause can affect digestion

Constipation:

The hormones progesterone and estrogen both directly impact bowel movements. During menopause, these hormones are on the decline. This slows down GI motility, meaning it takes longer for food to get through your digestive system. This allows more water from the stools to be absorbed into the bloodstream and ultimately leads to constipation.

Gallbladder disease:

Ageing and hormone replacement therapy are both risk factors for gallstones and gallbladder disease. Gallstones are basically hardened deposits of bile salts. Since estrogen and progesterone affect the production of bile and its movement in the digestive tract, it contributes to the formation of gallstones.

Bloating:

The reduced GI motility slowed digestion, and constipation contributes to bloating in menopausal women.

Diarrhoea and incontinence:

During menopause, the pelvic floor muscles weaken, which makes women more susceptible to incontinence. Also, lower progesterone levels during menopause can cause an increase in bowel movements which may lead to diarrhoea.

IBS:

Symptoms of IBS such as diarrhoea, constipation, and bloating are often worsened by menopause due to the reduction of secretion of estrogen and progesterone on GI motility and function. Hormonal imbalances can exacerbate underlying GI disease and make diarrhoea, constipation, gas, and bloating worse.

How can these GI symptoms be averted?

Though these GI symptoms are common in menopausal women, the following lifestyle changes can help a digestive disorder:

  • Eat food slowly, chewing it well
  • Try to avoid eating when you feel stressed
  • Avoid junk and processed food
  • Eat foodstuffs rich in ‘dietary estrogen’ known as phytoestrogens which can help you overcome the hormonal imbalance
  • Some foods are easier to digest and break down than others. Stimulants such as caffeine, alcohol, and refined sugar will just help in your digestion as well as on your nervous system
  • Stay hydrated – this is highly essential for your general health, also supporting your digestive system
  • Use prebiotics – Prebiotics nourish the good bacteria and thus improve the microbial balance in the gut which results in improved digestion.

To summarize, menopause is an important life-changing phase for women. Hormonal imbalance is one of the side-effects that occurs during menopause, and it significantly affects digestive health. However, with the consultation of an expert physician and good food habits, these symptoms can be averted, and you can have a happy transition into the next phase of your life.

References:

1. Menopause, Perimenopause and Postmenopause Available at https://my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause Accessed on 18th August 2021
2. Menopause Available at https://www.webmd.com/menopause/guide/menopause-basics Accessed on 18th August 2021
3. Estrogen Function Available at https://www.news-medical.net/health/What-Does-Estrogen-Do.aspx Accessed on 18th August 2021
4. Baker JM, et al. Estrogen–gut microbiome axis: physiological and clinical implications. Maturitas. 2017 Sep 1;103:45-53.

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