The importance of good gut health in perimenopause and menopause



Menopause Advisor
eileentalksmenopause
Ask Eileen


10 July 2023

Chat transcript:

Eileen: The gut microbiome is basically all the different types of bacteria that live in your gut. So how does the menopause affect the gut microbiome?

Whether you're menopausal or not, and we know this just from our own lifestyles, busy women tend to suffer from reduced digestive function. I think a lot of women are not aware that what they do on a daily basis (such as running around whilst you're eating, eating in front of the computer at your desk, eating while you're watching the TV) can cause a lot of digestive problems.

And if you're stressed which, let's face it, most of us are these days, one way or another, then we can get that hit of adrenaline that will basically switch our digestion off, regardless of where it is in the whole digestive process. And that means your food doesn't get dealt with effectively, which can lead to things like bloating, wind, and cramping. And if we've got general anxiety caused by menopause, maybe we don't even know where it's coming from, that's going to be affecting everything to do with digestion as well.

Ali: You very rarely meet a midlife woman who isn't incredibly busy and juggling all sorts of things. And the last thing they're giving priority to is time to sit down and eat. You know, it's more about how quickly can I get this food down so I can rush on to the next thing.

So, to counter this tendency for stress to shut down your digestive system, it's really important to consciously take your time and relax when you're eating or if you're going to be eating. Just take a breath, sit down, relax, take a breath, and then consciously chew your food. This is probably one of the simplest things that we advise women to do, and it's one of the most effective despite the fact that it's free and it's relatively easy to do it. It really has a huge amount of effect for how easy it is.

Chew your food and try not to drink when you're eating, because that just encourages you to wash your food down instead of chewing it. And also, it dilutes your digestive enzymes. And this is really important because, actually, women start at a little bit of a disadvantage compared to men in terms of their digestive function, because women generally don't produce as much stomach acid as men do.

So, their digestive system or their digestive response isn't quite as sharp right from the start; and because their stomach acid production isn't as high, then their stomach empties a little bit slower than a man's. They are therefore a little more prone to constipation or a sluggish gut, which in turn makes them more likely to bloat and feel windy and uncomfortable. And just because of the way that a woman's digestive tract has to be structured around the womb, so obviously different to a bloke, it can be a little bit more susceptible to irritability, not as well able to cope with a bout of diarrhoea, for example.

And another thing, which is actually really interesting, is that higher oestrogen levels make your bile thicker and therefore a bit more sluggish, and women are more prone to gallstones if they have high oestrogen. And especially during perimenopause, you often get these surges of higher oestrogen levels, which can mean you've got that slower bile movement.

Eileen: I think as well it's the nausea with the bile, which is so common, isn't it?

Ali: Absolutely. And struggling to metabolise fats effectively, so then fatty foods start to trouble you a bit more than they might have done previously. So, all of these things conspire against women, really, in terms of digestion; and it does mean that women are something like six times more likely to get IBS than men are.

And all of these things can be addressed or counterbalanced by what I call the "good eating mechanics," which are the things that I was just mentioning: sitting down, relaxing, taking a breath before you eat, chewing your foods well, and not drinking while you're eating. Also, just sit up as well, because that gives your stomach walls room to move.

Eileen: We do this, don't we, in front of the TV or when we're working on a computer? Plus, with the bad posture, you're actually squashing your stomach.

Ali: And the other thing that we talk about frequently is to eat more during the day and then less at nighttime. And that also means that you will have less digesting to do during the night, so you're less likely to get problems with your sleep. And that's really important because, if you're not sleeping well, you will crave more carbohydrates the next day.

Immediately, the day after the first night of bad sleep, you'll crave more carbohydrates. And that's a problem because then you're likely to be going for sugary foods, which will feed the unfriendly bacteria in your gut.

So, you've got that disturbance of your gut bacteria, alongside the fact that unfriendly bacteria tend to enjoy it when your gut is quite sluggish. So, keeping your gut moving well is important.

Eileen: It's the weight thing as well, because if you're not sleeping, if you're craving the carbs, then that's going to perpetuate overeating and the weight gain which is also really common in the menopause. So, the thing to do here, we're looking at supporting our friendly bacteria in as many different ways as we can, and you only have to make a few changes. It's not that you're going to have to give up everything you like, but just a few good, healthy changes in your diet can make a huge amount of difference to the level of friendly bacteria.

And one of the things that a lot of research is showing now is that your friendly bacteria can help with hormonal balance. So here we are, in a situation where our hormones are going all over the place, if we're not eating well, if our friendly bacteria are being affected, that can have a knock-on effect on the type of symptoms that we're going to get in the perimenopause and the menopause.

If you've got a sluggish gut, and, you know, we are more predisposed to this in perimenopause and menopause, it will affect the friendly bacteria and your gut biome. And that means that you will end up getting all sorts of other symptoms, the ones we've talked about, the constipation and sometimes diarrhoea.

So, we're looking at doing things just to get those friendly bacteria up and running and stable in the gut. You're looking at plenty of water, and for those of you that have been watching, you know that it's one of the key things that I always recommend. As Ali mentioned, just don't have it whilst you're eating, because you will dilute all your digestive juices.

Make sure that you're eating loads of vegetables on a daily basis. And it's not hard. I mean, this morning, I had an omelette for breakfast, and I had tomatoes, mushrooms, and spinach. You know, that was three portions of vegs just with my breakfast. So, you can add lots of little things in just to make sure that you're getting loads of vegs, and that will also help if you're a bit sluggish as well.

And the friendly bacteria's biggest enemies are a lot of the white foods, so that's things like your white sugar, your white pasta, your white bread, and rice as well. Highly processed foods are not going to help your friendly bacteria, so just make sure that you're getting a rainbow on your plate, as much colour on your plate as possible.

Ali: Natural colour!

Eileen: Yes, as much as you possibly can. And the other thing is exercise. Walking is one of the best things for your digestive tract because, as you're walking, especially if you're pumping your arms, you're massaging all your internal organs. And I think too, for the perimenopause cramping that you might get, then just doing 15 minutes brisk walking a day can be worth its weight in gold.

Ali: The other great benefit of getting your gut bacteria into a good state is that you're then less likely to get things like cystitis, vaginal issues like thrush, or discomfort in that area, and even things like urinary leakiness problems. All of those things will be less likely if your gut bacteria is in a good state, because the environment in the gut goes on to affect the environment in these other areas.

One of the things that we really like to recommend is a probiotic called For Women, which is made by a company called Optibac. And that's brilliant, isn't it? We've had some really good results.

Eileen: But, as far as I'm aware, it's just available in the UK and Ireland, but if you are not in the UK, then there will probably be local versions where you are.

Ali: You can have a look at it online and see what's in it, and then you can maybe find something locally for you. But, yeah, so that's just a supplement that can help if you're particularly experiencing problems in that area. But overall, it's a question of doing the practical things that we've been talking about.

And also choosing some bitter foods because, especially in the summer, that's a nice thing to do. Foods like artichoke, and chicory, radicchio, radishes, rocket, those kinds of foods that have a bitter flavour. Those are very stimulating for your gut and help to establish a good environment for your friendly bacteria.

Eileen: And those foods are all prevalent in the Mediterranean diet, which I think a lot of people are attempting to follow these days.

So, I hope you found this helpful. It's a huge subject. We could go on and on talking about it because our friendly bacteria... I call them our friendly little helpers … do so much to support our health in so many different ways; and just taking that little bit of extra effort to get them growing well in our gut can make a huge difference.

If any of you out there have tips as well, what have you done to help improve your digestion? What sort of digestive problems have you had that you've managed to fix just by changing your diet a little bit? Please share your stories. They're always so helpful, and we love to read all about them.

And until next time, take care.

You may also find these topics helpful:

Signs you might need a probiotic during menopause

5 signs your digestion is struggling during menopause

Disclaimer:

The information in this blog is for informational or educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your doctor or another qualified healthcare provider if you have any concerns or ongoing symptoms. Never ignore professional medical advice in seeking treatment because of something you have read in this article or on this website.

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