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How to Deal with Normal Gut Changes During Menopause, Including "Menopause Belly"

By Jill Levy

September 19, 2024

While hot flashes, occasionally disrupted sleep and shifting outlooks can mark menopause for many, there are often changes in the gut, too, that go less recognized. Researchers, however, are beginning to see that the gut microbiome can undergo changes as well.

In particular, there is a connection between your gut bacteria and your changing hormones when going through menopause. You can start to transition into menopause as early as your mid-to-late 30s, with most women entering menopause in their 40s or 50s.

Menopause is marked by the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period. The road to menopause is preceded by pre-menopause and perimenopause. This is a natural, normal progression.

Learn how the gut can change during menopause below, including how it can mean lower gut microbiome diversity and slower digestion, among other shifts. It might even mean a “menopause belly.”

Studies indicate that healthy aging (and overall health) is associated with a diverse set of gut bacteria. Fortunately, it’s still very possible to maintain a healthy gut microbiome with the right kind of foods, certain supplements, stress relief plus some lifestyle changes.

As always, you should consult with your healthcare professional prior to beginning any new dietary or lifestyle regimen.

How Can the Gut Change During Menopause?

In a 2022 International Journal of Women’s Health study entitled “Spotlight on the Gut Microbiome in Menopause,” research indicated that menopause yielded lower gut microbiome diversity and an actual shift towards greater similarity to the male gut microbiome.

For example, in a large study of U.S. Hispanics, the gut microbiome of post-menopausal women was found to be less diverse than pre-menopausal women. More studies are warranted.

Beyond the gut microbiome becoming less diverse, here’s how the gut can change during menopause’s hormonal changes:

• Slower digestion and occasional constipation — When estrogen and progesterone levels go down, the digestion may slow, leading to occasional constipation, gas and bloating.

• Gut barrier impacts — In smaller studies, it’s been shown that those estrogen and progesterone levels declining may impact the gut barrier. While the gut is semi-permeable and designed to absorb both water and nutrients from food into our bloodstream, too much permeability is not desired, which is why it’s important to support a healthy gut barrier.

• Healthy inflammation levels — When estrogen levels naturally drop, it’s important to promote and monitor healthy inflammation levels.

• Stress — Lower estrogen levels can directly impact the body’s response to stress. That’s why it’s a good idea to manage stress through exercise, creating margin and more.

• Menopause belly — Normal fluid retention can occur because of shifting hormone levels and occasionally cause a bloated menopause belly, which may bulge and be relatively firm. Weight gain also may happen during menopause (due to a combination of lower estrogen, declining physical activity, sleep impacts and a slower metabolism overall) and increased body fat in the abdomen area can change gut function as well.

What do these gut changes during menopause mean for the body? As the gut microbiome diversity lowers, there’s often a greater need to focus on maintaining overall health .

How to Help Support the Gut During Menopause

A balanced diet with vegetables and fruit, certain supplements, being active and getting on top of your stress can all help to support your gut health during menopause.

1. Mediterranean-style diet

As emphasized in the Mediterranean diet, a quality menopause diet should be full of nourishing, unprocessed foods that help the body adjust to changing hormones while also assisting in healthy weight management (in addition to a healthy lifestyle, including regular exercise).

This diet emphasizes plant-based foods, with a focus on fruits, vegetables, whole grains and healthy fats. Moderate portions of fish, poultry and legumes round out the dietary picture.

In general, omega-3 fatty acids support healthy inflammation levels and also help make you feel fuller. Omega-3 foods include fish like sardines, salmon and herring, as well as flaxseeds, walnuts and natto.

If you find it difficult to get enough omega-3s into your diet, consider an omega-3 supplement. Ancient Nutrition’s Ancient Omegas Whole Body formula provides 1,000 milligrams of omega-3s (including ALA, DHA, ETA and EPA) and features a special combination of organic plant and wild ocean omega fatty acids.

2. Prebiotics plus probiotics

Consuming prebiotic and probiotic foods alongside healthy fats can help feed the healthy gut bacteria and help maintain a healthy response to inflammation.

Why is this important? A 2022 review of three studies showed that post-menopausal women sometimes have a higher concentration of a certain kind of intestinal bacteria. To help make sure your intestinal bacteria are balanced, it’s important to have an array of probiotics which can help promote a healthy response to inflammation levels and help support a healthy gut lining.

If you’re looking for a quality probiotic supplement, consider Ancient Nutrition’s SBO Probiotic Gut Restore formula, which features 25 billion CFUs* (*at time of manufacture) of SBOs per serving in combination with organic fermented blends of superfoods and mushrooms. It can help reduce occasional constipation, gas and bloating, plus promote healthy elimination. It also supports healthy digestion and bowel transit time.

Ancient Nutrition also offers Regenerative Organic Certified® Menopause Support Probiotics. As shown above, research shows that there is a powerful connection between our gut health and hormones. This exclusive formulation combines prebiotics, probiotics, postbiotics, and Regenerative Organic Certified® superfoods specifically chosen to support women entering or experiencing menopause.

3. More fiber

While more studies need to be conducted, a 2023 study in the journal Menopause looked at the normal menopause symptoms of nearly 700 women and found that women who had normal bowel habits dealt with fewer hot flashes than women who were occasionally constipated. High-fiber foods and a fiber supplement can help address such a scenario.

Ancient Nutrition's Organic Fiber (available in pineapple mango and raspberry lemonade flavors) is a gentle-acting, easy-to-mix fiber powder. It features certified organic and non-GMO ingredients like acacia fiber (a prebiotic) and konjac root, both of which are full of soluble fiber. It also contains a SBO probiotic strain called Bacillus coagulans for additional gut support and for promoting nutrient absorption.

4. More protein (and fewer calories)

Roughly 20 percent of one’s diet or more should consist of protein, in order to maintain healthy muscles as well as create satiety. Remember that diets with higher protein only result in healthy weight management (or, in some cases, weight loss) if the overall calorie count is also considered (in addition to a healthy diet and lifestyle, including regular exercise).

Ideas for reducing calories include removing snacks, eating smaller meals and avoiding alcohol and sugary drinks.

To eat more protein, try having a protein with each meal, having protein supplements at the ready and selecting leaner cuts of meat.

5. Exercise

While many people will tell you that diet is the key to achieving weight loss or managing a healthy weight, exercise also plays an important role.

The best workouts don’t include just cardio, but incorporate strength training as well. Building muscle helps you lose inches all around, keeps your metabolism going after leaving the gym and will help you look better, too. Researchers even discovered that weight training could be more beneficial for helping to reduce belly fat than aerobic exercise.

6. Manage stress

Lower estrogen levels can mean more stress, which then can lead to weight gain for many. Even worse, when the hormone cortisol is released when you’re stressed, it can lead to more fat in the belly.

Meditation or mindfulness has been shown to help train the brain and body to help tone down the stress response and promote more relaxation.

In addition, some studies show that physical settings play a role in stress reduction, and being in nature is a well-documented way to promote relaxation. Try going for outdoor walks, visit your local parks (such as forest bathing), garden at home and try to stay away from technology for parts of the day … or even an entire weekend.