Bloating and Menopause: Helping Women Cope

While it’s usually not one of the chief complaints related to changes in a woman’s body at mid-life, some women experience uncomfortable bloating during perimenopause, the 3-4 year period before menopause.

On average, women enter the perimenopause period at age 47, followed by menopause at an average age of 51. The age can vary by 1-3 years in either stage.

“High levels of estrogen and a lack of progesterone can lead to decreased bile production which causes the digestive system to slow,” said Lorena Tinoco, M.D., an obstetrician and gynecologist affiliated with West Kendall Baptist Hospital and South Miami Hospital. “This can cause dry stools and constipation, which in turn often cause bloating. The fluctuating hormones can also cause water retention, leading fluid to get trapped in the digestive tract and result in bloating.”

In addition to bloating, the changing hormones at play during this time in a woman’s life can cause several other changes in the body, including weight gain, hot flashes and sleep interruptions. The hormone estrogen rises significantly during perimenopause, prompting the changes.

Dr. Tinoco, who is certified as a menopause practitioner by the North American Menopause Society, adds it’s important to differentiate bloating from extra weight.

“Weight gained as a result of the menopause transition consists of more fat deposits in the abdominal area,” she said. “Bloating happens when the gas gets trapped in the digestive tract, leaving the person feeling full and having extra flatulence and burping.”

Normal bloating during menopausal changes is usually mild for most women, happening occasionally. If it occurs daily or is accompanied by abdominal pain, diarrhea, blood in the stool, marked weight loss or weight gain, these symptoms could signal a more serious condition, Dr. Tinoco cautions.

Further investigation often times leads to uncovering a gastrointestinal condition, such as reflux, irritable bowel syndrome, lactose intolerance or in severe cases, celiac disease, she added.

Treatment for Bloating

Bloating relief almost always involves lifestyle changes, Dr. Tinoco says.  The list of recommendations she offers to her patients includes:

• Stop smoking.
• Limit excess caffeine and alcohol.
• Change your diet. Eat anti-bloating foods which include bananas, grapes and eggs. Milk can sometimes worsen bloating symptoms, especially for those who are lactose intolerant, Dr. Tinoco says.
• Eat smaller, more frequent meals. Instead of 3 main meals, try 5-6 small portions a day.
• Increase intake of whole grains which have fiber that helps keep the digestive tract functioning properly.
• Drink ginger or green tea. Dr. Tinoco says green tea is especially helpful because it’s a diuretic.
• Exercise and move around. A sedentary digestive system can get stuck, trapping gas bubbles. “If you’re experiencing bloating, it’s important to change positions frequently to help expel gas,” Dr. Tinoc said.

Over-the-counter remedies that relieve gas might make some patients feel better and can help ease discomfort, Dr. Tinoco also advises patients.

“If the bloating is constant, does not improve, persists or worsens, it’s always important to investigate further because it can mean there are other things causing it,” she said.