Hot flushes and brain fog are perhaps the best-known menopause symptoms. But a growing body of research suggests that gut symptoms are also very common.
While gut symptoms aren’t officially recognised as key menopause symptoms in international or national guidelines, a menopause survey conducted by Symprove found that more than one-third of respondents experienced gut symptoms.
These symptoms can be unpleasant and may include bloating, diarrhoea and abdominal pain.
However, there are things you can do. Supporting your gut health can help reduce the impact of these symptoms on your quality of life.
In the survey, Symprove found that three-quarters of those with the worst menopausal symptoms had experienced gut health issues throughout most of their adulthood.
This raises the possibility of a connection between poorer gut health in earlier life and more severe menopause symptoms.
Similarly, there’s now evidence that caring for your gut microbiome may help reduce gut issues and other menopause symptoms elsewhere in your body.
Your ‘gut microbiome’ refers to the trillions of microbes that live in your intestines. Below, we explain why this microbiome is so important during the menopause – and why digestive symptoms occur during this stage of life.
Most importantly, we also suggest ways to improve your gut microbiome and help manage any unpleasant gut symptoms.
The gut microbiome and the menopause
Before the menopause begins, you experience a phase called the perimenopause.
During this time, your hormone levels – oestrogen and progesterone, in particular – can fluctuate wildly. This fluctuation is what causes the wide range of symptoms you might experience.
We often associate oestrogen with the ovaries, where much of this hormone is produced. But oestrogen influences many areas of the body, including the gut.
Interestingly, this relationship is a two-way street: your gut microbiome can also influence your oestrogen levels.
When your body is clearing away circulating oestrogen, this hormone is first deactivated in your liver. Next, it travels to your gut, and it later passes out in your poo.
However, certain gut bacteria can ‘recycle’ this inactive form of oestrogen. These bacteria can stop it from being lost to the toilet and reabsorb it into your bloodstream for circulation.
Before the perimenopause, this mechanism helps keep oestrogen levels just right, but once your production of oestrogen drops, your body struggles to maintain this balance.
The community of gut microbes that recycle oestrogen are collectively called the ‘oestrobolome.’
The key takeaway is that a thriving oestrobolome (within your gut microbiome) helps regulate circulating oestrogen levels. And in this way, it can help reduce overall menopause symptoms.
Gut symptoms during the menopause
Alongside fluctuating hormones, the menopause is associated with less diversity in the gut microbiome. And lower diversity is a sign of a less healthy microbiome.
Meanwhile, having reduced oestrogen may increase sensitivity to pain, making us more sensitive to what’s going on in our gut.
It can also reduce gut motility – how quickly food moves through the gut.
Taken together, these factors help explain the gut symptoms commonly associated with the menopause, including:
-
bloating
-
constipation
-
stomach cramps
-
acid reflux (heartburn)
These symptoms often quite closely mirror those of irritable bowel syndrome (IBS), and research exploring possible links between IBS and the menopause is ongoing.
Beyond the microbiome, gut symptoms may also result from changes in your:
-
Energy levels: The menopause might sap your energy, so you may be less inclined to keep active. This can have a negative impact on your digestion.
-
Mood: The menopause can cause psychological symptoms, including low mood. When we experience this, we may be less inclined to eat healthy foods or eat in a regular pattern.
How to support gut health
Thankfully, there are several ways to support your gut health during the menopause. We’ll explore these strategies next.
1. Focus on fibre
Your gut bacteria need fibre to flourish, and the best sources of fibre are plants.
Experts recommend aiming for 30 grams of fibre per day, but most people don’t get anywhere near that. So, try to add more plants to every snack and meal.
Because different gut microbes prefer different types of fibre, it’s important to focus on eating a diverse range of plants, to help fuel as many ‘good’ species of microbes as possible.
If you need a little inspiration, try some of our high-fibre recipes.
2. Eat the rainbow
Colourful fruits and vegetables often contain plant compounds called polyphenols. These are another source of fuel for your gut microbiome.
Again, polyphenols and other healthy plant compounds exist in diverse ranges. So, try to eat the rainbow every day to feed as many of your microbes as possible.
Some foods particularly rich in polyphenols include:
-
berries: especially elderberries, blackcurrants and blueberries
-
spices: especially cloves and star anise
-
nuts and seeds: especially flaxseeds, chestnuts and hazelnuts
-
olives: especially black olives
-
beans: especially black and white beans
3. Try probiotics
Therapies that can improve your gut microbiome, such as probiotics, may help ease menopausal symptoms.
But at the moment, the evidence is limited.
It’s possible that certain probiotics may relieve some of the mental and physical menopause symptoms by supporting a healthy gut microbiome.
Meanwhile, there are so many probiotic products on the market that it can all feel a bit confusing. This article includes information about how to select a probiotic that suits your needs.
4. Add in fermented foods
Like probiotics, some fermented foods contain live ‘good’ bacteria, so they may also help.
And many fermented foods are plant-based, so they contain nutrients such as fibre, prebiotics and polyphenols – all of which can support a healthy gut microbiome.
When shopping for fermented foods, make sure to choose products that have not been pasteurised, so they still contain live microbes.
Other ways to manage menopause gut symptoms
Setting aside specific foods, microbes and nutrients, here are some other strategies for managing your menopause-associated gut symptoms and supporting your gut microbiome.
Change the way you eat
If you’re experiencing gut symptoms:
-
Try eating more slowly: Your gut may be working more slowly, so this will give it a chance to catch up.
-
Eat smaller meals more often: This also gives your gut more time to work, preventing it from becoming overloaded.
-
Keep a food and symptom diary: This record can help you identify foods that you’re more sensitive to, such as fatty or spicy foods.
-
Only drink beyond meal times: Staying hydrated is important, but if you drink while eating, it might cause excess wind and bloating.
-
Minimise fizzy drinks, caffeine and alcohol: These are often responsible for a buildup of gas.
Keep active
Although motivation and mood may make it difficult, staying active is crucial.
Not only could it have a positive effect on your gut symptoms and gut microbiome – it may also improve other menopause symptoms.
You don’t need to run a marathon or swim the Channel, just try to do a little more than you’re doing now. Some options include:
-
walking
-
swimming
-
cycling
-
light jogging
-
using weights at home
-
doing aerobics
-
practicing tai chi
-
doing pilates
-
practicing yoga
Manage stress levels
Though it can be easier said than done, try to carve out some time to de-stress every day. Effectively handling stress may reduce both gut symptoms and overall menopause symptoms.
If you struggle to wind down and relax, these approaches can help:
-
breathing exercises
-
a warm bath
-
an enjoyable book
-
meditation
-
yoga
-
a conversation with a friend or family member
-
massage, including self-massage
-
a reduction in social media use
-
apps such as Headspace or Calm
Speak to your doctor if you need help managing stress levels. You can also refer yourself directly for talking therapies.
Try supplements?
We’ve mentioned probiotics, which may work for some people. You’ve probably also noticed the vast number of other supplements targeted at people experiencing the menopause.
Because menopause symptoms can significantly affect your quality of life, it’s no surprise that many people experiment with different supplements to try and find relief.
So, it’s important to know that the vast majority of these supplements aren’t evidence-based. At the same time, many do contain active ingredients – which might help or make things worse.
These ingredients might also interact with medications you’re taking. So, if in doubt, speak with your doctor.
Supplements can help if you have a deficiency in a certain vitamin or mineral. However, if you have a healthy, balanced diet, you're likely to be getting all the nutrients you need.
When to visit your doctor
Make sure you speak with your doctor if:
-
A stomach-ache becomes very painful quickly.
-
Stomach pain or bloating won’t ease up or keeps coming back.
-
You have trouble swallowing food.
-
You’ve lost weight without trying.
-
You suddenly start peeing more or less often, or peeing becomes painful.
-
There’s blood coming from your bottom or you can see any in your poo.
-
Any blood or abnormal discharge comes from your vagina.
-
You experience diarrhoea or vomiting that doesn’t stop after a few days.
Be sure to also discuss hormonal and non-hormonal options for your symptoms with your doctor.
FAQs
Here are some frequently asked questions and answers about gut health and the menopause.
Does the menopause cause gut issues?
Yes, many people experience gut issues during the menopause, such as bloating, excess wind, diarrhoea and constipation. Experts also believe there may be links between the menopause and IBS.
What’s the best menopause supplement?
Very few supplements have been tested in high-quality scientific studies. There’s some evidence that probiotics may help relieve gut symptoms associated with the menopause, but the research is still limited.
Remember that some supplements contain active ingredients that may do more harm than good or interact with medications, so speak with a doctor if you’re concerned.
How do I get rid of menopause gut?
Dietary and lifestyle factors can make a real difference. For instance, focus on eating more fibre and fermented foods, include a range of colourful plants in your meals, keep active and minimise your stress levels whenever possible.
Summary
There’s a close relationship between the menopause and gut health. The menopause is associated with decreased microbiome diversity and increased gut symptoms.
Thankfully, there’s also evidence that improving your gut health can reduce not just gut symptoms, but overall symptoms of the menopause.
To support your gut health, increase your fibre intake, eat the rainbow, and try probiotics and fermented foods. Changing the way you eat, staying active and reducing stress will also help.
To learn more about gut health, visit Symprove’s Gut Hub.
Sources
Assessing the efficacy of a structured stress management program in reducing stress and climacteric symptoms in peri- and postmenopausal women. Archives of Women’s Mental Health. (2021). Link.
Berry phenolic antioxidants – implications for human health? Frontiers in Pharmacology. (2018). Link.
Daily stress and gastrointestinal symptoms in women with irritable bowel syndrome. Nursing Research. (2007). Link.
Estrogen-dependent changes in visceral afferent sensitivity. Autonomic Neuroscience. (2010). Link.
Exploring the gut-exercise link: A systematic review of gastrointestinal disorders in physical activity. World Journal of Gastroenterology. (2025). Link.
FoodData Central. (n.d.). Link.
Identification of the 100 richest dietary sources of polyphenols: An application of the Lactic acid bacteria: A promising tool for menopausal health management in women. Nutrients. (2022). Link.
Identification of the 100 richest dietary sources of polyphenols: An application of the Phenol-Explorer database. European Journal of Clinical Nutrition. (2010). Link.
My Food Data. (n.d.). Link.
NHS talking therapies for anxiety and depression. (2022). Link.
Perceived stress in patients with common gastrointestinal disorders: Associations with quality of life, symptoms and disease management. Explore. (2017). Link.
Physical activity improves symptoms in irritable bowel syndrome: A randomized controlled trial. The American Journal of Gastroenterology. Link.
Physical activity, symptoms, esteem, and life satisfaction during menopause. Maturitas. (2005). Link.
Role of estrogen and stress on the brain-gut axis. Gastrointestinal and Liver Physiology. (2019). Link.
Stomach ache. (2023). Link.
The athletic gut microbiota. Journal of the International Society of Sports Nutrition. (2020). Link.
The gut microbiota in menopause: Is there a role for prebiotic and probiotic solutions? Post Reproductive Health. (2025). Link.
