Gut Health & Stress Can Impact Your Menopause Experience

Midlife women know peri/menopause is more than just hot flashes. Mood swings, sleep problems, digestive issues, and a general feeling of being “off” are all common — and often dismissed. It’s something that comes up all the time in our community. While doing a bit of research on some of those “feeling off” symptoms, I dug up a 2023 study published in Menopause that connects some of the dots, showing a deeper link between menopausal symptoms, gut health, and stress.

For the study, researchers surveyed 693 women aged 40 to 60 from premenopause to postmenopause. They asked about:

• Menopausal symptoms (using the MENQOL questionnaire)
• Perceived stress (via the PSS-10 scale)
• GI function (frequency of bowel movements and stool consistency)
• Lifestyle and other factors like physical activity, sleep, and BMI

Unsurprisingly, they found that menopausal symptoms worsen as we travel through the menopause transition. Hot flashes, sleep trouble, and physical symptoms were highest in early postmenopause, but symptoms ramped up during perimenopause.

Stress is a major amplifier. Women who reported high levels of perceived stress also reported worse symptoms across every domain, including mood, physical discomfort, and even sexual symptoms. A diagnosis of anxiety or depression made symptoms even more severe.

Gut health matters. Women with constipation or less frequent bowel movements reported more severe menopausal symptoms across physical, psychosocial, and sexual domains on the MENQOL questionnaire. Hard, lumpy stools (indicative of constipation) were also associated with worse hot flashes and physical discomfort. Past studies have shown that our gut microbiome plays an important role in the metabolism of our female sex hormones, and also sex hormones influence the gut microbiome. Stress and gut function are also tightly linked. 

Lifestyle factors help. Good news for active women is that more physical activity equals fewer symptoms. Having better sleep (which, of course, can be tricky during this time) also was linked to having fewer symptoms, and a lower BMI was associated with fewer physical complaints.

🧠 Respect the Gut Brain Axis

This study adds weight to the idea that menopause isn’t just about hormones. It’s about how your brain, gut, stress levels, and lifestyle all interact. The gut-brain-hormone axis—the communication loop between your microbiome, nervous system, and endocrine system—may play a bigger role in how you experience menopause than is often appreciated.

🥦 Don’t ignore digestive issues during midlife* They could be more than a nuisance. Doctors and dieticians who specialize in midlife women who we’ve featured on Hit Play Not Pause all agree that fiber is a top priority and we should be aiming for 30 grams a day (about twice what many women get). That means eating more plants (which is also associated with less severe menopause symptoms…Coincidence?🤔 Probably not).

🧘🏽‍♀️Stress management isn’t just nice to have — it’s a critical piece of the menopause puzzle. We all might be weary of hearing about taking some moments for breathing, mindfulness, and meditation each day, but it works…and may help with symptom management (as well as gut health), too. 

🚴🏻‍♀️ Exercise, sleep, and aiming for a health body composition are meaningful levers for symptom relief. We all know this and do our best. It’s just another reminder that lifestyle really does make a difference.  

*I’ll note here that members of our community who struggle with constipation have shared with me that Previnex’s Gut & Green Superfoods has helped them find relief. It contains resistant potato starch (Solnul), which has prebiotic effects and can reduce constipation and G. glabra (GutGard), which helps with indigestion. Previnex is a sponsor our ours and community members get a 15% discount (with the code FEISTYMENOPAUSE). They have supported the podcast for years. I myself don’t have gut issues, but the women I know who do have sung its praises.