Perimenopause (or peri) can involve various different symptoms experienced differently between individuals, including fatigue, gas, bloating, pain, nausea, changing bowel movements and more. While many women navigating this stage of life are quick to blame peri for these experiences, oftentimes poor gut health can actually be the root cause or a key contributing factor to these symptoms. Problems with your gut can trigger or worsen peri-related symptoms. In blaming perimenopause, many women overlook or ignore problems or imbalances in their gut, leaving them bewildered and confused as to why they’re feeling so low and lethargic. It’s important to understand how to address these gut symptoms first, to help manage and relieve perimenopause symptoms more effectively.

Symptoms which are commonly associated with perimenopause, yet are often caused or exacerbated by poor gut health or gut microbiome imbalances include irregular bowel habits, bloating, fatigue and brain fog. Let’s dive into how poor gut health may actually be a major contributor to these symptoms, and how you can effectively manage and relieve them.

Irregular Bowel Habits

If you’re experiencing constipation, your body is unable to remove toxins or excess hormones from your bloodstream, which can contribute to symptoms such as fatigue, low energy, bloating and brain fog. Normally, toxins and excess hormones can bind to fibre and be excreted in your stools, however, if you’re regularly constipated, this doesn’t happen as it should. This can result in the buildup of these toxins, causing unpleasant gut symptoms.

On the other hand, if you’re regularly experiencing diarrhoea, your ability to absorb nutrients is likely impaired. Important vitamins and minerals such as iron may be going straight through your body, giving you less chance of absorbing and using them as you should be. This can again cause fatigue, brain fog, and other unwanted symptoms.

Both constipation and diarrhoea can be the result of gut health problems. If you have any imbalances or disruptions to your gut microbiome (the balance of good and bad bacteria living in your gut), this can trigger either of these symptoms. Gut bacteria play a significant role in controlling how quickly or slowly your food moves through your digestive tract and your body. If your food moves too slowly, this can cause constipation, and if it moves too quickly you may experience diarrhoea. It’s important to support your gut health using dietary and lifestyle strategies to ensure your good bacteria far outweighs the bad bacteria residing in your gut, to prevent toxins building up in your gut and worsening your symptoms, and to reduce irregular bowel movements.


Bloating is another indicator of poor gut health (though this isn’t always the reason behind bloating – some bloating is very normal, while other times bloating can indicate something more serious is going on in your body). Hormones and stress can also play a large role in bloating – making perimenopause a time during which many women experience this symptom.

If you regularly experience bloating after eating, or notice pain, cramping, gas or other discomfort, your gut may be imbalanced.

While some gas is normal, if it’s excessive this shows your digestion isn’t functioning as it should be. This is often due to an imbalance of bacteria in your gut. Your gut bacteria normally digest and ferment carbohydrates, in a very important process to provide energy for your body and optimise your gut health. However, if there’s too much fermentation happening, this indicates that the carbohydrates you’re consuming were properly absorbed earlier in the digestive process before they reached your gut. This can be caused by constipation, leading to food clogging up your intestines and causing bloating, or even due to hormonal changes associated with perimenopause. Oestrogen and progesterone both influence your gut motility, or the speed at which food enters and stays in your gut – so any changes to these hormones can result in bloating, gas and discomfort too.

Fatigue, brain fog and low energy

While fatigue and low energy levels are regularly attributed to perimenopause, they can also be the result of poor gut health. Research increasingly shows that gut imbalances can lead to feeling constantly exhausted or tired, and contribute to low energy levels. Not only do disruptions to your microbiome interfere with your production of serotonin, a neurotransmitter closely linked to your sleep quality and mood, but gut bacteria also impact your nervous system, and therefore your focus, concentration and energy levels. If you have too many “bad” bacteria in your gut, this causes inflammation, and leaves you feeling fatigued and lacking in energy constantly. Plus, the flow-on effects compromising your sleep quality only contribute further to these symptoms.

So how do you optimise your gut health to reverse these symptoms?

There are several lifestyle and dietary interventions which can effectively improve your gut health and therefore may be able to relieve some of these symptoms associated with gut disruptions and perimenopause. Try to implement the following:

  • Eat a balanced diet, with plenty of fibre and whole grains. Fibre is essential for supporting your gut health and keeping digestion and bowel movements regular. Make sure to include lots of fruit and vegetables in your diet, and try to leave the skin on where possible – as this is where most of the fibre is found! Similarly, make sure you’re balancing each meal with a healthy source of fat, a lean protein, and a whole grain carbohydrate source. Eating balanced meals like this will help to slow down your digestion, allowing you to better absorb the nutrients from your food, and giving your gut time to properly digest your meals to prevent excessive gas, bloating and discomfort.
  • Avoid eating on-the-go. Take time out to eat your meals, making sure you’re really chewing each bite and not rushing through your food. Put down your cutlery between bites, and stop eating when you’re full, as overeating can worsen these symptoms. Make sure you’re not eating while watching TV, as this can interfere with your digestion and your ability to notice your body’s fullness cues.
  • Eat regularly. Try to avoid skipping meals, as this can lead to overeating later on, and also affect your body’s digestion. Missing meals can actually exacerbate bloating, so ideally you want to make sure you’re eating every 3-4 hours, prioritising balanced and nourishing main meals, with snacks in between as needed.
  • Don’t overdo the caffeine. Caffeine can disrupt your gut balance if consumed excessively. And most importantly, don’t drink caffeine on an empty stomach if possible! This can hugely spike your production of cortisol, which is closely linked to symptoms like bloating, weight retention, and digestive and bowel problems. By all means enjoy your daily coffee, but try to eat a balanced breakfast before you reach for the caffeine.
  • Exercise regularly. Exercise is fantastic for your gut health and digestion, and really helps to relieve some of the symptoms we’ve discussed including bloating, constipation and low energy levels. 
  • Go for a gentle walk after eating. Even a 10-15 minute walk after a main meal can support your digestion, and help to keep your gut healthy and balanced.

Remember, the reverse can be true: perimenopause can also contribute to these gut-related symptoms. They can often be the result of changes to your hormone levels, in particular declining levels of progesterone and oestrogen, as well as increasing production of your stress hormone, cortisol, which can lead to bloating, gas, irregular bowel movements and weight retention. However it’s important to address any gut imbalances first, in order to help effectively reduce your perimenopause symptoms. Without considering this side of the coin, you won’t get the relief you deserve from these unwanted experiences. 

If you’re ready to manage your perimenopause symptoms, optimise your gut health and find the relief you so deserve,
book a consultation with me today!