Menopause and IBS: How Hormones Can Hinder the Gut

Does menopause cause IBS?

While menopause itself doesn’t cause IBS, fluctuations in ovarian hormones can cause gastrointestinal symptoms in women. Multiple studies have shown that hormones may influence the occurrence, or worsening, of abdominal pain and discomfort during menopause, even if you haven’t been diagnosed with IBS before.

Menopause is the result of a drop in sex hormones (estrogen and progesterone) that leads to a reduction in eggs being released by the ovaries. Common side effects of menopause are:

• Hot flashes/night sweats
• Mood swings
• Fatigue
• Loss of monthly periods

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Although these are some of the most commonly discussed symptoms of menopause, a change in gut function is also frequently experienced. Interestingly, the gut symptoms you experience during menopause may be similar to those experienced around your monthly menses, pre-menopause when estrogen and progesterone dipped as part of your monthly cycle.

If you have already been diagnosed with IBS, you may notice that menopause worsens or alters your regular symptoms. Even those without a previous IBS diagnosis report digestive upset during menopause.

The impact of estrogen and progesterone on digestion

The drop in hormones causes the bowel, and the digestive tract as a whole, to behave differently than it may have pre-menopause. Progesterone and estrogen keep the muscles in the gut working smoothly and consistently to ensure food moves through your digestive tract at a healthy pace.

1. Increased constipation and/or diarrhea

When levels of progesterone and estrogen drop, the transit-time of your digestion slows down, which can lead to symptoms like constipation then diarrhea. The fast your body processes waste the more water it retains, and stools can be loose. The slower it processes the waste, the more water the body reabsorbs, making stools harder to pass. These are often symptoms of IBS.

2. Changes to stomach acid and bile production

The reduction of estrogen and progesterone may also impact the body’s ability to produce stomach acid and bile. Additionally, as estrogen levels decrease, cortisol and blood pressure rises, resulting in the slowing of the digestive system.

Stomach acid helps to break down food in your stomach, allowing the body to absorb nutrients and travel through the digestive tract. Gastric acid imbalances can lead to symptoms such as heartburn or acid reflux, bloating, diarrhea, and constipation.

Another digestive fluid needed for digestion is bile, which is made by the liver and stored in the gallbladder. Drops in progesterone and estrogen, as experienced in menopause, have been associated with lowered bile levels. If the liver isn’t producing enough bile to break down food, the stores in the gallbladder are depleted and fats can’t be digested properly, resulting in the inability of the body to absorb essential fat-soluble vitamins.

3.  Increased nausea

Another specific example of a gut-concern stemming from menopause is nausea. Although the exact reason for nausea during menopause is unknown, it’s generally understood that fluctuating hormone levels play a role, similar to what is experienced during pregnancy.

Like morning sickness, hormonal nausea isn’t easy to manage, but there are options. Some over-the-counter products, such as  Pepto Bismol, may assist in soothing nausea by protecting the lining of your stomach. Other drug-free remedies, such as ginger chews, sea-bands, peppermint tea, as well as sticking to bland foods, may assist.
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Hypnotherapy has also been shown to be helpful in reducing the experience of nausea, particularly in the treatment of nausea caused by chemotherapy and pregnancy.

Should I look into getting an IBS diagnosis?

If you think that menopause may have brought on IBS, then you may want to talk to your doctor about being assessed for an IBS diagnosis. Additionally, if you have experienced IBS previously, and find that your symptoms have returned or worsened, it may be time to speak to your doctor about updating your treatment plan.

An IBS diagnosis is made using the Rome IV criteria. Your healthcare provider will analyze your symptom severity and frequency to see whether you qualify for an IBS diagnosis, and also rule out other conditions with similar symptoms. According to the criteria, you need to have recurrent abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following:

• Related to defecation
• Associated with a change in frequency of stool
• Associated with a change in form of stool
  

If you think your symptoms may be a sign of IBS, make an appointment to discuss your symptoms with your doctor. Be careful not to self-diagnose IBS, because other, potentially serious, conditions can produce similar symptoms.

How to calm your gut during menopause

Menopause is a significant event in every woman’s life and can be both physically and mentally taxing on your well-being. The first step to soothing gut symptoms is to speak openly and honestly with your healthcare provider so that they can help guide you through this new chapter of your life and advise on appropriate treatments or management tools.

In addition to speaking to your doctor, there are some simple at-home remedies you can try to  manage menopause-related gut symptoms, such as:

• Eating smaller meals: Smaller portions, eaten slowly, may help to keep the digestive tract from working over-time. Try chewing your food slowly and sipping water.
• Reducing fatty foods: As menopause can reduce the amount of bile the liver is producing, too many fatty or fried foods can hinder the digestive process.
• Exercise: Taking some gentle exercise can help keep your digestive system moving and help to relieve constipation. Try walking, swimming, or yoga for a gentle exercise option.
• De-stress: Stress can increase gut symptoms. So, if you find yourself wound up or feeling anxious, try to make time to relax; take a warm bath, go for a walk, catch up with a friend.
• Try hypnotherapy: Hypnosis has been proven to be a safe and effective way to manage the symptoms of IBS. Some app-based hypnotherapy options, like Nerva, are easy to complete at home and can fit in around your schedule. Additionally, hypnotherapy has been shown to improve the symptoms of other menopausal symptoms, such as hot flashes.

The Wrap Up

While menopause is an expected part of a woman’s life cycle,  the addition of IBS symptoms during the time may come as a shock to some! The drop in sex hormones during menopause that leads to symptoms such as hot flashes, mood swings, and fatigue can also lead to, or worsen, gut symptoms such as constipation, diarrhea, and cramps. Fortunately, there are ways you can manage gut-symptoms at home, including making some simple changes to your diet and exercise routine or talking to your doctor about medical interventions or hypnotherapy.