WTH?! (What The Health?!) is a Scary Mommy series answering health questions relevant to moms and women that we don't talk about enough. Think: "What is this weird pregnancy symptom? WTF is happening to me postpartum? Are these signs of perimenopause?" Let's normalize these and other women's health issues by talking about them more in a relatable, less clinical, and no-BS way.
You know those fun stomach issues you've probably experienced at some point — constipation, bloating, nausea, heartburn? Maybe you chalk it up to a bug your kid brought home. Maybe there hasn't been enough time to make meals, so you've relied on fast food. Or maybe it's stress. (Let's be real: It's stressful as hell trying to stay on top of everything between kids, jobs, family, friends, and more). But it turns out that hormones can also have a huge impact on your digestive system, especially during perimenopause.
When you go through perimenopause (the transition to menopause), your hormones are constantly changing and eventually wind down.
"We call estrogen, progesterone, and testosterone our sex hormones, but they control so much more than just our sexual function… They really play a big role in our bodies, and [even] in digestion," says Dr. Heather Hirsch, founder of the Menopause and Midlife Clinic at Brigham and Women's Hospital and author of Unlock Your Menopause Type.
Scary Mommy talked to doctors about how perimenopause can affect your digestive system (and yes, even your poop), what you can do to feel better, and when to reach out for help.
So how exactly does perimenopause change your digestion… and poop?
While not all women will have to deal with these symptoms, it is common to experience new constipation and bloating once you start going through perimenopause. As hormones are slowing down, they could be slowing the absorption of foods and the process of moving food through the gut, explains Hirsch.
This can also result in an increased amount of water being withdrawn from stool by the body, leading to harder, drier stools that are harder to pass (aka constipation), says Dr. Rabia de Latour, a gastroenterologist at NYU Grossman School of Medicine.
While constipation and bloating are usually the most common symptoms, some women may also have diarrhea, abdominal pain, nausea, acid reflux, and gallbladder issues, according to Dr. Supriya Rao, a Massachusetts-based gastroenterologist.
Rao says the symptoms can last anywhere from months to years but usually do improve when you reach menopause. (The average length of perimenopause is about four years, although it can last anywhere from a few months to more than four years.)
How do you know if changes in your digestion are due to perimenopause or something else?
If you have symptoms like hot flashes, irregular periods, or other perimenopausal symptoms in addition to the digestive changes, perimenopause may be the reason, explains Rao.
But it's important to recognize that not just hormones cause constipation, bloating, and other GI problems. Lifestyle habits (like eating a lot of processed foods) or underlying medical issues (like hypothyroidism) can also be culprits, according to Mayo Clinic.
If you have troublesome symptoms that aren't improving (see below), it's important to see a doctor. It's also now advised that all women get colonoscopies at age 45 to rule out colon cancer.
Thankfully, there are lifestyle changes that you can try to relieve and prevent constipation and other digestion issues.
A few tips from Rao:
- Eat a healthy diet that includes high-fiber foods (like lentils, whole-wheat pasta, and blackberries) and magnesium-rich foods (like pumpkin seeds, almonds, and spinach).
- Drink plenty of water. (The Institute of Medicine recommends that women drink at least nine cups of fluid daily.)
- Chew slowly because it decreases the amount of excess air you swallow, which can help avoid bloating.
- Get enough exercise and restful sleep.
- Limit alcohol and avoid smoking.
- Stress can worsen GI symptoms, so try breathing exercises, yoga, or other techniques to reduce stress.
Here's when you should see a doctor.
De Latour says to make a doctor's appointment if:
- You're still having symptoms with no improvement after a couple of months despite trying lifestyle changes.
- You see blood in your stool.
- You have a family history of colorectal cancer and notice digestive changes.
And lastly, know what the symptoms are for perimenopause.
There are at least 34 symptoms of perimenopause and menopause, and they couldn't vary more, from constipation to erratic periods to burning mouth syndrome. Knowing what to expect during this natural transition and that there are absolutely things you can do to manage the symptoms can make all the difference.
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