Why You’re Always Bloated in Perimenopause

You've just finished a meal, and before you know it, your stomach feels like it's ready to burst. Many women over 40 experience this not-so-pleasant, not often talked about, side effect of perimenopause, often leaving them feeling uncomfortable and confused about why it is happening. 

The list of foods that you think are causing the bloating gets longer and longer. Is it just food, or could it be something else? 

In this episode you’ll learn:

• The Role of Hormones: Learn how shifts in your hormones could be causing your bloating issues.
• Stress and Your Gut: Understand how stress influences your digestive system and what you can do to mitigate its effects.
• Diet Tips to Ban the Bloat: Simple diet adjustments that can significantly ease your discomfort.
• Microbiome Management: Explore the importance of a healthy gut microbiome in managing bloating and overall health.

Every woman’s journey through perimenopause is unique, but the discomfort of bloating doesn’t have to be a constant companion through it. By understanding the underlying causes and using the practical solutions in this episode, you can take  steps to feeling more comfortable and in control of your body.

Ready to ban the bloat and feel confident about eating again? Listen to the full episode for all the details and transform your approach to managing perimenopause. 

If you have any questions you’d like Sarah to answer, or a personal bloating story, please send them in for our FAQs segment by emailing info@akesohealthcare.com.au or sending us a DM at https://instagram.com/theperimenopausenaturopath 

Find out more about Sarah, her services and the Freebies mentioned in this episode at https://www.ThePerimenopauseNaturopath.com.au

• OPEN NOW: Discover how to use food as your most powerful medicine, smoothing hormonal fluctuations and easing perimenopause symptoms naturally. (Yes, you have more options than hormone therapy!) Say goodbye to feeling out of control and hello to feeling more like your old self every day, with PerimenoGO (because who wants to pause anyway?!)
• The Perimenopause Decoder is the ultimate guide to understanding if perimenopause hormone fluctuations are behind your changing mood, metabolism and energy after 40, what phase of perimenopause you're in and how much longer you may be on this roller coaster for.
• Been told your blood test results are "normal" or "fine" while you feel far from your best? Discover the power of optimal blood test analysis with The Blood Test Decoder: Optimal Ranges for Women Over 40.
• For more, follow on Instagram at @theperimenopausenaturopath.

Transcript

Sarah McLachlan: 0:00

Hello and welcome to Chaos to Calm podcast, episode number 45. I'm Sarah, the perimenopause naturopath, your guide through this spectacular journey that is perimenopause. Now, if you're over 40 and feeling like you're changing hormones, hijacking your mood, your energy, your weight, and you want to change that in a holistic way, well then, this is the place for you. Each episode, I share with you my views on what the heck is happening in your body, why you're feeling the way you are and what you can do about it, with actionable advice to help you feel more calm, in control, less stressed and, importantly, more comfortable in your body. So I'm so glad you've joined me today. Let's get on with the discussion of today's topic so we can start shifting your perimenopause experience from chaos to calm. Now I bet you've had one of those days where, well frankly, you can't wait to unbutton your pants the moment that you step through the door or when you're on your own after lunch. Yeah, I know, I've been there too, it's true, but I know that that happens for lots of you, and you can feel like you're about to burst when your belly is that bloated. Maybe even people are asking if you're pregnant again because it is really common. It's not really that much spoken about, but it is a really common symptom in perimenopause to get new gut or bloating issues. So many women that I speak to on my free clarity calls before they work with me every day like clockwork. Their stomachs puffing up, making them feel like a balloon, you know, and you stick a pin in it ready to pop it and yeah, they look like they're six months pregnant again. Which is wonderful if you're pregnant, but when you're not, it's not very comfortable. Actually, it's probably not very comfortable when you are six months pregnant. I was just thinking the other day about how you do forget all the ups and downs of pregnancy and birth and labour and all of that, and I guess that's why the human race survives. And we have more than one baby. My baby is 10. So those days are long gone and it's fair enough that I forget about them, anyway. So maybe you've been there.

Sarah McLachlan: 2:19

I guess this is the other type of bloating that some people are really familiar with. You've eaten, you've overeaten, you ate like a feast enough for a small family and you, you know, totally regretted it soon after because you feel really uncomfortable, full and bloated. So yes, that is a type of bloating, but it's not what I'm going to be talking about here today. This isn't just about the occasional overindulgence. I'm talking about the daily struggle that leaves you really uncomfortable, confused, and probably frustrated because you can't work out what's happening. You don't know what foods are triggering it. Some days it's one thing and then the next day that same food is fine. So you want to know why it's happening. It's not a quirky party trick, but it is super annoying and it does happen a lot during perimenopause. So let's go and dive in, unravel the mystery of what's making you so gassy, and I'll also teach you how to deflate the bloat for good or get a good start on it there. So, like I said, bloating isn't just about feeling stuffed. It's actually about what's happening inside your gut, as we like to call it your gastrointestinal system, and you know it usually happens in the lower half of your abdomen, around or below your belly button. Can happen above your belly button too, and that tells us about how your small intestines are going. Anyway. So it's not about just feeling over full there, although that can be part of your picture. I'm really talking about how, when you've eaten and then, like soon after you're eating, you feel your stomach just like you can almost see it expanding in front of your eyes there.

Sarah McLachlan: 4:05

Now, as we age, and especially during perimenopause, our hormones change our physiology which is how things work in our body changes and one of the things that changes is our stomach acid, or lack thereof. Our bodies start producing less stomach acid and digestive enzymes, which makes it harder to break down our food and it can lead to more gas production in your intestines and discomfort and bloating. So I did talk in more depth about low stomach acid and your digestive enzymes in episode 41, why you don't tolerate meat anymore. So you're very welcome, of course, to go back and have listen to that again, or for the first time, and learn a bit more about what is happening there and how our stomach acid and digestive enzymes can be reduced. So less stomach acid, less enzymes can slow down how our food travels through our digestive system, but so can hormone changes of perimenopause as well.

Sarah McLachlan: 5:07

If you think about it, it's like, say, we're on a highway, we're in Adelaide, so our highway, Anzac Highway. You're doing 60 on that highway, but in peak hour or rush hour it slows right down. It's bumper to bumper, it's stopped. That's not that nicely paced 60 k's per hour. So think about that peristalsis the movement of your food through your intestines can get like that too. It can really slow down. When it slows down, it sits there longer, it ferments and we get gassy.

Sarah McLachlan: 5:38

Now another contributing factor to the slowing of your peristalsis is stress, and I've talked about it a lot, probably every single episode. I know, and I think I've also said every single episode, stress is the biggest blocker to health, happiness and weight loss. So there you go. I've said it for today as well, but it is that significant and hopefully from the last few episodes I've done on mum, burnout, cortisol, stress and weight loss, resistance all those things you're getting an idea of just how much it impacts you and also how your decrease in stress, resilience and perimenopause impacts you as well. So stress it impacts your autonomic nervous system or your stress response, your hormones that are produced in that and puts you into fight or flight mode. When we're in fight or flight mode, our sympathetic nervous system is dominant and our rest and digest mode our sympathetic nervous system is not.

Sarah McLachlan: 6:37

So it impacts your peristalsis, your transit time, your microbiome, your nutrient absorption and all of that impacts your capacity to create the enzymes and acids that you need to break down and get the nutrients out of your food. So it can become quite a cycle and, like I said, when food isn't broken down enough into small enough pieces and then it sits in your stomach or in your intestines for too long, it starts to ferment, it creates gas and it also impacts your microbiome. So an imbalance of the microbes can be at play here too. So too much of a good thing, it's not always a good thing. So, specifically, we could talk about some microbes in our intestines produce methane and we know well hopefully you know that methane is what makes cow poo stinky and it makes our wind and gas, our farts, stinky as well.

Sarah McLachlan: 7:38

S o you do want some methane-producing microbes because they help reduce hydrogen in the intestines, which can also give you some great volume in your toots. But too much methane production isn't great either. So too much hydrogen, no good. Too much methane, no good. Too much methane production can contribute to slowing of your transit time in your intestines, so slowing down how your food moves through, and that can lead to bloating, constipation and that distension, that expansion of your gut, and your abdomen.

Sarah McLachlan: 8:12

Now, when the hydrogen-producing species are high, those are the microbes that decrease your tolerance to fibre-rich foods. Now, fibre-rich foods are fuel for our microbes, so that's not a good situation to be in. But also, when you have decreased tolerance to fibre, you're going to get more windy and experience more distension and abdominal discomfort and bloating there as well. So you can see, we want to get the balance just right. We're like Goldilocks we don't want too much, we don't want too little, we want it just right. So it's about what you eat and how you eat things as well. But it's also playing into your hormones and your stress hormones there, not just your female hormones and what's going on in your body. So you always want to step back and have a look, a broad look, at what's going on for you there, and that's why sometimes it can be much easier to figure this out if you're working with someone who's experienced in interpreting your symptoms, like wind and gas and how quickly it happens after your meals and things like that.

Sarah McLachlan: 9:15

All right, now it's time to press pause on our discussion of bloating. I'm super excited if you can't tell, because I'm introducing a new segment in the podcast. I don't have a name for it yet, so if you t hink of a name, please do let me know, but it is driven by you, dear listener, and I'm super excited about it. It's FAQs time, that's FAQ, so this is where I'm going to take a question that I've had from someone on social media, in an email or in the street. I get questions everywhere and I'm going to answer it, and it may or may not be related to the particular topic that we're covering today. This week's question is from Nicole, and she asked her question in a review of my podcast. So her review was very positive. So thank you so much, Nicole. I can't actually reply to that review on Apple podcasts and it's taken me this long 30 episodes to figure out how I can answer you, Nicole, so I really hope that you're listening. Now.

Sarah McLachlan: 10:27

Nicole's question was in regard to episode 11, where I covered off the use of hormonal contraceptives like the pill and IUDs for perimenopause symptoms. Now her specific question was doesn't the Mirena release progestin? You mentioned in your podcast on the pill and Mirena that the Mirena releases estrogen. I'm really keen to understand, all right. So thank you, Nicole, as I said, for submitting your question and I did in episode 11, I mentioned that the oral contraceptive pills are a combination. One can have synthetic estrogen and progesterone i n them Synthetic, so they're not body- identical.

Sarah McLachlan: 11:11

What I did mention about the Mirena was it contains a progestin and the progestin that it contains is levonorgestrel Levonorgestrel. So perhaps it sounded like I said estrogen or it might have had a brain fart, but I've looked through the transcript and couldn't see that I'd mentioned that it's estrogen. I think it might've ju st been the way I pronounced Levonorgestrel. You have a go at it, say five times fast. So I wanted to say a couple of things here. Go back and listen to the episode, please do, because I talk a lot about why this is not really the best option for you in terms of managing perimenopause symptoms.

Sarah McLachlan: 11:55

But one thing I want to say is that Livon or Gestrel is more similar in structure to testosterone than progesterone, so you're not going to get the benefits, like you would, of your own progesterone from using or taking that. And so I was talking with Bonnie today on a clarity call and we were talking about how she'd been offered the pill to solve or regulate her period, and I was like I wish that it would stop being sold as that because it doesn't regulate, it stops, it suppresses symptoms. It stops the problems, for sure, but it doesn't resolve the underlying issue. And so when you stop taking the pill or at some point, you get your Mirena out, you're going to have the problems still there, maybe worse, and usually these problems express in some other way. When we suppress one symptom, it comes out another way there as well. So you don't get the benefit of making your own progesterone because you're not ovulating and that's what they use progestins for. So, for example, like progesterone really supports healthy hair and hair growth, whereas Levon or gestrel can cause hair loss because it's similar to testosterone and when we have higher testosterone we can get that pattern of balding. But also testosterone can mess with our insulin levels as well. So when our relative testosterone levels, relative to estrogen, are out of balance, it can put us in that fat storage mode because it impacts our insulin. And this is one of the pathways or processes in PCOS, and I have a lot of women with PCOS who really struggle through perimenopause. They respond really well to what we do in the Chaos to Calm method.

Sarah McLachlan: 13:38

But that's what I was talking with Bonnie about this morning. That's why she'd been offered the pill to try and regulate her period. But it's not regulating, it's just shutting it down. So let's be clear on that. Like the Mirena, if you're going to choose something, the Mirena is better than the pill from that perspective because it doesn't completely suppress your ovulation process. So you do get to make your own progesterone some of the time and it is good for heavy bleeding because most people will not have a bleed on it. But you need to talk with a GP and make sure it's suitable for you because there are contraindications and it can impact your mood and stress resilience and, frankly, most women over 40 do not need any messing with their stress resilience or their mood. So, answering Nicole's question in less than 10 seconds, the Mirena doesn't have estrogen in it but it does have levonorgestrel, which is a testosterone-like compound used to inhibit ovulation, so you don't get pregnant, all right. So if you liked my little FAQs segment and you have your own FAQ you want me to answer, I'd love to hear from you. Check the show notes and I'll pop in there how you can email me your questions.

Sarah McLachlan: 14:51

All right, back to bloating. Let's get on with deflating it and getting rid of i t, shall we? So, first up basics chew your food, and don't eat on the run. First up basics chew your food, don't eat on the run. Think of your food like a fine wine that you need to savour and swill around your mouth and you're really going to chew it well, because, yeah, mum was right chewing maybe not 30 times, but chewing your food is really an unsung hero of your digestive health and reducing things like bloating too slowly. It'll also decrease the amount of air that you swallow, and less air equals less gas, less wind and water.

Sarah McLachlan: 15:28

Often people you know, we want to drink water. I don't want to discourage you from hydrating you know I love it, but you need to get it again. Like Goldilocks, it needs to be just right. Not enough water, you're going to get bloating. Too much water at once, you're going to get bloating. So smaller amounts through the day are good, and not so much with your meals or, you know, in the 10-15 minutes around your meals. You don't want to flood your system all at once. Think about when you water your plants. If you flood them, the water just kind of it rushes off and it disappears really quickly and goes down the drain. But if you do little bits and or gently sprinkle it, you get a nice deep watering right down to the roots and we think of that as the water moving into our cells and not just moving straight through us so that we're drinking a whole bunch and then off to the toilet again to do another way.

Sarah McLachlan: 16:23

So, like I said, water is a must for your digestion. It helps move food through your intestinal tract, it actually helps prevent water retention and it flushes out excess sodium there as well. But if you get to six o'clock and you think, oh, I didn't drink enough water today, and down she goes a whole litre or whatever, you're going to get bloated. And you think, oh, I didn't drink enough water today, and down she goes a whole litre or whatever. You're going to get bloated and you're going to be on the toilet and probably have to get up during the nighttime. And again, you probably don't need that disruption because your hormones might be already messing with your sleep. So a good rule of thumb is to consume 250 to 500 mils of water at a time. If it's hot and you're doing intense exercise, well, you might need more, but still pace your intake. Take it down over a period of time, don't just gulp it all down at once.

Sarah McLachlan: 17:12

Now, just to note, while we're talking about, drinks are fizzy drinks, and I'm talking about even soda water and kombucha. They can add to your gas and inflate you or add to bloating there as well, and so can artificial sweetness. So I know a lot of you think that by drinking, say, I don't even know what they're called because it's been so long since I've drunk them. But those I don't know, whatever soft drink you like, insert brand name and they have a diet or a zero version of it or whatever it is. Those artificial sweeteners, oh my gosh, they're hideous and I probably should do a whole podcast episode on it, but they can lead to bloating because they mess with your microbiome.

Sarah McLachlan: 17:55

You might think that having this artificial sweetened or the sweetened alternatives is better than having a sugar. What I tell my clients and my friends and my family is that actually rather you drink the fully loaded sugar version than the artificial sweetened one, and usually you'll find that you drink less of it because it's so sweet. You can't and you're also quite aware of the sugar that you're consuming, but it's much better for your liver and your guts to have the sugar version. Actually, the best is to have no soft drink like that, but, yes, it's better to have the sugar than the sweetness. So the sweetened alternatives, particularly the sugar, alcohols, so they're any ingredients that end in I-T-O-L, like sorbitol, maltitol, xylitol, or they can really just wreak havoc in your gut and make so much wind and bloating. So chewing gums particularly have that in it a lot and they can make you have lots of gas but also diarrhea as well. So it's probably best to avoid them unless you're close to a toilet and at home and there's a whole bunch of reasons why I don't or I'd say, avoid chewing gum as well. It's going to get more air into your intestines but also messes with your hunger and satiety and your insulin levels there as well. So other forms of things that make extra gas into your body is mouth breathing. This is what we breathe through, not here Drinking through straws, smoking and vaping as well. So hopefully you're not doing any of the smoking or the vaping or if you are and you have bloating, it might be what's contributing to it.

Sarah McLachlan: 19:45

So I want to talk about your microbiome because it is really the key here and it's what we want to figure out when you have bloating. So we want a good balance in your gut and a good balance of microbes beneficial. We sometimes have some baddies in there, but that's okay. But we don't want them overtaking things here. So the way to get a nice balance in your gut is to focus on the environment within and to do that we want a nice wide variety of colourful foods and fibres. That helps promote the health of your intestinal wall or cells.

Sarah McLachlan: 20:18

And they make a particular mucus called mucin that our beneficial microbes live in and live off. They love it and they go crazy for it and they thrive and multiply and get really strong in there and they crowd out the buddies. So we have this beneficial microbe ca lled Akkermansia and they love to live in that mucin. And when there's not enough mucin, so if you're stressed, if you're in stress response mode, your mucin production's decreased. So stress impacts your microbiome just like the food that you eat and the things that you're drinking and all of that stuff as well. So when there's not enough mucin, it's thinner and there's less of a ho m e for our little Akkermansia. Well, so when there's not enough mucin, it's thinner and there's less of a home for our little Akkermansia buddies. So when there's less mucin, there's also the opportunity for microbes and this is where we're thinking more about our baddies to come into contact with your intestinal wall when they shouldn't and pass through to the bloodstream and contribute to triggering the immune response that is inflammation and make you feel unwell. So, like I said, we want to crowd out the buddies, and support the good ones to thrive and multiply.

Sarah McLachlan: 21:27

I don't really use probiotics to do this. I know they're often really popular and the first choice, but they can actually create a lot of problems as well if it's not the right strain. I do love using prebiotics, which are the fibres that help promote that healthy environment and your mucin production. So prebiotic supplements, fermented foods and drinks come into that as well. They temporarily improve the diversity in your microbiome and they are useful to help improve conditions for your microbes to flourish and multiply. But you just may not tolerate them at all if you have an out- of- balance microbiome. So they are usually the last things that I'll incorporate for my clients. But yeah, if you tolerate them and you've sort of done that intestinal healing, then include some fermented foods and drinks foods with your meals and drinks around it. You know that as well and it'll support and optimize your microbiome health there as well.

Sarah McLachlan: 22:23

The more diverse plant foods you consume over a week, the more diverse your bacterial, your microbe species are going to be in your intestines and the better your health will be, the less things like bloating or constipation that you're going to experience. The fibres within the plant foods feed and encourage those different bacterial species. So if you try and aim for like 40 plus minimally processed, unique plant foods over the week, you're really going to hit the mark there as well. So unique it could be like a red apple one day and a green apple another. Maybe you might have an orange carrot and a yellow carrot another time. So it doesn't necessarily have to be completely unique types of vegetables or plant foods. It can just be different colours count as a unique food there as well. So herbs and just eat more fruit, vegetables, nuts and seeds because they have especially if you can eat some raw, they'll have some microbes on them. Green tea, matcha, almonds with the skin on cocoa, colourful berries and vegetables, brown rice, and olives all of these things are really wonderful foods that will feed your microbiome and help with your microbiome balance and help reduce the bloating there.

Sarah McLachlan: 23:33

So some other important things to remember in your microbiome health or your digestive health is exercising moderately actually helps increase your diversity. So moving your body walking, swimming, riding, pilates, yoga, strength training we're not. We're not flogging ourselves, remember because? So go back in the archives. I've done a podcast episode on what sort of movement works really well for women in perimenopause and menopause. The main thing I want you to do, though, for your microbiome health is please don't snack and don't graze all day. Three meals per day. Have a nice break in between so that you can let your intestines do their self-cleaning function, which is really optimizes and supports a healthy microbiome and is really beneficial for relieving or reducing bloating. So that's a wrap on today's episode.

Sarah McLachlan: 24:27

I feel like I've just run a race. Hopefully, I didn't talk too fast and that you can hear everything that we've gone through. So we've unpacked why you might feel bloated, and I've shared some strategies or some information with you as well to help you manage that and reduce the gas, reduce the toots. So remember, it's really about the basics of chewing your food properly. Digestion starts with our eyes, our nose, our mouth and your stress manag ement there as well super important. Drinking wisely through the day and around your meals, and cutting down on those bubbles and the artificial sweeteners and you know the things that get in the. They're adding more gas into your body. And thirdly and most importantly, that microbiome of yours. Show it some love, because there's more of them than there are of us own cells in our body. So we really want to look after them because it has such a significant impact on our health, and particularly with bloating. So you want to plant-based, so lots of plant foods, whole food diet that's rich in fibre. Keep aiming for those 40- plus unique plant foods each week and you'll totally nail it there.

Sarah McLachlan: 25:34

If you're looking for more resources or you want to submit your own FAQ, I'd love to hear it. I'd love to answer it. Please visit the show notes and, while you're there, don't forget to subscribe to make sure that you never miss an episode. Thank you for listening and sharing your time with me today. I'm so looking forward to exploring functional pathology in the next episode. It's not as boring as it sounds. We're going to be covering off normal lab marker ranges versus the optimal. What are they? Why should you care? How? They're designed for women's best state of health, and they're the key that's going to help you work out what's underlying what's going on for you and how to take preventative action with your health, so that you're not waiting for a disease or dysfunction to develop and you can start shifting your perimenopause experience from Chaos to Calm right now. So thank you again for joining me. I hope you've enjoyed this episode and I look forward to speaking with you next time.