Changes in gut health during menopause

The link between changes in gut health and menopause hormonal flux is not often considered by women as the cause for their digestive issues. If your gut isn’t happy you can be sure that it will have an impact on your overall wellbeing too.

Emily describes herself as a ‘53-year-old, stressed accountant!'

What added to her stress was the mystery surrounding the mounting list of gut problems she experienced as she entered menopause.

We asked Emily if she’d share her story. We’d like to emphasise that whilst Emily isn’t an expert, ‘digestive issues’ are the top rated search on our website, so we thought her experiences and discoveries could help others suffering with similar conditions to find their own solutions.

My Gut Feeling: Linking changes in gut health during menopause!

Just as I hit menopause, and along with the heart palpitations and restless nights, I started having stomach cramps, bloating, acid reflux and diarrhoea. I was given Omeprazole, for acid reflux, but it didn’t help. I lost a stone in weight quite rapidly and my GP was so concerned I was referred to the Rapid Access Diagnostic Clinic at Guys Hospital where I underwent an army of tests from chest X-ray, colonoscopy, Pelvic Ultrasound to numerous blood tests. Everything came back clear, which was an enormous relief, but didn’t explain my symptoms!

FODMAP trials

I experimented with FODMAP, which classifies a group of carbs that trigger digestive symptoms, believing it might be allergy related, but this meant cutting out many foods including vegetables and I didn’t notice much difference.

The gut-hormone connection

Searching the internet, I came across studies linking the gut and hormones. Without going into the whole science of it. There are hormone receptors in the gut that respond to Oestrogen and Progesterone and the state of the gut affects hormonal metabolism – it’s a two way process.

Inflammation of the gut can be caused by:

Poor diet
Hormone imbalance
Stress
Lack of sleep
Antibiotics & Painkillers
Alcohol

Well, perimenopause had caused havoc to my hormone levels and disturbed sleep was becoming the norm. My mother had just been diagnosed with dementia and my stress levels had hit the roof and I needed that glass of wine every night! I’d taken antibiotics for a series of urinary tract infections (another common symptom of menopause) and I knew I had a ‘sweet tooth’ so I’d managed to tick every bullet - but not in a good way!

I began to wonder if my gut bacteria could be the problem and knew I could improve my diet, even if I couldn’t control all the other issues.

A better diet

I went privately to see a nutritionist and was advised to:

Cut down on fruit, particularly dried fruit (which is high in sugar) to 2 portions a day
Eat more green leafy vegetables like kale, chard, spinach (a rich source of minerals and vitamins) and eat least 5 portions of vegetables a day
Eat 30g of nuts and seeds like walnuts, almonds (high in antioxidants)
Cut down on red meat (high in saturated fats) and avoid processed meats (which are linked to bowel cancer)
Eat more oily fish such as sardines and mackerel (which are high in Omega 3)
Switch to wholegrain versions of foods like bread and rice (which are higher in fibre) and eat pulses
Drink plenty of water and cut down on caffeine (a gut irritant)
Eat fermented foods like yoghurt, kefir and kimchi (which increase the good bacteria in your gut)

I realised just how much sugar and saturated fat I had in my diet and blame ‘The Great British Bake off’ which had inspired me to bake cakes, bread and pastry and eat far too much of them!

Instead I bought books like The Doctor’s kitchen by Dr Rupy Aujla and experimented with vegetables. I made my own yoghurt and kefir and cooked all my meals from scratch. I’ve grown to love colourful meals rich in vegetables!

Has my gut improved?

It took around three months to get a real improvement in my stomach problems but I no longer have stomach cramps, bloating, acid reflux or diarrhoea eighteen months later.

A good diet had other benefits - I could see how much better my skin, hair and nails looked.

There were other positive signs - my cholesterol dropped from 7.5 to 5.7 mmol/L (24% decrease) which is still higher than normal but acceptable and my fasting blood sugar dropped from a pre-diabetic level of 6.0 to a normal 5.6 mmol/L.

Any conclusions?

Perimenopause and menopause affects your hormones, sleep patterns and may increase anxiety and stress which could all cause inflammation in the gut. If you add to the mix a high sugar diet, too little veg and take courses of antibiotics then the balance of healthy bacteria in your gut may be lost. But the good news is your gut health can improve by changing your diet.

Hippocrates wrote ‘All diseases begin in the gut’ and I’m beginning to believe he is right!

I’m not a saint and I still enjoy an occasional home-made chocolate brownie! I also eat 2 pieces of 70% dark chocolate every night because its rich in antioxidants – shame it can’t be the whole bar…

Emily Montague

August 2019

We’d like to add that, if you’re experiencing digestive issues, you should talk to your doctor, or consult a Registered Nutritional Therapist.

To find a qualified nutritional therapist in your area contact The British Association for Nutrition and Lifestyle Medicine BANT.

For further information read our SYMPTOMS section on Digestive Issues and Feeling Bloated.

Gut health and menopause