Perimenopause and Bloating Remedies: What can you do?

Mar 14

Bloating is a common symptom for women around menopause, so if you are feeling bloated, you are not alone.

Studies have shown that perimenopausal and postmenopausal women experience more bloating, distension and gas, compared to men. (1)

If you don’t know where to start to help ease the discomfort of bloating, you’ve come to the right place.

In this article I will explain what bloating is, why it’s more common around the menopause and, most importantly, some remedies you can try to relieve it.

Let’s jump in.

What is Bloating?

Bloating can be described as the sensation of an inflated balloon in your abdomen, leaving you feeling tight, stretched and uncomfortable.

Many people see bloating as a mild symptom, however, at A Gutsy Menopause® we know differently. Symptoms such as bloating can be painful and frustrating.

The two main causes of bloating are:

water retention in the abdomen
gas retention in the abdomen

Bloating may sometimes be confused with weight gain as the body can feel heavier (2).

If you have been diagnosed with irritable bowel syndrome (IBS), bloating can be a common symptom you experience (3).

The causes of water and gas retention in your abdomen will, but often it’s caused by the following:

Swallowing excess air whilst eating
Constipation
Excess wind and/or burping (4)

In some cases, bloating can be caused by:

Coeliac disease
Food intolerances
IBS

As always, please contact your GP/doctor or appropriate health care professional if you are concerned about any of the above.

Why Does Bloating Happen in Perimenopause?

One possible theory about menopausal bloating is the shift in ovarian hormones.

Fluctuations in oestrogen and progesterone appear to increase visceral sensitivity, i.e. the sensitivity for the internal pain of our organs which can cause the sensation of bloating. This theory also applies to bloating commonly experienced during monthly periods. (5) (6)

Studies have shown that female sex hormones can directly affect how the body absorbs water. (7) Women receiving estrogen therapy through HRT tend to retain more water, a known cause of bloating (7b).

Some researchers have suggested that it is the combination of menopause symptoms, such as hot flashes, mood swings and sleep disruptions, which worsen gastrointestinal symptoms (including perimenopausal bloating).

Of course, these symptoms alone, and in combination, can cause stress which may also be contributing to worsening gut symptoms! (1)

Bloating can be a side effect of oral hormone replacement therapy (HRT). One study found that oral HRT (similar to birth control pills) users have longer transit times (i.e. the amount of time it takes food to travel through the gut) This may cause both gas and water retention, leading to bloating symptoms. (8)

Despite some evidence relating to menopause and bloating, there may be other over-looked reasons as to why you’re experiencing bloating. These may include; swallowing air whilst eating, drinking carbonated beverages, stress, trigger foods, lactose intolerance can all play a part. (9)

In summary bloating can happen in perimenopause because:

Increased sensitivity in our gut leading to increased likelihood of pain with bloating
Other menopausal symptoms like sleep disruptions worsening gut symptoms like bloating
A side effect of oral HRT
Drinking carbonated beverages
Eating quickly
Potential lactose intolerance
Stress

Want to learn more? Download our “Guide to Gut Calm for Bloating” E-book

Bloating Remedies: What can help?

Figuring out how to reduce bloating can be tricky and ultimately it comes down to figuring out why you are experiencing bloating in the first place.

1. Figure out your trigger foods

Carbohydrate-rich foods higher in fibre are generally harder for our bodies to digest.

I think we can all agree that beans, broccoli, cabbage, and brussels sprouts are known to cause farting! Tricks like soaking beans in water and cooking high-fibre foods thoroughly before eating can ease your digestion but if this has no effect, avoiding them might be the best.

It is always best to speak with a dietitian or registered nutritionist before eliminating foods from your diet. They can help you to identify foods you do and don’t need to reduce or eliminate so that you don’t run the risk of a nutrient deficiency.

Common foods that can cause bloating are (10) (11):

Beans & legumes
Cabbage
Brussel sprouts
Artichokes
Asparagus
Onions
Celery
Bran
Carbonated drinks
Dairy products
Foods containing sugar alcohols (some artificial sweeteners) sorbitol, mannitol, xylitol

2. Watch your sodium intake

A 2020 study found that a high sodium intake promotes water retention in our bodies which can lead to bloating (12).

Salt is the main source of sodium so reducing your intake may ease your perimenopause bloating.

Lowering salt intake is also beneficial to reduce blood pressure which reduced your risk of cardiovascular disease.

Processed foods often contain high levels of salt, such as:

processed meat
crisps
instant soups
soy sauce
salad dressings
sauces
cheese

Choosing low-salt alternatives more often, such as reading traffic light labels on food or seasoning with herbs and spices, can be a good place to start.

3. Increase fibre & Water

Increase fibre (and water), gradually. Fibre can help to make bowel movements more ‘normal’, and prevent constipation (18).

Your bloating may be due to constipation so ensuring you’re getting enough fibre in your diet may help. Check out the article on perimenopause and constipation for more information.

Remember that it’s important that you increase your dietary fibre gradually and include water or unsweetened drinks regularly.

A quick increase in fibre may cause unpleasant gut symptoms, including bloating and gas.

Make sure to keep hydrated too, increasing fibre without water/fluid won’t help to relieve your symptoms and will leave you feeling uncomfortable.

Take small steps to increase your daily fibre intake like switching to wholemeal bread and adding an extra portion of vegetables to your dinner.

4. Consider taking probiotics

Probiotics are live microorganisms that can help our bodies, especially our guts. These are ‘good’ bacteria that can help keep our guts in tip-top shape.

Supermarket shelves are filled with a variety of probiotic brands, so choosing one may be confusing.

Unfortunately, there isn’t enough evidence for probiotics use and improved gut symptoms, but they may work for some.

Common probiotics include:

L. sporogens/Bacillus coagulans
Bifidobacterium species (13)

Popular probiotics brands available in the UK include:

Symprove
Optibac
VSL #3

Did you know that different strains of probiotics are recommended for different conditions?

Before you head out to a health and wellness store, consulting with a dietitian or registered nutritionist with an expertise in gut health is always a good idea if you wish to try probiotics as they will have the latest evidence on the best probiotics for a particular symptom or health condition.

It’s helpful to know that when you first start taking a probiotic that you may experience bloating as a side-effect until your body gets used to probiotic, this is normal.

If you have a weakened immune system, check with your doctor/GP or dietitian prior to taking probiotics or any supplements for menopause bloating.

5. Rule out any medical conditions

a) Irritable Bowel Syndrome

IBS is a common condition among all ages, but some women can develop symptoms during perimenopause.

In addition to bloating, IBS can include symptoms such as abdominal pain, constipation and diarrhoea. (14) (15)

B) Lactose Intolerance

Lactose intolerance is caused by the body’s inability digest lactose sugar, found in most dairy products, which can cause digestive discomfort and bloating.

Our ability to digest lactose decreases with age, so it is not uncommon to develop this later in life.

In most cases, bloating is not serious and can be managed with lifestyle changes. However, if you are concerned, please do consult with your GP or relevant health care professional.

6. Get active

Some studies show that symptoms of bloating resolve after exercises like walking and cycling, although the evidence isn’t completely clear (16).

However, we all know that participating in physical activity has a host of other benefits such as maintaining a healthy weight and managing stress levels (which we know contribute to gut issues).

7. Eat mindfully

Eating quickly and talking during mealtimes can cause too much air to enter our digestive system, leading to trapped wind and bloating symptoms.

Try to limit talking while eating and make sure you chew your food slowly and thoroughly.

Walking or moving whilst eating can also cause you to swallow air, so try to find time to sit comfortably when eating. Chewing gum can also have the same effect.

Home Remedies for Bloating

Below are some home remedy ideas to try and ease your bloating symptoms.

Disclaimer: although these remedies may work for some women, they may not work for others. Try one at a time, so you can identify if any have had an impact on your symptoms.

A) Ginger

Yes, ginger does it again. Ginger can be effective in easing bloating for some women, so including some in your diet may bring some relief (19).

Ginger has been found to be beneficial for other gut symptoms such as nausea. Check out my article on perimenopause and nausea for more information.

Ways to include ginger into your day:

Ginger iced tea:

Sliced ginger, lemon and spoonful of honey - make warm, let steep for 15 minutes, then place in the fridge for an hour (or overnight, ready for the next morning). Serve with ice.

Ginger chews/sweets:

We don’t want to have too many of these as there can be quite a high amount of free (added) sugars but a couple of these may do the trick.

You can choose a sweetener-based sweet if you’re watching your blood sugars but beware that if there is a sugar alcohol (ending in ‘ol’) sweetening the product this may cause gut distress for those with GI symptoms and/or IBS.

Try having a recipe featuring ginger for dinner: We found this great ginger chicken recipe from BBC Good Food.

B) Make time to relax

We know that stress can have a major impact on gut symptoms.

For some, stress can slow down the digestive system causing feelings of bloating and constipation.

For others, it can speed it up, causing diarrhoea and an urgent need to use the toilet!

Tips for making time to relax:

Take time for yourself, curl up with a good book or watch a new TV series.
Lower your screen time. Set aside a few hours in the day where you don’t need to look at your mobile or tablet.
Try not to use alcohol to relieve stress.

When Should You Seek Medical Advice?

Hopefully this article has provided some useful tips to help ease your bloating symptoms.

However, if your symptoms have been long-standing and are disrupting your day-to-day life, please seek the help of a GP/Doctor or dietitian.

If you are experiencing constipation, diarrhoea, excessive gas or cramps alongside your bloating, a GP/Doctor can help rule out any underlying cause.

In Summary

Bloating is something that all of us have experienced at some point, however, bloating in menopause can be even more common.

Why it is more common is likely a result of fluctuating hormone levels, a side effect of oral HRT use, stress or potentially other dietary habits such as eating quickly.

Remember that figuring out how to ease your bloating ultimately comes down to figuring out the root cause of why you are experiencing bloating in the first place. These reasons can be conditions such as IBS or a lactose intolerance to things like eating quickly which brings too much air into the digestive tract.

Ways to manage and banish bloating can include identifying trigger foods, watching your salt, exercise, trialling probiotics, and eating slowly.