Perimenopause and Your Bowel: How Low Oestrogen Can Affect Gut Health
When we think about perimenopause, symptoms such as hot flushes, night sweats, changes in periods and mood are often the first things that come to mind. But hormonal changes during perimenopause can affect much more than reproductive health — including the digestive system.
Many women notice changes in their bowel habits during perimenopause, such as constipation, bloating, abdominal discomfort, increased wind or changes in stool frequency.
How does low oestrogen affect the bowel?
Oestrogen receptors are found throughout the gastrointestinal tract, and sex hormones appear to influence gut motility, sensitivity and the gut microbiome. As oestrogen levels fluctuate and gradually decline during perimenopause, some women may notice changes in how their digestive system functions.
Research suggests that gastrointestinal symptoms can become more noticeable during the menopause transition, although the relationship between changing hormones and individual bowel symptoms is complex and still being investigated.
For some women, this may mean that the bowel becomes slower, contributing to constipation or harder stools. Others may experience more bloating, abdominal discomfort or changes between constipation and looser bowel movements.
Women who already experience irritable bowel syndrome (IBS) may also notice that their symptoms change during perimenopause. Research has identified an association between periods of lower or fluctuating ovarian hormones and increased gastrointestinal symptoms, although more research is needed to understand exactly why this happens.
What can help support your bowel during perimenopause?
There are several simple ways to support digestive health during this stage of life:
Eat enough fibre: gradually include wholegrains, vegetables, fruit, nuts, seeds and pulses according to your individual tolerance.
Drink regularly: adequate fluid intake is particularly important if you are increasing your fibre intake.
Keep active: regular movement can support healthy bowel motility.
Eat regularly: consistent meals can help establish a more predictable bowel routine.
Look at your individual triggers: if bloating or IBS-type symptoms have developed, keeping a food and symptom diary can sometimes help identify patterns.
Avoid unnecessarily restrictive diets: cutting out large numbers of foods can make it harder to meet your nutritional needs during midlife.
It is also worth considering the wider picture. Sleep, stress, physical activity, medications, dietary changes and other aspects of the menopause transition can all influence digestive symptoms.
When should you speak to your GP?
New or persistent changes in bowel habits should not automatically be attributed to perimenopause. Speak to your GP if you have persistent symptoms, unexplained weight loss, blood in your stool, significant abdominal pain, a persistent change in bowel habit or any other symptoms that concern you.
Looking after your gut during perimenopause
Changes in bowel habits can be an overlooked part of the menopause transition. Understanding the potential relationship between oestrogen, the gut and bowel function can help women make sense of symptoms that may otherwise feel unrelated to their hormonal changes.
A personalised approach to nutrition can be particularly helpful if you are experiencing constipation, bloating, IBS symptoms or changes in your bowel habits during perimenopause.
References
Shaw N, Abbott R, Pettinger C. The volume and characteristics of research on gastrointestinal symptoms in 'natural' peri- and postmenopause: A scoping review. Women's Health. 2025.
Ley D, Saha S. Menopause and gastrointestinal health and disease. Nature Reviews Gastroenterology & Hepatology. 2025;22:556–569.
Heitkemper MM, Chang L. Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome? Gender Medicine. 2009.
Lurati AR. Effects of Menopause on Appetite and the Gastrointestinal System. Nursing for Women's Health. 2018;22(6):499–505.
