Perimenopause vs Menopause: Why Digestion Changes in Midlife

If bloating, constipation, or food sensitivities suddenly appeared in your 40s or 50s, it’s not random—and it’s not “just aging.”

For many women, digestion starts to feel harder during perimenopause and menopause because hormones directly influence how the gut works. When oestrogen and progesterone shift, digestion shifts with them.

Let’s break down what’s actually happening—and why supporting your gut matters more than ever in midlife.

How Hormones and Digestion Are Connected

Your digestive system doesn’t work in isolation. It’s deeply influenced by your hormones, nervous system, and stress response.

During perimenopause and menopause, oestrogen and progesterone gradually decline and fluctuate, which impacts:

• Bile production

• Gut motility (how fast food moves through)

• Inflammation levels

• Microbiome balance

That’s why symptoms often show up even if you’re eating the same foods, you always have.

Lower Oestrogen = Slower Fat Digestion & Constipation

Oestrogen plays a key role in bile production, which helps you break down and absorb fats.

As oestrogen declines:

• Bile flow can decrease

• Fat digestion becomes less efficient

• Stool can become harder and slower to pass

This often shows up as constipation, bloating after meals, or feeling uncomfortably full—especially after higher-fat foods.

Lower Progesterone = Sluggish Gut Movement

Progesterone helps regulate smooth muscle movement, including the muscles of your digestive tract.

When progesterone drops:

• Gut motility slows

• Food sits longer in the intestines

• Gas and bloating increase

This is why many women notice more bloating, pressure, or irregular digestion as they move through perimenopause.

Stress and Sleep Disruption Make It Worse

Midlife often comes with more stress—and less sleep.

Insomnia, night sweats, and chronic stress increase cortisol, which:

• Disrupts the gut lining

• Alters the microbiome

• Increases inflammation

The result? Digestion feels chaotic even when your diet hasn’t changed.

Midlife Symptoms That Can Start in the Gut

Digestive changes don’t just affect your stomach. A struggling gut can contribute to:

• Bloating and abdominal weight gain

• New food sensitivities

• Brain fog

• Fatigue

• Skin issues

• Poor hormone metabolism

This is why gut health is foundational—not optional—during perimenopause and menopause.

Why Supporting Digestion Helps Hormones Work Better

A healthy gut helps:

• Metabolize and eliminate hormones properly

• Reduce inflammation

• Improve nutrient absorption

• Support hormone therapy effectiveness

If you’re on HRT or considering it, digestion matters even more. Hormones can’t work optimally if the gut isn’t supported.

The Takeaway

Your gut isn’t broken.

It’s hormonally different now.

Bloating, constipation, and digestive discomfort in midlife are common—but they’re also addressable. Supporting digestion is one of the most effective ways to support hormone balance, energy, and overall well-being during perimenopause and menopause.

If midlife digestion feels confusing, you’re not alone—and there is a reason behind it.

Save this for later if digestion has felt “off” in your 40s or beyond.

We offer comprehensive Dutch, hormone and gut testing health programs – reach out to us for more information, see our website.

Get in touch for a free discovery call.