Gut Health and Perimenopause: Why Your Digestive Symptoms Might Be Hormonal

As I entered my 40s, I began to notice subtle yet persistent changes in my body and mind. I felt uncomfortably bloated after meals, my energy levels fluctuated unpredictably, and brain fog seemed to creep in at random moments. At no point did it occur to me that I might be in perimenopause.

Like many women, I had a particular picture of what perimenopause “should” look like—hot flashes, night sweats, and dramatic mood swings. Since none of those were happening, I dismissed my symptoms as stress or just the result of being busy. But those early signs were actually the whispers of hormonal change.

It wasn’t until later—when the hot flashes and night sweats finally appeared—that I realised my earlier symptoms were all interconnected.

In this blog, I want to share the link between perimenopause and gut health, why it happens, and what you can do to support your digestion, energy, and overall well-being during this transitional phase. Why Gut Health Often Declines During Perimenopause

Hormonal fluctuations—especially declining estrogen—play a central role in gut health.

As estrogen drops, it directly affects:

1. Gut Microbiome Balance

Lower estrogen levels can shift the composition of gut bacteria, leading to dysbiosis—an imbalance in which beneficial microbes decline and more inflammatory or opportunistic microbes increase.

2. Digestive Function

Estrogen supports healthy gut motility, enzyme production, and intestinal barrier integrity. When levels fluctuate, women may experience:

• bloating

• constipation or looser stools

• increased gas

• food sensitivities

• abdominal discomfort

3. Gut Lining & Inflammation

Declining estrogen may contribute to leaky gut, allowing inflammatory molecules to pass through the intestinal wall and trigger symptoms elsewhere in the body, including mood changes and brain fog.

Suddenly, the symptoms so many of us brush off—“I must have eaten too fast,” “It’s just stress,” “This food doesn’t agree with me anymore”—begin to make sense.

How to Improve Gut Health During Perimenopause: A Holistic Approach

Supporting gut health during perimenopause involves a combination of nutrition, stress reduction, movement, and targeted lifestyle changes.

Nutrition: Build a Gut-Friendly Plate

A nourishing, diverse diet provides the fibres and compounds your microbiome needs to thrive. Focus on:

• fibre-rich vegetables and fruit

• prebiotic foods like onions, leeks, garlic, artichokes, and bananas

• probiotic foods such as kefir, plain yoghurt, kimchi, sauerkraut, miso

• lean protein to stabilise blood sugar

• healthy fats to support hormones

Try to reduce or avoid refined sugars, alcohol, processed foods, and artificial additives, which can worsen inflammation and dysbiosis.

Yoga: Not Part of Nutritional Therapy, But a Powerful Support

Although yoga isn’t a formal component of nutritional therapy, it is a powerful complementary tool—and one I’ve seen transform clients’ stress, digestion, and confidence.

Gentle practices that support gut health include:

• deep diaphragmatic breathing

• twists to massage the digestive organs

• forward folds to calm the nervous system

• restorative poses to reduce cortisol

Yoga nidra and meditation help activate the parasympathetic nervous system—the “rest and digest” state where true gut healing happens.

Lifestyle: Small Daily Habits That Change Everything

Supporting the gut isn’t just about food. It’s about the whole system.

• Prioritise restful, earlier sleep

• Build consistent movement, like walking or cycling

• Reduce stress through meditation, journaling, or time outdoors

• Eat mindfully: slow down, chew thoroughly, avoid rushing meals

These may seem simple, but they are foundational for gut repair—especially during hormone transition.

Assessing Gut Health: The Power of Comprehensive Stool Testing

If digestive symptoms are lingering or unclear, a comprehensive stool test can offer clarity.

This advanced, non-invasive test measures:

• diversity of the gut microbiome

• overgrowth of yeast or harmful bacteria

• parasites

• inflammatory markers

• enzyme levels

• markers of gut permeability

For women in perimenopause, stool testing often helps connect the dots between symptoms and root causes—making personalised, effective treatment possible.

Final Thoughts

Perimenopause is a profound transition, and gut symptoms are prevalent during this time—yet often overlooked. By understanding how hormonal changes influence digestion, you can take steps that dramatically improve your comfort, energy, and long-term health.

Small daily practices—adding more fibre, incorporating gentle yoga, supporting sleep, reducing stress—can create meaningful improvements.

With the proper support, this stage of life can become a time of renewal, strength, and deeper connection to your body.