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How Does Perimenopause and menopause affect our gut function.


During perimenopause and menopause, hormonal changes can significantly impact gut function and digestion. Here's how:

  • Estrogen: Estrogen plays a role in maintaining the health of the intestinal lining. As estrogen levels decline during menopause, the lining of the digestive tract may become thinner and less efficient at absorbing nutrients. This can lead to issues like leaky gut syndrome, where the intestinal barrier becomes more permeable, allowing toxins and undigested food particles to pass into the bloodstream and potentially triggering inflammation and other digestive issues.

Low estrogen levels can contribute to constipation through several mechanisms:

  • Reduced intestinal motility: Estrogen helps regulate the movement of food through the digestive tract by affecting the smooth muscle contractions that propel waste material forward. When estrogen levels decline, this can lead to slower intestinal motility, which can result in constipation. Constipation during menopause may be a mechanism to increase the reabsorption of estrogen from the colon. Estrogen is excreted from the body via the bile into the intestine. In the colon, bacteria break down estrogen into various forms, some of which can be reabsorbed into the bloodstream.

  • Constipation slows down the transit time of feces through the colon, allowing more time for bacterial action and potentially increasing the reabsorption of estrogen. Estrogen can also influence other hormones that play a role in digestion, such as serotonin. Serotonin is involved in regulating intestinal motility and is sometimes referred to as the "happy hormone." Changes in estrogen levels can impact serotonin levels, which may affect gut motility and contribute to constipation.




  • Progesterone: Progesterone can affect gut motility, or the movement of food through the digestive tract. During perimenopause and menopause, progesterone levels also decline, which may lead to changes in bowel habits such as constipation or diarrhea.


  • Gastrointestinal symptoms: Hormonal changes can contribute to common gastrointestinal symptoms like bloating, gas, and indigestion. These symptoms can be exacerbated by factors such as stress, diet, and lifestyle changes that often accompany menopause.. Estrogen and progesterone can influence the production of digestive enzymes, such as amylase, lipase, and protease, which are responsible for breaking down carbohydrates, fats, and proteins, respectively.

  • Changes in hormone levels can alter the balance of these enzymes, potentially leading to digestive issues such as bloating, gas, and indigestion. Additionally, hormonal fluctuations can impact the function of the pancreas, which produces many digestive enzymes, further affecting digestion.As we age, the production of digestive enzymes tends to decrease. This natural decline in enzyme production can begin as early as in our 30s and 40s, but it becomes more noticeable as we get older. Several factors contribute to this reduction in enzyme production:

  • Decreased stomach acid: With age, the stomach tends to produce less hydrochloric acid, which is necessary for activating enzymes and breaking down food.

  • Reduced enzyme production: The pancreas, which produces many digestive enzymes, may become less efficient over time, leading to lower enzyme levels.

  • Changes in gut function: Aging can affect the overall function of the digestive system, including the gut lining and muscle contractions, which can impact enzyme activity and digestion.

  • Diet and lifestyle factors: Poor diet, stress, and other lifestyle factors can also affect enzyme production and digestive health over time.

As a result of these changes, older adults may experience digestive issues such as bloating, gas, indigestion, and nutrient malabsorption. To support digestion as you age, it may be beneficial to consume enzyme-rich foods, such as fruits, vegetables, and fermented foods, and consider enzyme supplements.



  • Microbiome changes: Estrogen and progesterone can influence the composition of gut microbiota, the community of bacteria and other microorganisms that live in the digestive tract. Changes in hormone levels during menopause can alter the balance of gut bacteria, which may impact digestion and overall gut health.


  • Weight gain: Hormonal changes during menopause can also contribute to weight gain, especially around the abdomen. Excess weight, particularly visceral fat, can increase the risk of digestive issues such as acid reflux and heartburn.

Reflux and heartburn can also be caused by insufficient stomach acid and digestive enzymes. We’re happy to help you dive into this if you’d like!

  • Bone health: While not directly related to gut function, it's worth noting that hormonal changes during menopause can also affect bone health, which is important for overall health and can indirectly impact digestion and nutrient absorption. If we are  not digesting our foods and getting all the nutrients, it can lead to increased risk of osteoporosis. 

However, hormonal changes can play a role in gut health for many women during this stage of life. 

You can however take the wheel and start to investigate the root causes of your GI issues. In Fact that’s a huge part of what we do on the inside of our coaching program.

We recommend getting some testing done to identify how your gut is functioning. 

Then addressing the issues specific  to you. Each person's gut health and hormone journey is going to look different. So sorry, there's no blanket supplement or protocol suggestions, because often doing things blindly can exacerbate one issue or another. If you’d like to dive in, we’re happy to help.


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