The most known aspects of menopause are the hot flushes and the intimate area changes, but what about the gastrointestinal system? Here, we will tell you everything that you need to know - changes, symptoms that you can have and some tips and recommendations to improve your bowel health.

What is the gastrointestinal system and why is important?

The gastrointestinal system is composed of the digestive tract (mouth, oesophagus, stomach, bowels, and anus) and accessory organs (liver, pancreas, and gallbladder) (Ruiz, 2019b). Its main function is to digest food, absorb nutrients, and eliminate waste material known as faeces. However, it makes other activities, such as (Marcotegui et al., 2022; Ruiz, 2019b):

• Producing substances to boost blood coagulation.
• Triggering chemical modifications produced by medication.
• Contributing to the production of some hormones.
• Eliminating toxic substances in the blood.
• Acts as a barrier against viruses, bacteria, and toxins that may be in food.

Potential disruption factors for the gastrointestinal system

The digestive system involves the systematic and organised action of many organs, which may be affected by different factors, such as (Marcotegui et al., 2022; Ruiz, 2019a; Yang et al., 2021):

• Emotional stress.
• Advanced age.
• Anatomic dysfunctions such as sphincter alteration or oesophagus pressure rise.
• Consumption of different medicines such as antacids or non-steroidal anti-inflammatory drugs (ibuprofen or diclofenac).
• Sleep alterations.
• Digestive system illness: ulcers, digestion problems and irritable bowel syndrome.
• Viral, bacterial, or parasitic infections.
• Alimentation and water intake.
• Hormonal changes.
• Pregnancy.
• Previous surgeries like hysterectomy.
• Menopause.

How does menopause affect the digestive system?

Usually, menopause reduces oestrogen levels and generates changes across the body, including the gastrointestinal system. Bowel movements become slower, leading to constipation and digestion problems. Furthermore, the gut microbiota change (the bacteria that protects the digestive tract) is also impacted, causing potential digestive and nutrient absorption alterations, with manifestations like diarrhoea, nausea, bloating and excessive flatus (Theimer, 2022; Yang et al., 2021). Many women often experience a worsening of previous bowel diseases during menopause. Symptoms of colitis or irritable bowel syndrome are exacerbated (Yang et al., 2021). Also, it is important to highlight that the gastrointestinal system has a strong connection with the brain, known as the brain-gut axis. So, psychological factors may interfere with digestive system functions causing symptoms such as diarrhoea, constipation, and nausea. Menopause can bring mood swings, depression, or anxiety, which can promote the appearance of bowel symptoms (Yang et al., 2021).

Potential signals and symptoms

Perimenopause, menopause and post menopause present typical gastrointestinal signals and symptoms. The most frequent include (Ruiz, 2019a; Yang et al., 2021):

• Stomach-ache.
• Bloating.
• Intestinal gas.
• Diarrhoea.
• Constipation.

Gastrointestinal illness during menopause.

Menopause can cause gut sickness or worsen pre-existent conditions due to women's corporal and hormonal changes and age. Some of those illnesses are (Ruiz, 2019a; Yang et al., 2021):

• Worsening of chronic constipation symptoms.
• Reflux or gastritis.
• Irritable bowel syndrome.
• Lactose intolerance.

Recommendations to maintain good gut health

Some tips and suggestions to follow to care for your gastrointestinal system health during menopause are (Yang et al., 2021):

• Learn and practice stress control techniques.
• If you feel very anxious or extremely sad, look for professional help.
• Exercise daily.
• Intake enough water.
• Eat well! A balanced diet with fruits and vegetables as a fibre source.
• Get 8 hours of sleep a night.
• Check if any food makes you bloated and excessive flatus.
• If you are under medical treatment, follow it strictly.

The gastrointestinal system changes during menopause. The most vulnerable women are those with a history of gut illness. Fortunately, there are healthy habits that may help you to deal with the symptoms, but if they aren’t enough, don’t hesitate and consult your physician.

References

• Marcotegui F., Zabala M., Gozalo M. (s.f.) 7. Gastrointestinal. Farmacia hospitalaria. Available on: https://www.sefh.es/bibliotecavirtual/fhtomo2/CAP07.pdf Ruiz A. (2019a). Effects of Aging on the Digestive System. Available on: https://www.merckmanuals.com/es-pr/hogar/trastornos-gastrointestinales/biolog%C3%ADa-del-aparato-digestivo/efectos-del-envejecimiento-sobre-el-aparato-digestivo
• Ruiz A. (2019b). Overview of the Digestive System. Available on: https://www.msdmanuals.com/es/hogar/trastornos-gastrointestinales/biolog%C3%ADa-del-aparato-digestivo/introducci%C3%B3n-al-aparato-digestivo
• Theimer S. (2021). Researchers examine how sex steroid hormones change gut and vaginal microbiota. Available on: https://newsnetwork.mayoclinic.org/discussion/investigadores-analizan-como-las-hormonas-sexuales-esteroideas-cambian-la-microbiota-intestinal-y-vaginal/
• Yang P., Heitkemper M., Camp K. (2021). Irritable bowel syndrome in midlife women: a narrative review. Women's Midlife Health. 7, 4. Available on: https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-021-00064-5#Sec3