Are you bloated, swollen, and pooping pellets?
Welcome to the bowel changes of a woman's life: constipation and menopause.
As if abdominal pain from your period wasn't enough.
Abdominal cramping from sluggish bowel activity during the menopausal transition is just as much of a doozy.
Let's talk some s**t about these crazy symptoms of menopause and shed some light and good news about how to care for our digestive health.
Hormones, Constipation and Menopause: The Gut Health Connection
I've been pretty lucky most of my adult life. Waking up and pooping without needing the obligatory cup of coffee is a feat.
It wasn't always like that, though.
As a young kid, I had significant bouts of constipation. The enemas and suppositories type of constipation. Hours were spent crying on the toilet in pain with my mom holding my hand, begging me to go.
Unfortunately, the house I grew up in as a young child was filled with tension.
So it made sense that I "held it all in".
To this day, I am 'poop shy,' called parcopresis, the fear of pooping when others are nearby.
As a result, I can't poop in any public place or a bathroom that isn't my own, a type of social anxiety.
Early on, I learned that emotions and hormones play a prominent role in gut health. Therefore, as we age, it can also contribute to menopause and constipation.
This post is all about constipation and menopause and is dedicated to my fellow hard-to-poop ladies. Here's to learning to embrace what it means to "LET GO."
What Is Constipation?
The medical definition of constipation is having 2 or fewer regular bowel movements per week.
Digestive health relies on metabolizing and moving food waste from the body.
The digestive tract begins at the mouth and ends at the anus. We have hollow and solid organs that contribute to proper bowel function.
The hollow organs of the GI tract are:
- large intestine
- small intestines
The three solid organs that also make up the digestive system are:
If any of these organs become problematic, they can contribute to possible causes of constipation.
The Menopausal GI System
If you are reading this, you aren't alone! You are in the company of 3 million other women entering menopause this year.
A recent study showed that more pre- to postmenopausal women complain of acid reflux. Whereas, 80% of these women had never complained of gastrointestinal symptoms in their younger years.
The results concluded that postmenopausal women were 2.9 times more likely to have digestive problems.
A second study result from China revealed an increase in women's chronic constipation as they age.
Women who had the worst complaints of digestive issues had the following criteria:
- physical inactivity
- a high body mass index / obese (> 50 lbs)
- works a sedentary job
- poor sleep
- unhealthy lifestyle choices (smoking, alcohol consumption, not eating enough fruits and vegetables)
A third US study revealed that women over 50 experience increased symptom severity related to irritable bowel syndrome.
There is reason to believe that the possible underlying condition related to constipation and menopause is connected to a woman's changing sex hormones, stress levels, and overall health.
Hormonal Changes and the Gut Microbiome
In women, the gastrointestinal tract is lined with progesterone and estrogen receptors. Estrogen, in particular, directly affects how the cells of the inner walls of the intestines secrete mucus.
This mucus helps to lubricate the tract and is essential for the digestive process.
Types of Estrogen
Women's bodies produce 3 types of estrogen during their lifespan:
- Estrone (E1): the dominant estrogen from menopause and beyond yet is weak in potency
- Estradiol (E2): is the most powerful of all estrogens and is present from puberty to premenopause.
- Estriol (E3): the weakest of the estrogens yet most abundant during pregnancy
In addition, some estrogen is produced by plants, known as phytoestrogens, and are typically consumed in foods (fruits, veggies, wine, teas).
Whereas synthetic estrogens are created by laboratories and are found in fragrances, chemicals, and plastics. These are known as xenoestrogens. These "fake" estrogens, like polyethylene glycol (PEG) found in plastics, are made synthetically.
These estrogens are consumed through what we put on our skin (lotions, perfumes, deodorants), what we breathe (room sprays, body sprays) or what we eat (plastic food containers). Food containers that are made from plastics degrade when we put them in the microwave or store hot foods in them.
They wreak havoc, have side effects, and can disrupt a woman's health.
Gut bacteria also contribute to making estrogen. The gut microbiome consists of trillions of microorganisms that live inside our intestinal tract.
These bacteria play a role in:
- helping us digest the nutrients we get from our food
- absorption of macronutrients (proteins, carbohydrates, fats)
- the breakdown of any drugs that we take
- keeps the barrier of the gut strong and protected
- activates our body's immune system to help us fight disease
- protects us against invading viruses or parasites or harmful bacteria
Health problems can emerge if the gut microbiome is not balanced and lacks bacterial diversity. This is known as dysbiosis. Beyond constipation and digestive problems, some issues that women suffer when their gut is out of balance include:
- vaginal or rectal itching or infections
- aching or inflammation of joints
- acne, psoriasis, or inflamed skin conditions
- concentration issues
- anxiety or depression
- chronic fatigue
Foods That Contribute To Menopause Constipation
Dietary changes can make a big difference in the bowel habits of women entering and going through the hormonal shifts related to menopause.
Dairy products can affect those sensitive to protein casein or whey in cow's milk.
Fatty foods in fried, greasy, oily processed meats and commercially baked goods can lead to dry stools and weight gain.
Keto dieting (low carb - high fat) can cause constipation early on due to sluggish bile production and low stomach acid.
Sugary sweets in rich desserts can cause a rise in glucose, leading to insulin resistance in menopausal women. Ingesting sugar substitutes (aspartame, sucralose, maltitol, or sorbitol) can lead to inflammatory bowel disease. IBS can cause alternating constipation and diarrhea.
Also, the aging woman has less thirst, making her more dehydrated than most. Any food or drink such as soda or caffeine can contribute to dehydration which also leads to constipation.
How Stress Affects the GI System
Cortisol is our body's primary stress hormone. It is an essential chemical because it works as an internal alarm system. When we are under physical, emotional, chemical or psychological stress, our body produces cortisol to help us get through the stressor. The "fight or flight" alarm bells get triggered when the brain perceives something as a threat.
When cortisol hormone levels are balanced (and not in an alarm state), they help us in many positive ways, such as:
- uses up blood sugar to keep us fueled properly
- allows us to have good sleep/wake cycles
- regulates how our body deals with inflammation and pain
- helps us break down proteins, carbs and fats from the foods we eat
If cortisol levels become imbalanced (too high or too low) as we respond to stress, the following issues can occur, which we see as common menopause symptoms:
- an increase in hot flashes
- mood swings and feeling more anxious
- high blood pressure
- random muscle contractions like restless legs or twitching
The Gut + Brain Connection
This information superhighway allows the gut microbiome and the brain's chemicals to communicate. It is a powerful two-way system that allows the brain and gut to talk to each other. Like any relationship, sometimes they jive, and other times they talk nonsense to each other.
Their connection coordinates how our bodies adapt to stress. It is part of the limbic system, our brain's emotional and memory control center.
Therefore, making the direct connection between emotions and digestion.
Emotions and Digestion
You've been told that you will give a speech in front of your company tomorrow. You have no experience in public speaking, and it petrifies you. You notice yourself getting flushed, and your heart starts beating fast. Your stomach feels queasy, and you run to the bathroom. You can't sleep the entire night before the speech and feel like you might pass out. Your body reacts to emotional stress immediately. This is how fast the gut-brain connects.
Lifestyle Changes To Reduce Menopause Constipation
Drink Enough Dietary Fiber Infused Water
Water consumption is a tricky recommendation for anyone. Drinking too little water will obviously cause sluggishness and dehydration.
On the contrary, drinking too much can cause health problems as well.
This is because overhydration can cause electrolyte imbalances.
- Aim to drink about 8 glasses of water per day
- Add 3 oz of prune juice to your water. Prune juice contains sorbitol, magnesium and potassium which all help to relax and pull water into the intestines. It can act as a mild laxative.
- Drinking warm lemon water in the morning upon waking. Squeeze 1/2 lemon into warm water and drink.
- Drink homemade apple juice. Blend up 1 apple in the blender with water. Apples contain insoluble fiber, which helps improve the bowels' movement.
Here is an excellent recipe for a natural electrolyte drink to rehydrate you during menopause.
Try A Salt Water Flush
An editorial by the medical journal of gastroenterology instructed patients to combine non-iodized salt with 4 cups of water before a colonoscopy.
This helped to "flush" their colons adequately before going in for a colonoscopy. As a result of this paper, the combination of salt and water became known in the detox community as the "salt water flush."
Pelvic Floor Exercises
If you gave birth vaginally in your lifetime, the chances of experiencing pelvic floor trauma are high.
About 50% of all constipated patients have a form of pelvic floor dysfunction.
In addition, the inability to relax and coordinate the pelvic floor muscles can contribute to constipation.
Finding a healthcare provider specializing in pelvic floor issues can significantly help.
Stimulate the Vagus Nerve
The vagus nerve is the 10th cranial nerve that spans from the brainstem to the abdomen.
It is known as the "wandering" nerve and has a significant connection to gut control. It helps to balance the gut-brain axis.
Deep, slow, rhythmical breathing techniques (exhalations longer than inhalations) can stimulate the vagus nerve.
This breathing technique can help relax the intestines, releasing tension in the intestines and abdomen.
Lack of physical activity contributes to a sluggish bowel.
Mild to moderate aerobic exercise improves how waste moves through the intestines. Exercise also enhances the amount of time food is transferred through the gut.
This movement is related to vagus nerve stimulation and an increase in certain hormones released by the GI system.
Physical exercises also stimulate the gut with bouncing activities, increased gravity, and contraction of the abdomen muscles, which enables moving stool through the intestines and rectum.
If you want to try to run your first 5K during menopause, try this exercise plan!
One of the most common symptoms of menopause is constipation.
For many premenopausal women, when the menstrual cycle begins to change, so do bowel movements due to the decline of estrogen levels.
As a result, it becomes essential for aging women to get in plenty of water, eat fiber-rich whole grains and improve their overall quality of life.
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Hormones, Constipation and Menopause: The Gut Health Connection
by DR. BIANCA BELDINI
August 14, 2022
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