When we think about menopause symptoms, hot flashes, brain fog, and weight gain are usually the first to come to mind. However, there’s one common symptom that often flies under the radar: digestive issues, including Irritable bowel syndrome (IBS), constipation, and diarrhoea.
Many women transitioning through perimenopause and menopause experience bloating, irregular bowel movements, or increased food sensitivities. But can menopause cause IBS? Research suggests that hormonal changes can significantly impact gut function, worsening symptoms for women who already have IBS and even triggering digestive issues in those who never had problems before.
Despite its prevalence, menopause-related digestive symptoms remain widely overlooked, leaving many women to suffer in silence without clear solutions.
Let’s explore why menopause affects gut health, how it may contribute to IBS, constipation, and diarrhoea, and what you can do to support your digestion through this transition.
Understanding Menopause: What Happens to the Body?
Menopause is a natural biological process where the ovaries gradually reduce the production of oestrogen and progesterone, marking the end of a woman’s reproductive years. It typically occurs between the ages of 46 and 55.
There are 3 stages that characterise the menopause:
1. Perimenopause (Transitional Phase)
- Starts several years before menopause, usually around age 46.
- Sometimes termed the “zone of chaos”, hormone levels fluctuate. For most women, this will cause symptoms such as irregular periods, hot flashes, mood swings, and many more.
- This phase can last anywhere from a few months to a few years.
2. Menopause
- Officially diagnosed when a woman has gone 12 consecutive months without a period, with the average age being 51.
- Symptoms experienced during perimenopause may persist.
- The ovaries stop releasing eggs, and hormone production decreases significantly.
3. Postmenopause
- The years following menopause, when hormone levels stabilise at a new low.
- While some symptoms improve, lower oestrogen levels increase the risk of osteoporosis, heart disease, and gut health changes.
Menopausal Symptoms
There are over 40 recognised menopause symptoms, affecting everything from mood and metabolism to digestion and circulation. Since every cell in the body has oestrogen receptors, menopause-related hormonal shifts affect nearly every organ system—including the gut.
| Physical | Psychological | Vasomotor |
| Heart palpitations Difficulty sleeping Feeling tired/low energy, lethargy Dizzy, faint Headaches Tinnitus Dry mouth and eyes Sore gums Muscle and joint pains Breathing difficulties Needing to go to the loo more often, urine leaks Vaginal dryness Vaginal soreness Thrust, cystitis Dry or itchy skin Thinning hair Poor sleep Breast changes/tenderness Taste and smell changes Irregular periods/period stops Fat redistribution Weight gain | Low mood Anxiety Stress Feeling tense/nervous Memory problems Anxiety/panic attacks Difficulty concentrating Loss of interest in most things Feeling unhappy/depressed Crying spells Irritability Mood swings Loss of confidence Reduced self-esteem Brain fog Loss of sex drive | Hot flashes Night sweats |
While some of these symptoms are widely discussed, digestive issues—such as bloating, constipation, and diarrhoea—often go unnoticed.
In fact, 25% of women will experience severe or debilitating symptoms, but only 1 in 10 actually receive treatment. Anecdotally, many practitioners note that women frequently report bloating and other digestive discomforts as they go through menopause’s hormonal shifts.
Menopause and IBS: How Hormones Affect Digestion
Many women experience worsening IBS symptoms during menopause, while others develop new digestive issues for the first time. But why?
Common Digestive Symptoms in Menopause:
- Bloating
- Constipation
- Diarrhoea
- Abdominal discomfort
- Increased food sensitivities
- Fluctuations in appetite
While menopause doesn’t directly cause IBS, hormonal changes can worsen existing IBS symptoms or trigger IBS-like digestive issues. In fact, IBS disproportionately affects women at a ratio of 3:1 compared to men, and research suggests postmenopausal women are even more likely to experience IBS symptoms than menstruating women (study, study). Women who suffer from IBS symptoms prior to menopause will also often experience worse symptoms as in menopause (study).
Why Does This Happen?
There are two primary reasons why menopause may disrupt gut health and lead to IBS, constipation, or diarrhoea:
- Hormonal Fluctuations Impact Gut Motility
- Oestrogen and progesterone influence how food moves through the digestive tract.
- As these hormones decline, food moves more slowly, leading to constipation and bloating.
- In some cases, this hormonal imbalance can cause sudden diarrhoea episodes, especially after meals.
- Menopause Alters the Gut Microbiome
- Oestrogen plays a key role in regulating gut bacteria.
- Menopause-related shifts may lead to dysbiosis (an imbalance of gut bacteria), which contributes to IBS symptoms, inflammation, and poor digestion.
How to Support Gut Health During Menopause
Thankfully, there are several diet and lifestyle changes that can help manage menopause-related IBS, constipation, and diarrhoea.
Eat More Gut-Friendly Foods
- Increase fibre intake (aim for 30-40g per day) from vegetables, whole grains, and legumes to support bowel regularity.
- Include fermented foods like yogurt, kefir, sauerkraut, and kimchi to promote a healthy microbiome.
- Consider prebiotics and probiotics to balance gut bacteria.
Stay Hydrated
- Dehydration can worsen constipation, bloating, and even brain fog.
- Aim for at least 1.5–2L of water per day.
Reduce Gut Irritants
- Limit fizzy drinks, artificial sweeteners, and ultra-processed foods, which can disrupt digestion.
- Cut down on excess caffeine and alcohol, as they may worsen diarrhoea or trigger IBS flare-ups.
Manage Stress for Better Digestion
- The gut and brain are closely connected—stress and anxiety can make digestive symptoms worse.
- Incorporate mindfulness, yoga, or gentle movement into your daily routine.
How can a dietitian help?
Managing IBS, constipation, and diarrhoea during menopause requires a personalised approach. Working with a registered dietitian ensures your diet and lifestyle interventions address not just your gut health, but also your overall hormonal balance, energy levels, and well-being.
At Third Sister, we take a holistic, evidence-based approach to menopause nutrition, integrating clinical dietetics, functional medicine, and lifestyle interventions.
Looking for expert guidance? Book a free consultation with Third Sister and take the first step toward better gut health today.
