Menopause and bloating

Hormonal fluctuations in menopause can cause bloating and your body to reabsorb and retain excess water.

You may find that bloating only happens after your meals or that it may have nothing to do with food. Menopause symptoms such as stress and fatigue may contribute to abdominal symptoms like bloating.

1. Water retention

During perimenopause and menopause, your hormones – particularly oestrogen, and progesterone – fluctuate dramatically. Studies show that these hormones can influence how your body retains water.

Oestrogen can trigger the production of the hormone aldosterone, responsible for sodium (salt) and water retention. When your body retains excess fluids, you experience bloating symptoms like distended abdomen, swollen legs, puffy eyes etc. 

This is why some report feeling bloated at certain points during their menstrual cycle when oestrogen levels are at their highest. On the other hand, progesterone – sometimes known as a ‘natural diuretic – blocks the effect of aldosterone and helps you get rid of excess water and salt. This could potentially relieve your bloating symptoms.  

2. Stress

Many find the time around menopause stressful. Not only is your body going through changes, but midlife often brings up its own challenges of increasing work and family pressures. As well as this, hormonal changes at menopause make you more likely to struggle with anxiety and depression.

Your brain responds by releasing stress hormones, particularly cortisol. And because of the brain-gut relationship, the stress hormones slow down the movement in your digestive system and cause a build-up. It’s no coincidence that when this happens, you will feel bloated.

3. Trapped wind

You may find that the fatigue and sleep issues caused by menopause have you reaching for sugary pick-me-ups and caffeine more regularly in an effort to keep your energy levels up. These foods linger in your digestive tract, ferment and decompose to produce gas. And, when you have too much intestinal gas, the outcome is bloating.

If you find yourself persistently bloating, it may be a sign of an underlying condition like irritable bowel syndrome, and you should see your doctor.

4. Constipation

Constipation is really common during and after menopause, and can lead to bloating and discomfort. It can be especially troublesome if you have any pelvic floor issues or prolapses, as these make it more difficult to open your bowels effectively.

To fight constipation, drink plenty of water (aim for 2 litres per day), take some exercise and eat a diet rich in fibre.

If you notice any problems with your pelvic floor – including continence problems, pain or prolapses – speak to your doctor, who may be able to recommend a more definitive treatment.

Bloating is usually temporary, and will subside within a few hours to days. Talk to your doctor to rule out possible causes if you have persistent bloating.

Weight gain is common during menopause and is gradual process taking a few weeks, months or even years. Menopause bloating happens suddenly.

Bloating is common, but can be a sign of an underlying medical condition. Check in with your doctor if this is a new problem for you, or if you notice that:

• Your stomach remains bloated for a longer time than usual or returns regularly (even if it settles in between)
• You feel bloated for more than a week
• You have persistently painful cramps
• You are constipated or have diarrhoea
• You have unexpectedly lost weight
• You can’t sleep
• You have symptoms like nausea or vomiting 
• You have any bleeding from your bottom 
• You have any irregular periods, bleeding after sex or in between periods
• You have any pain on intercourse
• You have any new swelling in your legs

Seek urgent help (the same day) if:

• You have any severe pain 
• You are unable to pass wind
• You have any other symptoms which are severe or worrying

While bloating is usually caused by a minor condition, it can sometimes be a sign of more serious illness. 

One rarer cause which you may have heard about is ovarian cancer. This can cause a number of subtle symptoms including bloating, feeling full more quickly after meals and an increased need to pee. 

These are all things that could be easily dismissed, and highlight the reason that it’s important to check in if something isn’t right – even if it isn’t dramatic or painful. If you are worried about ovarian cancer, your doctor can do a few simple tests (which may include examination, blood work or an ultrasound scan) to investigate further.

Bloating can also be caused by conditions affecting the bowels, liver and heart among others. Keep a log of your symptoms if possible – this may help your doctor to pinpoint the exact cause.