Navigating gut health during perimenopause
Why worry about gut health in perimenopause?
Perimenopause is a hormonal (and life) transition phase and good gut health can be a really helpful strategy to support a healthier and easier transition - mitigating some of the symptoms that can come with it.
We know that perimenopause is the phase around menopause - where ovulation changes and our bodies produce lower (or fluctuating) levels of oestrogen, progesterone and testosterone in the ovaries. These changing levels of hormones have a systemic impact as so many of our bodies cells have receptors responsive to these hormones.
Changing hormones impact the gut microbiome AND the muscle of the gut that affects the transit of food. This can cause constipation, bloating and food intolerances and have an affect on our energy, sleep, mood, immune system and so much more.
But it’s not inevitable, paying attention and taking gentle action can be really helpful.
The Gut-Perimenopause Connection
So, how do fluctuating hormones affect gut health?
There are a few ways in which our gut health is impacted by changing hormones, as well as by our lifestyle.
Progesterone seems to have an impact on our smooth muscle tissue, that of the intestine, and lower levels can slow down the the progress of digested food through the digestive tract, leading to constipation and discomfort, as a result of not moving waste products through the system quickly enough.
This can create an imbalance in other hormones, too, as our gut is how we get rid of excess levels of oestrogen. High levels of oestrogen in the gut can affect the gut microbiome causing dysbiosis (causing higher levels of oestrogen) which can contribute symptoms like:
Bloating and digestive upset
Acne
Low libido
Heavy, light, or irregular periods
Tender, swollen, and/or fibrocystic breasts
Headaches
Weight gain
Hot flashes
Mood swings
We also become more sensitive to stress hormones, and are often living through a particularly stressful life phase, so can experience higher levels of the stress hormone cortisol which can upset our digestive system (more on this later!).
Gut microbiome - what do we mean by this and why does it matter?
We have billions of microbes in our guts, belonging to different families of bacteria. Many of them are incredibly beneficial for our overall health and wellbeing. They benefit our immune system, they help digest our foods, even produce happy hormones for our brains.
But when these families are out of balance, this can reduce the populations of ‘good’ bacteria, or change the ratio of ‘good’ to ‘bad’. This can be due to lack of sleep, too much sugar, or alcohol, too little time between meals, high stress levels too many processed foods (some of the gums and stabilisers in these foods have been shown to change our gut bacteria and impact gut health, although this is often dose-dependent).
And, of course, changing hormone levels - affecting the speed of digestive transit and the microbe balance.
Stress, sleep disruption, and eating quickly can be a symptom of a hectic midlife, but their impact on the digestive system can be significant, but there’s plenty we can do to resolve this.
I enjoyed this article on the importance of the microbiome
Common Gut Issues in perimenopause and midlife
These aren’t just hormonal issues - these are lifestyle issues, but often symptoms include, bloating, constipation, increased food intolerances, reflux, as well as unpredictable bowel movements.
And it’s not fun. We can start seeking comfort in probiotics, prebiotics, cutting out various food groups to see what helps, but it can feel overwhelming and a minefield.
So, what do we do about it?
3 key areas to consider in supporting gut health
1. Balanced diet
Fibre is the KEY here. Plenty of vegetables and fruits, nuts and seeds, whole grains, legumes. A balanced and plant-forward diet helps. This is where planning meals and snacks can help.
Getting a variety of colours also means we get lots of variety for our different families of bacteria and for the variety of nutrients they deliver overall.
Making a meal plan can help us work out how to get this variety over the course of a week - because every day is different.
You know already that sugar and alcohol and processed foods are not going to help your gut health, you probably feel it in your guts after consuming them if you pay attention. So cutting down on these can really help.
2. Probiotics and Prebiotics: Should you take them?
You can get probiotics in tablet form, or in liquid form. Or from natural yogurts, and kefir, kombucha and fermented vegetables.
You can take prebiotics in tablet form too. Or from vegetables like leeks and onions, fennel, garlic, and jerusalem artichoke, or from linseed/flaxseed, oats, and cocoa (I don’t think chocolate counts though, sorry!).
Probiotics ADD to the number of healthy bacteria in the gut, and prebiotics FEED them to help grow the population of those same bacteria. You can also get them in supplement form.
Should you take them? I think the jury is out on just how effective it is to take these as a supplement, but if you decide to do so, keep track of the symptoms you’re hoping that they might help - that should give you the answer you need.
Should you add in the food sources, absolutely, if you can, and if you can digest them well. Excess consumption of any of these foods could have undesirable effects. It’s just worth noticing how you feel after a meal rich in any of these, or how you feel after yogurt or kefir for breakfast.
3. Lifestyle and behaviour factors: It’s more than your gut!
Our gut health isn’t just about what we put INTO our guts, but is deeply affected by the life we lead too.
High levels of stress, in particular, high levels of the stress hormone cortisol can slow down the digestive processes, as your body prioritises sending resources to your muscles and heart instead. So if you’ve had a difficult day at the office you might find it harder to digest your lunch or dinner as a result.
Exercise can be really helpful, it helps reduce stress, and uses up some of that cortisol in your bloodstream so you can be more productive again, and also seems to increase levels of good bacteria in our guts.
And sleep. Sleep is magic for SO many aspects of our wellbeing, but when we sleep, this is when our body does SO many of it’s detox and repair processes. The gut wall is only 1 cell thick so can be quick to damage, but also quick to repar. The key thing here is that repair can only happen after your stomach and intestines have completed their digestive processes, so leaving time between your last meal or snack of the day, and going to bed, actually helps your gut to heal (and can help you sleep better too - which is a win-win for a perimenopausal woman!). .
This healing can happen during the day too, so taking time between meals and snacks is helpful. Leaving at least 2/3 hours between meals and snacks is a good rule of thumb, but we all have our own needs.
And another key thing, that can be tricky for a busy midlife woman, is to take time. Digestion starts before food hits our stomachs, when we start thinking about, preparing, or choosing food, it sends messages to our brain and stomach to start producing digestive enzymes. And when we chew our food we start to break it down and make it easier to digest, coating it in saliva, enzymes and bacteria from our mouths (we have good and bad bacteria here too!).
So, what do you do next?
Start where I always love to start - paying attention. You could do a food diary for week and make note of any symptoms at the same time. Don’t change anything, just notice.
Then start adding in more plants - go wild in your local grocers or veg section, getting in plenty of colour. Roast, steam, or quickly stir fry - and add plenty of flavour too - garlic and ginger are great for your gut and make anything taste yummy. Spices like fennel seed, cumin and coriander are good too.
Chew slowly, at least for the first bite, and really savour your food. You might find it changes how you relate to the rest of your plate as a result.
And hydrate well between meals - this really helps all of the detoxification processes in our body, and helps our digestion overall (regular sips through the day are probably a lot better than guzzling gallons over lunch!).
If you’d like a structured approach to supporting good gut health in perimenopause, I have a super supportive 3 week programme to help. More details via the button below!