Menopause bloating

Menopause bloating, is it a symptom? Menopause comes with many changes and symptoms.

Commonly, you may have heard of the hot flushes, mood swings, brain fog and night sweats. Typically, bloating is not a common symptom of the menopause. 

In this article we will explore why some people could experience increased bloating during the changes of the menopause and any other reasons behind it.  

It must be remembered that menopausal symptoms greatly vary from women to women. Due to this, there is no evidence that menopause increases the rate of bloating (1).

You may know this by talking to the women in your circle of just how different everyone’s experience may be!

What is bloating? 

Bloating is a feeling of a full or distended abdomen. It can be painful, uncomfortable and increase feelings of self consciousness.

It can occur after having food or other factors could be at play such as high stress levels, physical inactivity or feeling fatigued. 

What is menopause?

In the UK, the average age of menopause is 51 years of age (2). 

The different stages of the change are as follows:

• Perimenopause: The time prior to the menopause this where menstrual cycles are more erratic
• Menopause: The menopause is diagnosed retrospectively once menstrual cycles have ceased for 12 consecutive months 
• Postmenopause: The time following the menopause and once in this stage this is where you will stay for the rest of your life. (2)

Maybe you’ve noticed more bloating than normal as you transition through menopause.

However, having IBS and going through the menopause could lead to worsening symptoms.

Check out our other article on ‘ is IBS worse during the menopause’

Bloating during the menopause

Gut related symptoms generally worsen in women with age (3). The age for the most gut related symptoms are typically found between 40-49 years of age (3).

This is thought to be due to the withdrawal of sex hormones such as oestrogen and progesterone during menopause. 

Due to the decreased production of sex hormones that occur consecutively for 12 months during the menopause.

Women experience increased abdominal pain and discomfort compared to perimenopausal women (4).

Changes in hormones during the menopause can impact how the body regulates water retention and excretion (5).

Reduced oestrogen can downregulate urine output and therefore lead to overall greater fluid retention, this could coincide with an increased feeling of bloating or fullness (5). 

As a result bloating may occur more frequently and could be causing you more discomfort than normal. 

Gut permeability is how quickly different molecules (this could be vitamins, minerals, amino acids from protein, different types of carbohydrates) travel through the wall (6). 

In a study carried out over a long period of time, gut permeability was found to be higher in postmenopausal women compared to premenopausal women (7).

Therefore, more molecules pass through the gut wall into the bloodstream.

Greater gut permeability is hypothesised to be associated with greater inflammation in the body and thus changing gut physiology such as increased bloating (7). 

Whereas another study found no differences in bloating between pre and post menopausal women (8). 

Currently, we can say that the evidence is conflicting and not strong enough to draw conclusions from in this area.

Bloating and menopause – Does Hormone Replacement Therapy help?

Throughout this article we’ve mentioned a lot about how the withdrawal of hormones during menopause could have an increased effect on bloating.

If you’re debating whether to start hormone replacement therapy (HRT) to then replace these hormones, it’s important to note that some women experience bloating as a side effect of HRT (9).

When HRT replaces oestrogen, oestrogen plays a role in sodium retention with other hormones in the body namely, aldosterone – when sodium retention occurs so does water.

This can contribute to the feeling of bloating. 

Don’t be put off trying HRT! It still remains the most effective treatment for physiological symptoms of the menopause (10)

So it’s not so straight forward as to whether HRT causes bloating or not, instead that bloating in women during the menopause is a very individual response.

Bloating and menopause – how to manage symptoms

Bloating in the menopause is not managed any differently to bloating at any other time of life so you experience bloating regularly you could try: 

• Trying some light physical activity
• Wear loose clothing
• Going to the bathroom

For more information and tips on bloating relief, check out our other article  instant bloating relief.

Ovarian Cancer

Ovarian cancer is the fifth most common cancer for women in the UK (11).

If you have been having persistent bloating and distension for over 12 months then it is important that you contact your GP to screen for ovarian cancer. 

Ovarian cancer can be screened for via a blood test and or ultrasound, before further tests are carried out such as an Xray scan (CT) to diagnose this cancer type.

For more information see Target Ovarian Cancer – a leading charity in this area.

Conclusion

To summarise, bloating is not a common symptom of menopause. It could occur due to a variety of reasons but it is not currently evidence based to be due to the menopause.

Hormonal changes have been suggested to be related to bloating however, other factors could be at play. 

Stress, sleep, physical inactivity, role of hormonal replacement therapy and if you have IBS or not. Ruling out other reasons for bloating such as ovarian cancer is important to identify the cause.

Written by Camilla Donaldson, reviewed by Kirsten Jackson, Consultant Dietitian BSc Hons, RD, PG Cert