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The Constipation Conundrum of Menopause

The menopausal journey introduces a myriad of challenges, and for many women, navigating gastrointestinal (GI) issues becomes an unfortunate aspect of the narrative. Constipation, characterized by fewer than three complete bowel movements per week, straining, and/or hard, small stools, often takes a prominent role.


Behind the Scenes:

  • Sluggish Scene: Estrogen receptors in the gastric and small intestinal mucosa play a crucial role. The decline in estrogen during menopause slows the bowel, leading to constipation.

  • Cortisol Curtain: Although estrogen typically regulates cortisol, during menopause, when estrogen is low, cortisol goes unchecked, which slows the bowel and contributes to constipation.

  • The Dry Act: The absence of progesterone in menopause slows bowel movements, causing food waste to linger and resulting in drier stools and constipation.

  • Pelvic Floor Fatigue: With decreasing estrogen in menopause, pelvic floor muscle tone weakens, which can lead to constipation.

  • Fluid Flow: Hormonal fluctuations cause disruption within the intestines. With insufficient fluid retention, stools can become dry and hard, resulting in constipation. On the other hand, too much fluid retention can make stools loose, resulting in diarrhea.

  • Microbial Ensemble: Hormonal changes can alter the gut microbiota, which may contribute to digestive issues, including constipation.

To prevent constipation, follow these director's notes:

  • Make Fiber the Star: Eat at least 25g of fiber every day. Raspberries, pears, apples, broccoli, baked potatoes, sweet corn, barley, bran flakes, and oatmeal are good options.

  • Empower the Pelvic Floor: Strengthen your pelvic floor. Talk with your doctor or a physical therapist about a routine that will work for you.

  • Spotlight Hydration: Increase water intake to counter the tendency of stools to become drier during menopause.

  • Add Action Scenes: Increase your physical activity. Walking, running, and other forms of moderate can help keep things moving. Add some resistance training to your routine to keep your core muscles strong.

  • Welcome Supporting Actors: Magnesium supplements can assist by drawing fluid into the bowel to facilitate flushing.

But don't forget the subplot! Common medications, including blood pressure medications, narcotics, iron supplements, thyroid medication, antidepressants, and calcium channel blockers also may contribute to constipation. Discuss with your doctor whether adjustments to your medications can alleviate symptoms.


In this grand production of menopause, each woman has her unique script, and not everyone experiences the constipation plot twist. Although occasional constipation can be treated with fiber supplements and/or stool softeners, persistent or severe cases warrant consultation with a healthcare professional.



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