When we think about perimenopause and menopause, we naturally want to focus on our changing hormones.
What isn’t usually top of mind, is gut health.
If you've noticed more bloating, constipation, reflux, food sensitivities, or changes in how your body responds to food, you're not alone.
Hormonal shifts can influence digestion, the gut microbiome, and how our bodies regulate blood sugar, inflammation, and metabolism.
And the relationship goes both ways. Your gut also plays a role in how your body processes and eliminates hormones, including estrogen.
The good news is that there are plenty of things you can do to support your gut health as you age.
And some of the most helpful things aren't particularly complicated.
1. Eat a greater variety of plant foods. Most of us tend to eat the same foods over and over again. But different gut bacteria thrive on different types of fiber and plant compounds. One of the simplest ways to support a more diverse microbiome is to eat a greater variety of plants. Think colorful vegetables, beans and lentils, nuts, seeds, herbs, spices, and fruit. You may have heard of the goal of eating 30 different plant foods per week. That might sound like a lot until you realize that herbs, spices, and even a handful of walnuts count! And you don't have to overhaul your diet to get started. Try adding a new vegetable to your grocery list, tossing some fresh herbs into your salad, or sprinkling chia or flax seeds onto your breakfast. Start by adding variety to what you're already eating.
One important note: If you're struggling with bloating or other digestive symptoms, simply adding more fiber isn't always the answer. Increase fiber gradually, and pay attention to how your body responds. Sometimes we need to understand what's interfering with digestion before piling on more foods that may leave you feeling worse.
2. Pay attention to your bowel movements. Do you look after you poop? It’s so important to have healthy daily bowel movements. Pooping is one of the main ways we eliminate processed hormones and other waste products. Our liver processes estrogen and sends some of it into your intestines for elimination. But certain gut bacteria produce an enzyme called beta-glucuronidase that can unpack some of that estrogen, allowing it to be reabsorbed into the bloodstream. This is a normal part of estrogen metabolism. However, changes in your gut bacteria and slower intestinal transit may influence how much estrogen gets recirculated. So if constipation has become your normal, it's worth investigating. And I'm not talking about simply reaching for MiraLAX and forgetting about it. While supplements can be useful tools (I’m not a fan of MiraLAX), to keep things moving, Daily, easy to pass and complete bowel movements are the goal, without excessive straining or a persistent sense of incomplete elimination. Don't normalize chronic constipation just because you've been dealing with it for years. And don’t ignore new changes in bowel habits like bloating or constipation. I want to understand why you're constipated in the first place. Are you getting enough fluids and fiber? Are you moving regularly? Is stress affecting your digestion? Could medications, thyroid function, or something else be contributing?
3. Don't overlook the foundations: The basics are never too basic. Adequate protein, balanced meals, hydration, sleep, movement, and stress management all support digestive and metabolic health. It may not be that new shiny object, but it works. And these habits become particularly important in midlife, when hormonal changes can affect insulin sensitivity, muscle mass, sleep, and how our bodies regulate energy.
A few places to focus:
Build balanced meals. Include adequate protein, fiber-rich carbohydrates, and healthy fats to support satiety, blood sugar balance, and nourishment.
Stay hydrated. Fluids support normal digestive function and can be particularly important when increasing fiber.
Move your body. Walking, strength training, and regular movement support metabolic health and can help with bowel regularity.
Prioritize sleep. Poor sleep can influence appetite, blood sugar regulation, stress, and digestive symptoms.
Give yourself time to eat. Slow down, chew your food, and create a little breathing room around meals.
You don't need to do all of these perfectly. Consistency is key.
4. Pay attention to what your body is telling you: If you're noticing changes in your digestion, energy, appetite, or how your body responds to food, don't automatically dismiss them as just another part of getting older.
Get curious.
What's changed?
What seems to help?
What makes things worse?
What might need a closer look?
Maybe you're noticing that certain meals leave you bloated.
Maybe your bowel movements have become less regular.
Maybe you're waking up tired despite getting what should be enough sleep.
Or perhaps you're eating what you consider a healthy diet, but your energy, cravings, and weight aren't responding the way they used to.
These are clues worth paying attention to. Are there any patterns you start to notice?
5. Look at the bigger picture: It's rarely just one thing. By the time we reach our 40s and 50s, there can be several things happening at once.
Hormonal shifts.
Changes in the microbiome.
Blood sugar and insulin resistance.
Chronic stress and poor sleep.
Digestive issues that may have been quietly building for years.
The old strategies may stop working because the physiology underneath has changed. This is why we need a more layered conversation around midlife health.
Not just hormones.
Not just symptom chasing.
Not just exercise.
Not calorie counting.
And certainly not just willpower.
Sometimes the missing pieces are in places we haven't thought to look, like the gut. And while eating more plant foods, staying hydrated, and getting enough sleep are excellent places to start, persistent symptoms deserve a closer look.
For some women, that may mean investigating digestive function, metabolic health, or other underlying contributors with appropriate testing and professional guidance.
If you're struggling with ongoing digestive issues, low energy, stubborn weight, or simply feeling like your body isn't responding the way it used to, I can help you figure out what may be getting in the way and create a plan that's individualized to your body and your goals.
This is the work I do with my 1:1 clients: I use functional testing to help stop the guess work so we can come up with a personalized nutrition and lifestyle plan, to help you connect the dots and take clear, doable steps toward feeling like yourself again.
If you're feeling like there are still missing pieces to your health puzzle, let’s talk.