Home

Why digestion changes in Perimenopause and how to restore gut health

For many women, perimenopause doesn’t begin with hot flushes or missed periods, it begins ever so quietly, in the gut. Foods you’ve eaten your whole life now leave you feeling bloated, uncomfortable, heavy, or sluggish. Your stomach feels distended by the end of the day, your jeans feel tighter by dinner, and your gut no longer feels calm or predictable. Some days you feel constipated, other days your digestion feels rushed, unsettled, or reactive and often, no matter what you eat, you seem to react to everything.

For many women, this is one of the earliest signs of perimenopause, yet it’s rarely talked about in a meaningful way. Most conversations focus on hot flushes, mood swings, or changes to the menstrual cycle, while digestion is quietly ignored, brushed off, or blamed on stress, aging, or just one of those things.

But digestion changing during this season of life isn’t random, and it isn’t a flaw in your body, it’s your body responding to shifting hormones, changing rhythms, cumulative stress, modern food systems, and a way of living that’s drifted far from how we were designed to nourish ourselves.

When we understand what’s actually happening beneath the surface, gut changes during perimenopause begin to make sense, and more importantly, they become something we can gently restore. There is hope!

The season of Perimenopause, a time of transition, not breakdown

Perimenopause isn’t something that suddenly starts one day in your 40s. It’s a gradual transition that can begin as early as your mid to late 30s, long before periods become irregular or cycles noticeably change.

During this time, estrogen and progesterone no longer rise and fall in predictable patterns,  and instead, they fluctuate, sometimes dramatically, sometimes subtly, but consistently enough to affect how every system in the body functions, including our digestion.

Hormones don’t operate in isolation either, they influence the gut, the nervous system, blood sugar regulation, immune responses, inflammation levels, sleep quality, and even how resilient your body feels day to day, so when digestion issues appear during perimenopause, it’s not because your gut is suddenly failing, it’s because our body is adapting to a new hormonal landscape, and it’s asking for support.

How hormones and the gut are deeply connected

Our gut is far more than a digestive tube, it’s a communication hub, constantly receiving and sending messages to our brain, immune system, and our endocrine system. Oestrogen and progesterone both influence how the gut functions.

Oestrogen plays a role in gut motility, meaning how efficiently food moves through the digestive tract. It also influences bile production, inflammation levels, and the diversity of beneficial gut bacteria.

Whereas Progesterone has a calming effect on smooth muscle tissue, including the muscles of the intestines. When progesterone is balanced, digestion tends to feel steady and rhythmic. When progesterone fluctuates or declines, gut movement can slow, contributing to bloating, fullness, and constipation.

During perimenopause, these hormones no longer work in harmony: Oestrogen may spike high one month and dip low the next, while progesterone often declines more steadily, this imbalance can leave the gut feeling sluggish one week and reactive the next.

At the same time, the gut microbiome, the vast ecosystem of bacteria living in your digestive tract, is influenced by hormones too. Certain gut bacteria help metabolize oestrogen, while others support inflammation balance and immune function.

When hormone levels shift, the microbiome shifts with them, sometimes losing diversity, sometimes becoming more sensitive, sometimes struggling to keep up with the demands placed on it.

Why bloating becomes so common in this season of life

Bloating is one of the most common complaints women experience during perimenopause, and it often feels relentless. I hear it from so many women and I too suffered with bloating for 10+ years. You wake up feeling flat (ish), by mid afternoon your stomach feels distended and by evening, you feel 3 months pregnant! This isn’t simply about food volume or overeating, there’s more to the story.

There are several reasons bloating becomes more noticeable during this stage:

1. First, slower gut motility means food spends longer in the digestive tract. This allows more fermentation to occur, which can lead to gas and pressure.
2. Second, changes in gut bacteria can increase sensitivity to foods that once felt fine, especially refined carbohydrates, sugar, ultra processed foods, and even certain healthy foods when digestion is already compromised.
3. Third, hormonal fluctuations affect fluid balance. Estrogen influences how the body holds onto water, which can contribute to abdominal fullness and swelling, particularly in the second half of the cycle.
4. And finally, stress plays a major role – Perimenopause often coincides with a busy, demanding phase of life, raising children, supporting aging parents, managing careers, running households, and carrying mental loads that rarely get acknowledged.

Chronic stress shifts the body into a survival state, diverting energy away from digestion and toward perceived threats and when our nervous system stays switched on, our gut struggles to function calmly.

Constipation, loose stools, or both, why digestion feels unpredictable

Many women notice that their digestion becomes inconsistent during perimenopause, one week they feel constipated, the next they experience looser stools, urgency, or discomfort after meals. This unpredictability is often tied to hormonal fluctuations combined with nervous system imbalance.

When progesterone drops, gut movement slows. When estrogen spikes, inflammation and sensitivity can increase, then add stress, poor sleep, irregular meals, caffeine reliance, or restrictive eating, and the gut loses its natural rhythm.

Our body thrives on rhythm, regular meals, adequate nourishment, consistent sleep, gentle movement, and periods of rest all support digestive flow.

When life becomes rushed and disconnected from these rhythms, our gut often speaks up first.

The role of the nervous system in gut health

One of the most overlooked aspects of digestion during perimenopause is the nervous system. Our gut is lined with nerves and is in constant communication with our brain through the vagus nerve. This gut brain connection determines how relaxed or tense our digestion feels.

When we’re calm, present, and safe, digestion flows, when we’re rushed, anxious, overwhelmed, or constantly alert though, digestion slows or becomes erratic.

Perimenopause can heighten nervous system sensitivity and many women notice increased anxiety, restlessness, poor sleep, or difficulty switching off. These changes aren’t separate from digestion, they’re deeply connected. If our body feels under pressure, our gut will certainly reflect that.

This is why healing digestion in perimenopause is not just about food, it’s about creating safety, rhythm, and gentleness in your daily life.

Modern living vs God’s original design for the body

When we look at digestion through a biblical and natural lens, it becomes clear how far modern living has drifted from how the body was designed to thrive. We eat on the go, distracted, stressed, and rushed, we rely on ultra processed foods that are stripped of life and nutrients, we override hunger cues, skip meals, restrict calories, then overeat at night, we sit far more than we move, yet move far more intensely than we rest.

God designed our body to be nourished, rested, and supported, not punished, restricted, or pushed beyond its limits. Our digestion thrives on simplicity, whole foods, regular meals, adequate nourishment, calm environments, gratitude and rest.

When these foundations are missing, especially during a hormonally sensitive season like perimenopause, symptoms appear as signals, not failures.

Foods that support digestion the way nature Intended

During perimenopause, the goal isn’t extreme diets or cutting out entire food groups, it’s nourishment.

Foods that support our gut health include:

1. Whole, unprocessed vegetables, especially cooked vegetables which are easier to digest than raw.
2. Quality proteins, such as eggs, fish, poultry, grass fed meats, and collagen rich foods, which support tissue repair and hormone balance.
3. Healthy fats, including olive oil, avocado, ghee, butter, and coconut oil, which support bile flow and reduce inflammation.
4. Fermented foods, like yoghurt, kefir, sauerkraut, and cultured vegetables, which gently introduce beneficial bacteria when tolerated.
5. Simple carbohydrates, like fruit, root vegetables, rice, quinoa and millet, which support thyroid function, nervous system health, and energy.

Our focus should always be on how food makes us feel, not rigid rules. Eating in a calm state, chewing thoroughly, and allowing time for digestion are just as important as the food itself.

Why restriction often makes digestion worse

Many women respond to bloating or weight gain by eating less, skipping meals, cutting carbohydrates, or over exercising and while this may offer short term relief, it often worsens digestive symptoms over time.

Restriction signals stress to the body and stress suppresses digestion. When our body feels deprived, it slows our metabolism, reduces stomach acid, impairs enzyme production, and disrupts our gut bacteria. This creates a cycle where digestion becomes weaker, not stronger.

Supporting our digestion during perimenopause requires nourishment, not punishment.

Gentle daily habits that restore digestive rhythm

Healing digestion doesn’t require perfection, it requires consistency. Simple habits that support gut health include:

• Eating regular meals at similar times each day.
• Sitting down to eat without screens or rushing.
• Starting the day gently, rather than jumping straight into stress (aka our phone!).
• Walking daily, especially after meals.
• Creating an evening wind down routine to support sleep.
• Honouring rest as much as productivity.

These habits may seem small, but they communicate safety to the body, and safety is essential for our digestion.

Where Probiotics and supportive supplements fit in

Food is always the foundation, but during perimenopause, targeted support can be helpful – a high quality, whole food based probiotic (like this one) can support gut balance, digestion, and immune health, particularly if gut diversity has been compromised by stress, antibiotics, or years of digestive strain.

The key is choosing support that works with our body, not against it, and using it as part of a wider lifestyle approach, not a quick fix.

Listening to our body’s signals with compassion

Digestive changes during perimenopause are not something to fear, they are messages inviting you to slow down, nourish yourself more deeply, and return to rhythms that support life.

Our body is wise and it responds best to care, consistency, and nourishment. When we stop fighting symptoms and start listening to them, healing becomes more than possible.

Unpopular opinion but one I firmly believe: Perimenopause is not the beginning of decline, it’s an invitation into deeper awareness.

It’s an opportunity to reconnect with your body, your rhythms, and the way we were designed to live. When our digestion changes, it’s not a defect, it’s because it’s asking for something different now. With the right support, our digestion can feel calm again, our energy can return, and our body can feel like home once more.💗