Menopause and bloating
Bloating is a common symptom of menopause and perimenopause. A full or swollen abdomen can be uncomfortable, even painful. It can also make you feel self-conscious about your body when your belly seems distended. Read on to find out what causes it, how long you can expect it to last, and most importantly, what you can do about it.
BLOATING DEFINITION
Bloating differs from person to person and is an uncomfortable sensation of tightness or heavy pressure usually felt around your abdomen. It affects people differently and severity can vary. For some people, there’s no pain and it’s simply uncomfortable and sometimes embarrassing. For others, the pain can range from mild to an intense, crippling abdominal cramp.
Although a swollen abdomen is a familiar indication of bloating, it doesn’t happen for everyone and you may instead feel uncomfortably full and heavy in your midsection. In many cases, bloating is caused by the build-up of unwanted substances in your body. The usual culprits include gas, water, air, or even poo. Certain medical conditions can also cause bloating. If this is a new or persistent problem for you, you should see your doctor to be sure of the cause.
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HOW COMMON IS BLOATING DURING MENOPAUSE?
- Bloating is common, especially in perimenopause, but there is a data gap showing exactly how many women this affects
- However, bloating is also commonly caused by a number of medical conditions, so it’s important to check in with your GP in the first instance
Read more about the stages of menopause.
WHAT ARE THE SIGNS OF BLOATING?
Swollen or distended abdomen, cramps
A feeling of heaviness or fullness
Puffy eyes and swollen ankles
Passing gas and burping
HOW TO STOP MENOPAUSE BLOATING
Drink lots of water
Though this may sound contradictory, if you’re bloated with water retention, upping your water intake will help to balance your system and flush out the excess fluids. Water also reduces the chance of constipation which can trigger bloating. You want to make sure you are hydrated because your gastrointestinal tract needs water to function effectively
Regular exercise
Being physically active can ease your bloating discomfort. Studies suggest that mild physical activity prevents gas retention because movement helps in clearing the intestines. If you’re new to regular exercise, start slowly, and build up gradually. Try low-intensity movements like yoga, walking, jogging, hiking, or any mild exercise whenever you feel bloated
Limit salt intake
Be mindful of the foods you eat to avoid overconsumption of salts. Most table salts contain sodium and chloride, and too much salt in your diet will lead to water retention
Find your triggers
Keeping a food diary will help you isolate which foods or drinks are causing you discomfort so you can make a decision whether or not that fizzy drink is worth it. Common triggers include beans, onion, garlic, spicy foods, carbonated drinks and caffeine. When you have an idea which foods affect you, try eliminating them from your diet and see if it makes a difference
Take probiotics
Up your intake of probiotics like yoghurt, kimchi, kefir, and sauerkraut. Probiotics are essentially good bacteria that keep our digestive system healthy
Massage your abdomen
Abdominal massage has been a long-time treatment for constipation. It decreases the severity of gastrointestinal symptoms and aids bowel movements to prevent gas and bloating. To give yourself an abdominal massage, lie on your back and gently massage your stomach. Massage both clockwise and anticlockwise. Apply a little pressure on the areas you feel any pain
Eat slowly
Try not to rush through your meals. Eat mindfully, being aware of every bite and focusing on the sight, sound, smell, taste, and how the food makes you feel. Eat smaller portions, take small bites, and chew slowly. Remove all distractions, and focus solely on your meal
Diuretics
If bloating is caused by water retention, talk to your doctor about treatment. They may suggest diuretics, which are pills created to help your kidneys release water and salt
Can HRT help?
Sometimes the best relief for menopause bloating is HRT, which can balance your oestrogen and progesterone levels. However, bloating alone is not usually a reason to start HRT, and your doctor will want to fully explore any underlying causes for your symptoms in the first instance. For this reason it’s important to discuss your symptoms with them.
It’s also important to note that bloating can actually be a side effect of HRT, particularly oestrogens. This tends to settle after a few months, but you should see your doctor if it persists, is severe or associated with any other new symptoms.
MENOPAUSE AND BLOATING FAQs
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.
- Womens Midlife Health: Irritable bowel syndrome in midlife women: a narrative review
- Medical News Today: What to know about menopause and irritable bowel syndrome
