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Nurturing Gut Health: Understanding Microbiome Changes during Perimenopause

Ah, perimenopause —the rollercoaster of hormonal twists and turns. If you’re in the midst of this, you’ve probably had your fair share of ‘fun’ experiences. Alongside the hot flashes and mood swings, there’s likely another aspect of your health taking front stage: your digestive system. I’m here to chat about why your GI track is acting up more than ever now, and what you can do to soothe, calm and keep things running more smoothly.

The Microbiome and its Influence on Gut Health 

The microbiome, a complex community of trillions of microorganisms residing in the gut, plays a crucial role in digestion, metabolism, immune function, and even mood regulation. See my blog post ‘Mood and Perimenopause’ to learn all about neurotransmitters, many of which are produced in the microbiome. The microbiome is a delicate balance, easily influenced by various factors, including diet, lifestyle, and hormonal fluctuations.

During perimenopause, oestrogen levels fluctuate and eventually decline. Oestrogen has an impact on the gut’s mucosal lining and can influence the composition (good bacteria vs bad bacteria) of the microbiome. These shifts can affect gut motility, digestive function, and even the susceptibility to GI issues.

Besides hormonal fluctuations and changes in the gut microbiome, several other factors can contribute to gastrointestinal (GI) flare-ups during perimenopause:

1. Dietary Changes

Shifts in dietary habits or increased intake of certain foods, like spicy or fatty foods, can irritate the digestive tract and trigger GI symptoms. As fatigue sets in, women often start drinking more coffee or tea, which can irritate the gut lining. To manage and reduce stress, women often turn to a glass of wine after work. Alcohol is anti-bacterial, it sterilises and kills bacteria so if it does that on the surface, then think about what it’s doing inside your gut? I believe in everything in moderation, but when these habits are used to manage stress, they usually exaggerate the detrimental effect stress has on the body, not eliminate it.

2. Stress & Anxiety

As progesterone starts to decline in the first stages of perimenopause, women can start to feel more anxiety and irritability which then translates into stress. Perimenopause, coined ‘the second puberty’ can be a stressful time in itself with new symptoms and period uncertainty occurring, and heightened stress levels can exacerbate GI symptoms. Stress impacts gut health and can lead to symptoms such as abdominal pain, diarrhoea, or constipation.

3. Reduced Physical Activity

Changes in exercise routines or a decrease in physical activity levels during perimenopause may affect digestion and contribute to GI discomfort. Women generally feel more tired and have less time and energy to do the exercise routines they may have done in the past.

4. Medications and Supplements

Certain medications or supplements, often taken to manage perimenopausal symptoms, may have side effects that affect the GI tract, causing bloating, nausea, or changes in bowel habits.

5. Hormonal Medications

Hormonal replacement therapy (HRT) or hormonal contraceptives can impact the gut and cause GI symptoms as the body adjusts to the hormonal changes.

6. Bacterial Overgrowth

Changes in hormone levels can disrupt the balance of bacteria in the gut, potentially leading to bacterial overgrowth and GI issues. UTIs and thrush can become more prevalent as well.

7. Food Sensitivities or Allergies

Perimenopausal hormonal changes can sometimes trigger or exacerbate food sensitivities or allergies, resulting in digestive discomfort and symptoms like bloating and diarrhoea.

8. Histamine Intolerance

Hormonal changes during perimenopause can increase sensitivity to histamine. Histamine intolerance is a condition where your body has trouble breaking down histamine, a natural chemical involved in various bodily functions like immune response and digestion. When there’s too much histamine or not enough of the enzymes to break it down, it can trigger a range of unpleasant symptoms.

Here are some of the most common symptoms of histamine intolerance:

  • Digestive issues: These are the most common symptoms, including bloating, diarrhoea, nausea, vomiting, and abdominal pain.
  • Skin problems: Itchy skin, hives, and flushing are also frequent symptoms.
  • Headaches and migraines: Histamine can trigger headaches and even migraines in some people.
  • Runny or stuffy nose: Sneezing, itching, and a runny or stuffy nose are common allergy-like symptoms.
  • Fatigue and brain fog: Feeling tired and having difficulty concentrating can also be caused by histamine intolerance.

Some tips for managing histamine intolerance:

  • Keep a food diary: This can help you identify foods that trigger your symptoms.
  • Avoid high-histamine foods: Some common culprits include aged cheeses, fermented foods, processed meats, smoked meats, citrus fruits, certain vegetables like tomatoes and spinach, alcohol, and some types of nuts and seeds.
  • Take a DAO enzyme supplement: This can help your body break down histamine more effectively.
  • Manage stress: Stress can worsen histamine intolerance symptoms.

9. Other Digestive Disorders

Pre-existing digestive conditions such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) can be aggravated during perimenopause due to hormonal fluctuations.

10. Menstrual Cycle Influence

Fluctuating oestrogen and progesterone levels throughout the menstrual cycle, which can occur during perimenopause, may affect GI symptoms in some women. Generally speaking, the second half of a woman’s cycle (post ovulation) will lead to more bloating and digestive upsets.

When it comes to digestion, it’s usually not straightforward. There’s the effect of a combination of any of the above which can make it tricky to unravel and find the solution to fix your gut. Starting with a well-rounded approach to diet, nutrition, and lifestyle, can help manage and alleviate GI flare-ups during perimenopause effectively.

Is Bloating Normal? 

Some bloating is normal. If you’ve eaten a big meal or at the end of the day, a slightly bloated stomach is totally fine. If you’re bloating all the time however, that’s not ok. You’ll want to check with your Healthcare Practitioner and investigate as to why that’s the case.

Diet and Nutrition Support for a Healthy GI Tract 

Be sure to cover all the bases of a healthy diet. Your microbiome loves fibre, vegetables and a variety of natural, minimally processed foods.

  • Aim for 30+ different vegetables weekly
  • Aim for 7 servings of veg + 2 servings of fruit daily
  • Eat whole grains over simple carbs
  • Eat a variety of different foods including protein, healthy fats, whole grains etc
  • Hydrate – 2+ litres of filtered water daily
  • Eat a serving of fermented foods daily – foods like yogurt, kefir, sauerkraut, and kimchi into your diet for their natural probiotics, fostering a balanced gut microbiome
  • Include prebiotic-rich foods such as garlic, onions, asparagus, and bananas to nourish and stimulate the growth of beneficial gut bacteria

Lifestyle Tips for a Healthy Gut 

You’ve heard all of these before, but I have to include them because they are foundational to a healthy digestion and microbiome.

  • Regular exercise
  • Adequate Sleep
  • Stress Management

Supplement Suggestions 

1. Probiotics

There are too many to name out there, but choose a good quality brand and one that has specific strains aimed to your health goal. A few recommended brands are Activated Probiotics, Invivo, Optibac, Biokult, Inessa and Cellcore Biosciences.

2. Digestive Enzymes

These are great to have on hand when you eat a big, heavy or rich meal. They help aid proper digestion and nutrient absorption.

3. Activated Charcoal or a binder

Think of these when you’re having a Chinese takeaway or big meal out, or drinking alcohol and overindulging. They can help bind some of the bad stuff in the food / drink you’re having. Just be aware that when they help bind and eliminate, that’s everything including other supplements or medications so take those at least 2 hours away from the binder. My personal favourite binders are from Cellcore Biosciences.

4. Fiber Supplements

Psyllium husks are a type of soluble fiber derived from the husks of the psyllium seed that is used as a bulk-forming laxative. Psyllium husk powder, used in products like Metamucil, is mixed with water and taken by mouth to treat occasional constipation and maintain regular bowel movements.

5. Prebiotic Supplements

These contain prebiotic nutrients and foods to help feed the good gut bacteria in the microbiome, helping to crowd out the bad bacteria. These can aid with diversity and overall quantity of good gut bacteria in the gut. PHGG, GOS and some medicinal mushrooms are a few common prebiotics found on the market.

6. Soothing Herbs for the Gut

Mother Nature offers a gentle hand when it comes to soothing your gut. Several herbs possess properties that calm and comfort your gastrointestinal (GI) tract, alleviating discomfort and promoting well-being. You don’t need the herbal tincture, good quality teas and food-grade essential oils (like Doterra) do the trick too.

Here are a few to keep in your cupboard:

  • Peppermint: This refreshing herb is a champion for gut health. Its key compound, menthol, relaxes the muscles in your digestive system, easing cramps, bloating, and gas.
  • Ginger: This versatile root boasts potent anti-inflammatory and antispasmodic properties. It warms your tummy, promoting digestion and quelling nausea.
  • Chamomile: This delicate flower isn’t just for calming bedtime teas. Its calming properties extend to your gut, easing inflammation and reducing anxiety that can worsen digestion.
  • Licorice Root: This sweet herb coats and protects the lining of your digestive tract, reducing irritation and discomfort.

Nurturing GI Health in Perimenopause

As you go through perimenopause, understanding and nurturing your gut health is crucial for overall well-being. The symbiotic relationship between your hormones and gut microbiome necessitates a thoughtful approach otherwise things can go Pete Tong quickly down there! By incorporating a fiber-rich diet, fermented foods, prebiotics, and embracing a healthy lifestyle, you can optimise your GI health. Supplements, when chosen wisely, can also offer valuable support. What’s your favourite tip for a healthy gut?

For personalised advice on nutrition and hormone balance during perimenopause, be sure to sign up to newsletter. If you’re struggling and would like help book in a discovery call with me to see how I might be able to help.



If you like this post you may also be interested in the following articles:

Perimenopause Quiz

Optimise Your Hormones for Energy and Vitality

Perimenopause Diet

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