Peri-menopause Bloating: Natural Remedies
What is peri-menopause?
Where ‘menarche’ marks the start of your periods, ‘menopause’ is the first year anniversary after your last period. The lead up to menarche is puberty, and the lead up to menopause is peri-menopause. The hormone changes work in reverse to each other during each transition, and both can be really challenging times! If you’re going through peri-menopause right now, you’ll probably be experiencing some of the ‘delightful’ symptoms that can come with it. One of them is bloating, and whilst it’s normal for our bodies to change shape at this time, peri-menopause bloating can feel uncomfortable and knock self-confidence. So, here’s what to do if you’re struggling to deal with peri-menopause bloating.
Does peri-menopause cause bloating?
Like puberty, peri-menopause is a unique experience for every woman and some really do have problems with bloating. The problem is that there are many other health issues that can show up in our 40’s and 50’s which also cause bloating. Whilst hormone changes are the most likely culprit, we need to be careful not to assume that bloating is always peri-menopause related and potentially miss other possible causes.
5 Reasons Why We Can Get Menopause Bloating
1/ High oestrogen (including from HRT)
Although we think of menopause as being that time when our oestrogen levels drop to almost nothing, that’s not strictly how it works. Menopause is ultimately not a drop in oestrogen as such, but a swap. Your body is swapping over from the most potent form of oestrogen, oestradiol, to less potent forms which will help protect your health thereafter. That process usually takes a number of years, and during the earlier stages oestrogen levels can climb significantly. When levels are high, you’ll likely get symptoms like breast swelling and pain, weight gain, bloating and heavy periods.
Even before we reach peri-menopause, many of us are in oestrogen excess just because of the way we live nowadays. As women we naturally create oestrogen, some of which is excreted in urine. We can also find ourselves on hormonal contraception and/or HRT which leads to increased hormone residues in our tap water. Unless you have a really good water filtration system at home, you will be drinking oestrogen every day. Then there are hormone disruptors in many cosmetics, skincare products and even food packaging, so there’s really no getting away from it.
Many women don’t realise that taking HRT for peri-menopause symptoms can sometimes lead to bloating and weight gain. This tends to happen more soon after starting HRT, but I have seen it in patients who’ve been taking HRT for quite a few years. Our oestrogen levels naturally ebb and flow during peri-menopause like they do during our normal menstrual cycle, just in more of an extreme way! Unfortunately it’s difficult to know exactly how much oestrogen and progesterone is needed on any given day, so there’s a constant supply being fed in via HRT whether we need it or not. Needless to say that sometimes we end up in oestrogen excess which can lead to peri-menopause bloating in some women. If this is you, I’d suggest talking to your prescribing Doctor about trying a new form and/or adjusting your dosage.
2/ Relatively low progesterone
A large part of oestrogen’s role is to keep our tissues moist, plump and well lubricated. It’s what drives the production of a nice new lining for the uterus every month, keeps the vagina moist, and helps to keep us in good overall health. It’s all about balance though and too much oestrogen is not such a good thing. We need adequate amounts of progesterone to keep our oestrogen levels in check. In early perimenopause especially, progesterone levels can be low in relation to oestrogen, so we don’t have that same ability to manage oestrogen levels. It’s a normal part of the process, but not ideal when it’s causing symptoms like peri-menopause bloating. We’ll talk more about how to deal with that later.
3/ High cortisol
Oestrogen and cortisol levels are closely interwoven, and as oestrogen levels drop later in perimenopause, cortisol levels tend to rise. Cortisol is your ‘high alert’ hormone. It’s a key part of our primeval survival mechanism which primes us to react quickly when we sense danger. Higher cortisol levels can partially explain why we can feel more anxious during perimenopause, but they also literally make us bigger and more bloated! High cortisol means more insulin resistance, which naturally leads to weight gain around the middle as well as chronic inflammation.
Too much cortisol can also disrupt sodium levels, so that we might crave salt and retain more water. If you’re a side sleeper, look at your body shape in the mirror when you first get up in the morning, you might notice that you’re a different shape down each side. That’s water retention.
4/ Poor Gut Health
As if that’s not enough, cortisol can disrupt the gut microbiome as well! That includes the ‘oestrobolome’: those strains of bacteria responsible for helping to regulate oestrogen levels. So instead of being broken down and excreted, oestrogen residues can stay hanging around in the gut before being reabsorbed back into the blood stream, fuelling the vicious circle all the more.
Any gut dysbiosis can increase the risk of a ‘leaky gut’ which allows larger molecules into the body which would not normally be allowed in. The immune system doesn’t recognise them as friendly, so it attacks, causing inflammation which then damages the gut lining further and so it goes on. In naturopathic approaches to health, the gut is the physical start of all health issues. If you want to keep your peri-menopause bloating and weight gain under control, it’s really important to take care of your gut health!
5/ New food intolerances
Changes in the way our gut is working can inevitably lead to new food intolerances. The strange thing is that they often seem to be intermittent depending on the hormone profile at the time. One day you might be able to have pizza for tea quite happily, and a week later the same kind of pizza might leave you on the loo for a day! Luckily there are lots of ways to help yourself if you think your peri-menopause bloating is down to food intolerances.
What To Do If You Have Menopause Bloating
Keep A Diary
We’re so caught up in the busyness of life that it can be hard to get clarity on how your bloating changes day to day. By keeping a diary of symptoms, what you’re eating, how stressed you are and where you are in your cycle, it can become much easier to unpick what’s causing it.
Look out for other symptoms
Bloating can sometimes be a symptom of something else other than simply hormones. Usually if it’s hormone related, the bloating will come and go throughout the course of the month, even if your periods have stopped.
Constant or very regular bloating, or bloating alongside any of these other symptoms is best checked by your GP:
- Losing your appetite, or feeling full when you haven’t eaten much.
- Needing to pee more than usual, or more urgently.
- Pelvic or abdominal pain.
- Fatigue
- Losing or gaining weight for no obvious reason
- Changes in bowel habit, e.g. diarrhoea or constipation
- Any abnormal bleeding from anywhere, even if it’s just once
- Any new lumps in your pelvis or lower abdomen
Again, it’s a good idea to note any of these in your diary. When you make the appointment, mention the symptoms that you’ve noted and take the list with you when you go.
Natural Remedies For Menopause Bloating
Love Your Liver
Everyone’s liver needs a little TLC these days and as it helps to clear all used hormones, it’s an important part of keeping them in balance. Here are three ways you can help your liver out:
- Keep your water/herb tea intake high enough to be peeing several times a day.
- Eat beetroot or drink 100ml beetroot juice daily (diluted if needed)
- Eat bitter tasting foods & minimise your sugar intake
Get Plenty of Rest
When we’re constantly tired, we naturally gravitate towards sugary or salty foods to keep ourselves going and neither are great for bloating! Peri-menopausal insomnia also aggravates brain fog, concentration and mental health in general, so it’s really important that we find ways to get enough rest. This blog has some ideas to help you if you’re not sleeping well.
Probiotics
I’ve found supplementing with probiotics really helpful both for myself and my patients when it comes to managing peri-menopause bloating. That’s because the fluctuations in hormone levels can disrupt the balance of bacteria which help to break down substances in the gut, including, ironically, oestrogen. Certain strains of bacteria, like Lactobacillus and Bifidobacterium help to break down used oestrogen for excretion. This is part of what we now call the ‘oestrobolome’, a sub section of the microbiome which specifically helps to manage oestrogen levels in the body. That’s why it’s important to include a mix of probiotic foods like plain live yoghurt, kefir, miso, sauerkraut and kimchi in your diet every day, but sometimes we still need to supplement with a good quality probiotic on top.
Magnesium
Magnesium deficiency is very common and because it’s needed for so many of the body’s processes, it can cause lots of symptoms during peri-menopause, including bloating. It’s a macronutrient, which means we need lots of it, and again, we’re not always able to get adequate amounts from foods like nuts, beans, peas and potato skin. It’s well worth trying a good quality Magnesium supplement but there are different kinds depending on which other symptoms you have. Personally I use a Magnesium Citrate powder in water to help me sleep at night, but some people prefer Magnesium Malate or Glycinate.
Exercise
A lot of peri-menopausal women are put off exercising when they don’t see their weight releasing however hard they try! It’s true that we need to focus less on cardio and more on weights as we move through peri-menopause, but it has so many health benefits I’d encourage it regardless of what your weight is doing. A lot of bloating comes from water retention, where the lymphatic system isn’t clearing the tissues of excess fluid effectively. Unlike your blood, your lymphatic system doesn’t have a pump. It relies on you moving your body in order to work effectively in carrying oxygen and nutrients into your cells, and waste products away. This is probably one of the many reasons why daily exercise has been shown to reduce risk of certain cancers, heart disease, degenerative brain disease etc. It really is non-negotiable but it’s also important to find some movement that you really enjoy. If the gym isn’t your ‘thing’, there’s always walking, dance, conservation volunteering, yoga or group classes you might prefer. Your body and mind really will thank you for it.
Herbal Remedies For Peri-Menopause Bloating
I’m not aware of any specific herbs for peri-menopause bloating, because there are always hormone imbalances sitting behind it. Luckily there are plenty of herbs we can use to address those!
If you watch this video, you’ll see how I put together a herbal prescription for peri-menopause symptoms in general. Both menstrual and menopausal symptoms are a barometer of how well we are overall, and the key to fixing them is to address the underlying issues. Simply giving herbs like Cleavers or Dandelion leaf might quickly remove any water retention, but they’re not going to fix the underlying hormone imbalance on their own. That’s why it’s important to get yourself properly assessed if you can, and have a herbal prescription personalised to you. At the same time we can look into whether drug side effects, adrenal fatigue, nutritional deficiencies etc need addressing.
Where to get more help
If your symptoms are below 5/10 in severity, you could download module 4 of my Online Programme, ‘Rejuven8’.
If your peri-menopause symptoms are above 5/10 in severity, click here to book your free call, and let’s explore some potential fixes for you.
