IBS and Menopause: Are Your Hormones Behind the Bloat?
If you’re a woman in your 40s or 50s battling IBS, you might have noticed something: your gut symptoms seem to have ramped up just as your hormones have started to shift. You’re not imagining it.
Women in the perimenopausal period can experience more frequent and intense GI symptoms, including IBS-like complaints, compared to premenopausal women.(1)
Symptom Prevalence and Severity
Both perimenopausal and postmenopausal women report a higher prevalence of altered bowel function and IBS-like symptoms, such as bloating, flatulence, and changes in bowel habits, compared to premenopausal women (1,2)
The prevalence of IBS-type complaints is highest during the climacteric period (ages 40–49), which typically corresponds to perimenopause, with up to 36% of women reporting such symptoms (2).
I certainly see this in clinics. Often women come in reporting regular bloating no matter what they eat.
They feel really frustrated as their bodies are already feeling like they are failing them and bloating is another thing to add to the list along with the brain fog, memory loss, joint pains, hair and skin changes….the list goes on.
There’s a real, science-backed link between menopause, perimenopause, and bloating — and understanding that link is a game-changer.
Let’s break it down.
What’s really going on?
IBS (Irritable Bowel Syndrome) is already a complex condition. Add fluctuating hormones into the mix and things can get...messy.
As oestrogen and progesterone levels start to decline (or bounce around unpredictably during perimenopause), they impact how your gut functions.
Times of low ovarian hormones, such as menstruation and early menopause, are associated with more abdominal pain and discomfort, suggesting hormone withdrawal may worsen IBS symptoms (1).
These hormones don’t just regulate your periods. They influence:
Gut motility (how quickly food moves through your digestive system)
Sensitivity of your gut lining- Oestrogen influences pain perception. Declining oestrogen levels may lead to increased visceral sensitivity, amplifying pain responses in the gut.(3)
Gut Permeability- Estrogens help maintain the integrity of the intestinal barrier. (4) Fluctuations in estrogen could compromise this barrier, potentially triggering inflammation and symptoms. (3)
How your body processes stress- Sex hormones interact with the brain-gut axis, influencing stress responses and emotionality, which are key factors in IBS.(3, 4).
The result? More bloating, constipation, diarrhoea, and abdominal discomfort. Even foods you’ve eaten for years without issue might suddenly cause problems.
Why does bloating feel worse now?
That full, tight, uncomfortable feeling? It’s not just in your head. During perimenopause and menopause:
Oestrogen drops can slow digestion, leading to constipation and trapped gas.
Progesterone fluctuations can relax the muscles of your digestive tract, causing sluggish bowels.
Stress (which often spikes during this life stage) can throw your gut-brain axis out of sync, triggering IBS flare-ups.
It’s like your digestive system forgot how to function smoothly — and the bloating becomes relentless.
I also find women also report more abdominal weight gain, which combined with bloating can make you feel sluggish and less likely to want to exercise, combined with the fatigue from inadequate sleep can make everything 100 times worse.
You’re not just sensitive. Your gut actually is.
Hormonal changes make your gut lining more sensitive. This means the bloating, cramping or urgency you feel is often a result of increased nerve sensitivity rather than a sign of something seriously wrong. Your body is simply reacting more strongly to everyday triggers.
And if your sleep is disrupted (thanks again, menopause), your gut suffers too. Poor sleep can increase inflammation and reduce your ability to tolerate certain foods.
So what can you do about it?
Here’s the good news: you don’t have to suffer through it or accept it as your new normal. Practical, evidence-informed steps can help you reduce bloating and feel more in control:
Track your triggers — food, stress, hormones, sleep. Patterns will emerge.
Consider the low FODMAP approach — (with professional support) if symptoms are significant.
Balance your plate — include fibre; protein and healthy fats help stabilise blood sugar and mood.
Support your nervous system — stress and gut are deeply connected.
Look at hormone support options — diet, lifestyle, or HRT where appropriate.
I think even though there’s a strong biological reason to believe that hormone changes during perimenopause can make IBS symptoms worse, research findings aren’t all in agreement.
Some studies suggest that IBS becomes less common after menopause, even though symptoms like constipation and body discomfort might still get worse.
Other research shows that low hormone levels might actually increase overall symptoms. These differences could be due to how each person’s body reacts to hormone changes, when symptoms are measured, or the fact that IBS can look very different from one person to another.
That’s why I personally feel more targeted research focusing on women in perimenopause is so important — to help doctors give better, more personalised care.
You deserve personalised support
Every woman’s experience of IBS and menopause is different and that’s exactly why a one-size-fits-all approach doesn’t work.
I’ve been supporting women with gut health for over 16 years and I’ve witnessed countless women navigating this exact hormonal transition.
What's needed is a combination of evidence-based clinical strategies with compassionate, real-world guidance that actually fits your day to day life. You should never be handed a generic list of foods to avoid and sent on your way.
I work with clients on a 1:1 basis where we get to the root cause of your symptoms and build a sustainable plan that fits around your life, not the other way round.
When Running Starts Feeling Like a Struggle: Claire’s Story of IBS, Perimenopause and Getting Her Life Back
Seven years.
That’s how long Claire had been battling bloating, erratic bowels, and that nagging “is this just my life now?” feeling.
She was 46, a dedicated runner, part of a local club, and training for a marathon with her friends. But this time, something felt off.
Her bloating had become relentless. She dreaded putting on her running kit, convinced everyone was staring at her tummy wondering if she was pregnant again. The discomfort made running feel like a chore—not the release it used to be. Her joints ached. Brain fog clouded even simple tasks.
Fatigue clung to her like a weight vest.
And the toilet situation? All over the place.
Some days she’d go twice, others not at all. She’d cut carbs (which, let’s be honest, isn’t ideal marathon prep) but still ended up sprinting to the loo mid-run with urgent diarrhoea. The gut symptoms were unpredictable and disheartening, and Claire was at breaking point.
She was seriously considering pulling out of the marathon. But the guilt of letting her friends down was heavy too.
So what was really going on?
When we looked closely, a pattern emerged.
Claire’s weekends were full of activity, but light on fluid and fibre. Come Monday, she’d start the week constipated—and her gut would play catch-up by Friday. The bloating and discomfort were part of this cycle.
We tailored her fibre intake (not just “add more veg”) and focused on realistic fluid goals that aligned with her training schedule. No generic advice—just personalised tweaks she could stick with.
We also talked about perimenopause. At 46, Claire had assumed she was too young. She put the brain fog, fatigue, and aching joints down to being a busy mum with a packed diary.
But after some reflection, she acknowledged that this could be perimenopause and started HRT soon after—and within weeks, the joint pain, mental fuzziness and fatigue began to lift.
Four months later, things looked very different.
No more waking up in pain. Her gut was more regular. The bloating? Tamed. Her energy? Back.
She started enjoying her training again. Her running kit felt better. Her mindset shifted from “maybe I’ll drop out” to “I’m ready.”
She ran that marathon. She did it with her friends. And she even bagged a personal best.
This isn’t just about fibre or hormones. It’s about not settling for ‘this is just what happens now’.
If you’re in that season of life where your body feels unfamiliar, your gut is unpredictable, and you’re wondering if you’re just supposed to get on with it—I want you to know:
You don’t have to figure it out alone and you don’t have to figure it out by yourself.
Book a consultation with me to get expert support and lets get you in control of your gut again.
References
Heitkemper, M., & Chang, L., 2009. Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome?. Gender medicine, 6 Suppl 2, pp. 152-67. https://doi.org/10.1016/j.genm.2009.03.004
Grellet, C., Finlayson, M., & Triadafilopoulos, G., 1998. Bowel dysfunction in postmenopausal women.. Women & health, 27 4, pp. 55-66. https://doi.org/10.1300/J013V27N04_04
Mulak, A., Taché, Y., & Larauche, M. (2014). Sex hormones in the modulation of irritable bowel syndrome. World journal of gastroenterology, 20(10), 2433–2448. https://doi.org/10.3748/wjg.v20.i10.2433
Meleine, M., & Matricon, J. (2014). Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones. World journal of gastroenterology, 20(22), 6725–6743. https://doi.org/10.3748/wjg.v20.i22.6725
