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When it comes to managing the hormonal seesaw that is peri-menopause, gut health is frequently overlooked. It’s no coincidence that my peri-menopausal clients notice a shift in their digestion – I often hear things like:

“I can’t seem to tolerate as many different foods as I used to.”

“I can’t handle more than a small glass of red wine anymore!”

“I’m farting more than my partner and teenager… put together.”

“I feel bloated and going to the toilet is definitely different.”

Hormonal health and gut health are intimately connected

But how? As progesterone and oestrogen reduce during perimenopause and through to menopause, the function, or efficiency, of your gut is impacted. This alters the balance of your microbiome. At the same time, other factors like stress, anxiety, fatigue, alcohol, medications, environmental toxins, allergens and lack of sleep will be impacting your gut function and microbiome health.

Everyone has fluctuating and reducing oestrogen and progesterone during perimenopause. However, not everyone gets the full experience of *all* the perimenopause symptoms. Gut health and stress management are often the differentiating factors here, and need to be at the forefront when supporting women’s health in perimenopause. Or any life stage for that matter.

What exactly is your gut?

When I talk about the gut, I mean the whole digestive tract from mouth to … the other end. The microbiome, liver and large intestine are particularly important because these organs are pivotal for detoxifying and excreting oestrogen from the body. (Find out more about the gut in this blog, here.)

Get out and don’t come back

When oestrogen isn’t detoxified and excreted efficiently, oestrogen can be reabsorbed in the bowel – it can go back into blood circulation and act on the body again. This means tissues of the uterus and breast can receive a bit of a double whammy from oestrogen, resulting in fluid retention, inflammation and symptoms like sore breasts, heavy periods and other premenstrual symptoms like mood swings and fatigue.

There’s a few different steps to oestrogen detoxification and excretion which means there are a number of ways that this process can be hindered.

Step 1

Oestrogen is taken into the liver and broken down into metabolites which makes it easier for the liver to package up and remove oestrogen from the body. At this stage, the metabolites can be more potent than the original form of oestrogen, so we need step two to be working well in order to avoid a traffic jam of toxicity.

Step 2

Your liver joins the oestrogen metabolite to another compound – pairing them up means that the liver can deliver the oestrogen to the intestine through the bile. So you also need healthy bile to transport oestrogen safely out. (Side note, hang on to your gall bladder by supporting your gut health!)

Step 3

Now that oestrogen has been packaged up and deposited into the large intestine through bile, this is when things get interesting. The large intestine is where the majority of your gut microbiome live.

Some species of bacteria that live in the large intestines produce an enzyme called beta-glucuronidase. You need this enzyme, but too much of it can sabotage oestrogen excretion. Beta-glucuronidase has the ability to unpackage oestrogen, undoing the work of the liver.

Oops, I did it again

Now the oestrogen is unbound, it can be re-absorbed into blood circulation. This can be worsened by a diet that is low in fibre or where constipation is an issue.

Because oestrogen is removed through your #2s, if you aren’t having a well-formed bowel movement, there is more time for the oestrogen to be released and reabsorbed. A diet high in fibre is also helpful for keeping those beta-glucuronidase producing bacteria in check.

So what’s “normal” when it comes to digestion?

If you’re experiencing any of the following, your gut health may be contributing to your perimenopausal symptoms:

  • Bloating
  • Reflux or heartburn
  • New or increased food intolerances
  • Reduced alcohol tolerance
  • Diarrhoea or constipation (or alternating between both!)
  • Excessive farting or burping

If you’ve resigned yourself to putting up with these symptoms, please don’t! Naturopathy really shines when it comes to digestive (gut) and hormonal health.

Take the guesswork out

I often recommend stool testing to work out exactly what areas of the gut need to be repaired and how to rebalance the microbiome without the blood, sweat and tears. This gets you feeling yourself again, more quickly and efficiently.

In the meantime, some easy ways to support your gut and microbiome health for balanced hormones include:

  • Eating a diverse range of plant foods
  • Choosing vegetables from different colours of the rainbow (bacteria love to eat colourful antioxidants!)
  • Add in small amounts of fermented foods like sauerkraut, kombucha, kefir, miso and tempeh
  • Drink plenty of water for regular bowel movements and to support bile
  • Add in fibres like psyllium husk or ground flaxseed to support a regular, well-formed stool

You can read more about supporting your gut health with diet here, and please do get in touch with me to talk more about how your digestive symptoms and peri-menopausal symptoms might be linked. You may feel like something isn’t right (although you’ve probably been told it’s ‘normal’), or you’d like more support to find your way out of the woods. Book a free 15-minute discovery call to find out more about how I’m here to support and encourage you, and develop a personalised plan to get you feeling more like you used to.

I’m looking forward to chatting all things digestion with you soon.