Perimenopause Bloating

If you wonder if bloating is a common perimenopause symptom – you have come to the right place. 

It may feel like you’re bloated all the time and look as though you’re eight months pregnant some days. 

This blog post contains lots of information on bloating during perimenopause.

Just because the perimenopause could last a long time does not mean you should put up with uncomfortable symptoms such as bloating for so long!

What is bloating?

Bloating is classified as having trapped gas, a feeling of pressure in the abdomen and fullness (1).

What are the first signs of perimenopause?

Perimenopause is classified as the time before menopause when the women’s menstrual cycle becomes more erratic. 

Including becoming longer, shorter or irregular altogether (2).

Other symptoms include anxiety, fatigue, mood swings, brain fog, hot flashes and vaginal dryness or itching. 

Perimenopause can last up to 10 years, and it may be confusing to get to the bottom of these changes. 

Is bloating a symptom of perimenopause?

Bloating is a common symptom of the menstrual cycle. Every woman is different, so you may experience various symptoms. 

If you notice that bloating is more frequent and outside your period, perimenopause could be the culprit. Read on to find out why. 

During perimenopause, oestrogen levels can become more erratic (3). Higher oestrogen levels can lead to more water retention, leaving you feeling bloated. 

Changes in hormones such as oestrogen and progesterone can increase visceral hypersensitivity. 

Visceral hypersensitivity produces a more considerable pain sensation and, therefore, could cause a feeling of bloating (4).

What could other causes of bloating be during perimenopause?

Bloating can occur for multiple reasons; perimenopause and the hormonal changes that ensure it could be just one of them.

Other reasons include: 

• Stress (5)
• Inactivity
• Constipation
• A high salt diet (6)
• Small intestinal bacterial overgrowth
• Symptoms of ovarian cancer
• Pelvic floor dysfunction

(7)

Less evidence-based reasons for bloating include:

• Swallowing air whilst eating 
• Wearing tight clothes

How long does perimenopause bloating last?

Bloating during perimenopause can lead to a negative experience of menopause, as found by women in the following study (3). 

It should subside in a few hours or a couple of days if it is related to digestion or hormone fluctuations. 

What helps with bloating during perimenopause

This article contains tips for instant bloating relief – including five proven ways to help with bloating.

Can hormone replacement therapy (HRT) help with bloating in perimenopause?

HRT can be prescribed during perimenopause to aid with mood and depressive disorders and prevent osteoporosis (8, 9). 

HRT is not a complete solution to side effects when going through perimenopause before menopause; it does come with its side effects, including bloating. 

This blog is helpful to find out What to expect when you start HRT by remembering the ‘four B’s’: 

• Bleeding
• Breasts
• Bloating
• The Blues 

However, specific research into bloating and the use of HRT is limited. 

Bloating can also be a side effect of HRT. 

As HRT replaces oestrogen, which generally declines throughout the process of perimenopause, oestrogen plays a role in sodium retention. 

Sodium retention is related to the feeling of bloating. 

Higher progesterone levels also found in HRT, slow gastrointestinal motility. Meaning that food moves slower through the gut leading to bloating and possible constipation. 

However, such symptoms will likely settle after a few months after starting HRT. If not, it is essential to contact your GP to discuss this.

How to get more support with perimenopausal bloating

Having to deal with perimenopausal bloating can be difficult. Check out some of these support networks so you are not tackling this alone.

• Perimenopause Hub
• Find a BMS-recognised Menopause Specialist
• The Daisy Network 

Should I be worried about bloating in the perimenopause?   

Generally, bloating during perimenopause does not indicate a cause for concern. 

However, certain conditions may be worth considering if you have ongoing bloating or it worsens.

Conditions to consider are: 

1. Ovarian cysts
2. Ovarian cancer
3. Small Intestinal Bacterial Overgrowth (SIBO) – bloating can be a symptom of SIBO to look out for (10).  

If you suspect, you might have SIBO or want to rule it out – read this comprehensive guide on how to get an accurate diagnosis. 

Summary

Overall, bloating is a symptom of the menopause due to hormonal changes. 

However, if this is a new symptom for you that is ongoing, report this to your doctor to check that nothing else is the cause of bloating. 

However, read this article for instant bloating relief during perimenopause; finding methods that work for you is crucial not to let it affect you day by day. 

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