How Perimenopause and Menopause Affect Digestion – And The Best Foods To Help

If you’ve reached the stage where your digestion feels unpredictable, you’re absolutely not alone. Many women notice more bloating, constipation, heaviness after meals, or general gut discomfort during perimenopause and menopause. And if you’re also taking a GLP-1 medication – known for slowing gastric emptying – you might feel these symptoms even more.

The great news is you can support your gut through these hormonal shifts with the right nutrition paired with regular exercise.

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Why Digestion Changes During Perimenopause and Menopause

During perimenopause and menopause, oestrogen and progesterone levels fluctuate and eventually decline. These hormones influence far more than reproductive health – they also help regulate motility, inflammation, stomach acid production, and even the diversity of bacteria in the gut.

Here’s how hormonal changes affect digestion:

1. Slower Gut Motility = Bloating, Constipation, Feeling Full for Hours

Both oestrogen and progesterone help control how efficiently food moves through your digestive tract.

• Progesterone relaxes smooth muscle, which can slow things down.

• Lower oestrogen levels reduce the strength of gut contractions.

This means food may move more slowly, causing bloating, constipation or that uncomfortable ‘still full hours later’ sensation. These symptoms can overlap with the effects of GLP-1 medications, which also slow gastric emptying.

Helpful foods: high-fibre fruits, oats, quinoa, spinach, broccoli, Brussel sprouts, and magnesium-rich greens.

2. Changes in the Gut Microbiome = More Sensitivity and IBS-like Symptoms

The gut and hormones are deeply connected through something called the estrobolome – the part of your microbiome involved in metabolising oestrogen.

When oestrogen levels drop:

• Microbial diversity declines

• Gut sensitivity increases

• Inflammation may rise

• You may notice new food sensitivities or IBS-style symptoms

Helpful foods: yoghurt, kefir, kimchi, sauerkraut, miso and other fermented foods to support microbial balance.

3. Lower Stomach Acid & Fewer Digestive Enzymes = Sluggish Digestion

As we age, stomach acid and enzyme production naturally decline. Menopause compounds this, making it harder to break down food efficiently.

This can cause:

• Reflux-like symptoms

• Slow, heavy digestion

• Poor nutrient absorption (especially B12, iron, magnesium)

Helpful supports: ginger tea, fresh ginger in meals, papaya for natural enzymes, and smaller more frequent meals.

4. Stress, Mood Changes & Poor Sleep = Gut-Brain Axis Disruption

Hot flushes, night sweats, anxiety and sleep disturbances can raise cortisol levels, impacting the gut via the gut–brain axis.

High cortisol may slow motility and increase gut sensitivity, making discomfort more noticeable.

Helpful foods: probiotic-rich foods, prebiotics to feed good bacteria, magnesium-containing greens, and fibre to support motility.

Foods That Support Digestion During Perimenopause and Menopause

Let’s revisit the foods that offer the biggest digestive benefits – especially under the hormonal rollercoaster of midlife (and if you’re on a GLP-1).

1. Fibre-Rich Foods: Essential for Motility and Regularity

Fibre helps counteract the natural slowing of digestion. It adds bulk, supports regular bowel movements, nourishes good bacteria, and helps reduce inflammation in the gut.

Top fibre-rich choices:

• Apples: high in pectin, which eases stool movement

• Oats, quinoa, barley: support soft stools and deliver B vitamins

• Spinach, broccoli, Brussel sprouts: provide insoluble fibre + magnesium for gut muscle contraction

2. Probiotic Fermented Foods: Boosting Gut Balance

As microbial diversity drops, probiotics can help replenish beneficial bacteria.

Great options include:

• Yoghurt

• Kefir

• Kimchi

• Sauerkraut

• Miso

These foods may reduce bloating, inflammation, and irregular bowel movements while supporting nutrient absorption.

3. Prebiotic Foods: Feeding Your Gut’s Good Bacteria

Prebiotics are the fuel your good bacteria need to thrive.

Top sources:

• Garlic

• Onions

• Leeks

• Asparagus

• Bananas

Prebiotics help strengthen the microbiome, reduce inflammation, and support smoother digestion.

4. Enzyme-Rich Foods: Extra Support for Slow Digestion

If digestion feels sluggish, enzyme-containing foods can help “lighten the load.”

Ginger: speeds up stomach emptying and eases nausea.

Papaya: contains papain to support protein digestion and relieve IBS symptoms.

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Supporting Digestion Through Hormonal Change

Perimenopause and menopause bring real, biological changes to digestion, but with the right foods, you can support your gut naturally. Combining fibre, probiotics, prebiotics, and natural enzymes creates a solid foundation for easier, more comfortable digestion, even when hormones or GLP-1 medications slow things down.