Everything You Should Know About Perimenopausal Bloating

What is Bloating?

Bloating is usually defined as a sense of gas.Many describe bloating as a sensation of an inflated balloon in the tummy. It is not always seen as an increase in abdominal girth. Sometimes, just a gassy feeling can make you feel tight, stretched, and uncomfortable.

Dr Shahnaz, Ayurveda consultant at Nirva, says that she often meets women with complaints such as "too much gas in the abdomen," "heavy and uncomfortable feeling in the abdomen", and "full belly."

Are all these the same or different?

The severity of bloating varies from mild discomfort to severe. Yet at times, it can affect the quality of life.

As you read on, you will discover what bloating is and why it is a cause of concern during the perimenopausal time. 
Also, let's fix perimenopausal bloating with natural remedies!

Wonder What Causes Bloating?

The deep-rooted exact cause is not yet concluded by the scientists but is considered as follows;

• Water retention
• Gas retention

Identify water or gas

• Gas bloating is a result of trapped air. It is typically located in the stomach. Gas bloating can be prevented by eating slowly, avoiding carbonated drinks, and eating smaller meals.
• Bloating from water retention is usually associated with retention in other body parts. In this condition, swellings will be seen in other parts of the body like hands, feet and flanks . Bloating from water retention sometimes comes with pain.

There Can Be Other Underlying Reasons for Bloating

Absolutely!

For example, if have IBS ( Irritable Bowel Syndrome) or other intestinal diseases, that can be the reason for your bloating.

Here are some main reasons for the retention of water or gas in the tummy.

• Swallowing excess air whilst eating
• Constipation
• Coeliac disease
• Food intolerances
• IBS 

You have to get in touch with your consultant before you decide if your bloating is from the above reasons or just a menopausal change. One clue to know is; perimenopausal bloating typically tends to reduce after complete menopause. 

Why Do Women During Perimenopause Feel Bloated?

In the US, 15-30% of the population experience abdominal bloating, of which women are more.

Researchers have related female sex hormones, estradiol, to bloating.

Bloating is also experienced during the menstrual periods, not only during perimenopause or menopause.

• Changes in oestrogen and progesterone are seen to increase visceral sensitivity, i.e. the sensitivity to the internal pain of our organs, which can cause the sensation of bloating.
• Also, it is observed that female hormones have a direct effect on water absorption qualities and function. 

Along with bloating, a perimenopausal women experience other symptoms, such as constipation, anxiety, hot flashes, etc., that add to her stress. This stress, again, can add to the worsening of gut symptoms, including bloating.

Sometimes, your lifestyle and food habits can add to the cause. These may include swallowing air whilst eating, drinking carbonated beverages, stress, trigger foods, and lactose intolerance, which can all play a part.

Let's not forget that bloating can also be a side effect of HRT (hormonal replacement therapy).

All in all, perimenopausal bloating can be from;

• Increased sensitivity in our gut leads to an increased chance of pain with bloating
• Other menopausal symptoms include sleep disruptions and anxiety.
• A side effect of oral HRT 
• Drinking carbonated beverages
• Eating off time and quickly.
• Potential lactose intolerance

Have You Experienced Stress Bloating ?

'Stress' is a small word that needs more attention. Women who have faced stress, anxiety and depression know how challenging it can be. It may feel confused, tangled, and blank for many.

This entangled feeling can change way too many aspects of your life.

Navigating menopausal transition, hormonal fluctuation, and everyday stressors can be exhausting for some.

Stress is first felt in the gut!

Daily stressors can affect our digestive function. They act through various pathways. 

Various facts are believed to be the cause of bloating from stress.

Gut-brain axis

With stress, the region of the brain responsible for memory and emotional responses becomes activated. The brain tells us to skip providing energy for digestion and decide whether to fight or fight. The body thinks, "we can worry about digestion when we're safe", and puts it on pause.

Modern-day stressors have become so common that we stop noticing them after a certain point. The brain starts to tune them out.

The result is that before we even realise that we are stressed, our gut has already felt the changes. 

Also, even after the stressor is removed, the effect remains for a long time, causing;

• Cortisol - leaky gut :The adrenal hormones called cortisols can lead to a loss of intestinal wall integrity. This leads to a leaky gut.
• Stress eating : Research has linked increased sugar consumption from stress eating to bloating. There is a microbial imbalance created from increased carbs intake, which causes reduced resilience to stress. 
• Stress - sleeplessness : Increased or decreased sleep can affect digestion. When it comes to the sleep cycle, the brain has its clock to which it responds. Reduced sleep from stress makes the pain-sensing nerves in the gut overactive, which ultimately sends off the wrong signals that the bloating is too much, even when there's minimal gas in the abdomen. 

Interesting fact 

The word bloating was first described in a woman patient with  psychological problems by Alvarez of the Mayo Clinic (1949).

Gut Microbiome During Menopause

The digestive tract is home to hundreds of species of bacteria called gut microbiome. 

Recent studies have established an interlinked relationship between menopause and gut microbiome.

With the changes in hormone levels in the human body, the types of gut bacteria keep changing throughout the lifetime.

So, women aged 45-50+ have a different set of gut bacteria.

This proves that hormones can decide what happens to your gut and that gut health decides what happens to your hormones.

Moreover, with menopause, there is a change in the strength of body muscles and composition which reduces the gut barrier allowing the bacteria to translocate from the gut to other tissues around the body. 

This gives chances for it to start an inflammatory reaction in the body, such as arthritis, depression, obesity, cardiovascular disease and a wide variety of digestive symptoms.

Maintenance of good gut health with an appropriate lifestyle can positively influence perimenopausal symptoms, menopausal transition and menopausal health. 

Did you know?

The high fat, sugar, and salt content of the Standard American diet can increase  the "pro-inflammatory potential of the Microbiome."

What's the result? 

Unpleasant digestive symptoms like bloating, gas, constipation, etc.

74% of Americans complain of some digestive disorder. It's no wonder there is a prevalence of salty, sugary, fattening, and processed foods in many diets.

Do not worry!

It is possible to disrupt this gut dysbiosis. 

Choosing different eating patterns can improve your Microbiome and gut health.

7 Natural Remedies to Avoid Perimenopausal Bloating

1. Avoid the food items that trigger your bloating.

Some of the foods that can cause bloating are

• Beans & legumes
• Cabbage
• Brussel sprouts
• Artichokes
• Asparagus
• Onions
• Celery
• Bran
• Carbonated drinks
• Dairy products 
• Foods containing sugar alcohols (some artificial sweeteners), sorbitol, mannitol, xylitol

2. Watch your sodium intake.

Salt is the main source of sodium, so reducing your intake may ease perimenopausal bloating through water retention.

Processed foods often contain high levels of salt, such as:

• processed meat
• crisps
• instant soups
• soy sauce
• salad dressings
• sauces
• cheese

3. Increase the intake of fibre and water.

Increase fibre (and water) gradually. Fibre can help to make bowel movements more 'normal', and prevent constipation.

Your bloating may be due to constipation, so ensuring you're getting enough fibre in your diet may help. 

Remember that it's important that you increase your dietary fibre gradually and include water or unsweetened drinks regularly.

4. Consider taking probiotics

There are hundreds of probiotics available in the supermarket. 

But, using probiotics without understanding what's going on in the gut can be like blindfolding yourself.

Some people have even reported that probiotics actually contribute to their bloating.

Some natural probiotics are;

• Yoghurt
• Traditional buttermilk
• Pickles
• Sauerkraut
• Acidophilus milk

5. Make sure you are active.

Humans are meant to move on a daily basis. Unfortunately menopause comes around a time when we tend to be so busy that we do not get time to hit the gym, jog around or go for a walk.

But the best thing about exercise is, it's not always the gym work. A 30 minutes of daily stretching can help you cut out a whole load of Ill health.

You can consult yoga experts at Nirva Health for daily workouts under supervision. ( link for yoga sessions)

6. Increase self-care and stress management

As mentioned in previous sections, it's very evident that stress can alter your digestive health.

Engaging yourself in habits you like such as reading, singing, drawing etc is mandatory in this busy lifestyle. Always remember to keep a 'me time', for yourself so that you get that time to relax.

7. Decrease the size of your meals.

A balanced meal, in the right amount at the right time, is very important for your overall health. 

Also, avoid heavy meals at night time as our body has less concentration on digesting food at night. It's biologically clocked for taking rest.

Expert note : To find lasting relief, determining the underlying cause and targeting the root of the problem is the answer. We need to find out what's going with our individual gut microbiomes so we can take the next steps to better our gut health – and hopefully find relief for our troublesome tummies.

Quick Home Remedies for Perimenopausal Bloating

1. Herbal Teas  

Replace caffeine intake with herbal teas.

Caffeine consumption is highly related to digestive troubles in the long run.  Herbal teas aid digestion and relieve gas.

Combining chamomile, peppermint, turmeric, ginger, and fennel tea is a great start. 

Water retention, which is one of the causes of bloating, can be relieved by Dandelion tea.

2. Cardamom   

One of the traditional methods for appetiser, anti-flatulent, and digestion management is adding cardamom to your food.

With warm water, cardamom can also be taken with dry ginger and rock salt as a fine powder. 

3. Star Anise

The star anise fruit is a carminative that relieves gas from the intestine.  

Mix some Star anise powder with honey for bloating, flatulence, stomach pain and colic ( abdominal pain).

Star anise is also taken in the form of tea.

4. Ginger  

Ginger is an essential part of every diet to balance different tastes. It is an easy trick to manage various digestive issues, including constipation, bloating, indigestion, etc. Adding ginger to your herbal tea helps a lot. Please take extra care to reduce the quantity of reflux gastritis.

5. Asafoetida

Experts in traditional and conservative medicine have seen the action of asafoetida on bloating, indigestion and abdominal pain. This can be taken with warm water or added to your food.

6. Bishops weed or Carom seed

Carom seeds have excellent anti-inflammatory properties.  Carom seeds are often chewed after having a heavy meal to aid digestion.  You can also boil the seeds in water, allow them to cook and drink it,

7. Turmeric  

Turmeric is considered one of nature's blessings.  It has potent healing properties and is scientifically proven to act in many disease conditions.

It is a perfect digestive stimulant as well as a carminative. It is often added to various dishes to improve digestion and reduce bloating. It can be taken as a dry powder mixed in plain water or buttermilk.

Know the difference!

Bloating or Weight Gain?

You should consult your healthcare provider if the bloating is prolonged or painful. Bloating from water retention can cause weight gain.  Women usually find it difficult to distinguish between bloating and weight gain. 

• Weight gain with a distended, swollen belly only after a meal is bloating. 
• In bloating, the size and shape of the stomach change throughout the day. 
• Short periods of bloating correspond to meals or hormonal fluctuations.
• By contrast, weight gain will not fluctuate in a day. 

During menopause, metabolism slows down, which can cause weight gain, which can occur with or without bloating.

When to Be Concerned?

It is not a cause for concern if bloating clears up. Experiencing occasional bloating due to hormonal fluctuations associated with menstrual cycles and menopause is typical amongst women.

When the bloating is prolonged or painful, it's time to speak to your doctor.

Painful bloating lasting several weeks may be because of any underlying medical condition that has to be diagnosed by an expert.

It would be best if you also looked out for other symptoms which need concern;

• Heartburn and vomiting.
• Diarrhoea
• Dark stools that look like tar.
• Blood in stools
• Weight Loss
• Abdominal pain

Conclusion

Bloating during perimenopause is a common experience but sometimes an unpleasant feeling.

However, without going into unnecessary pills, it can be managed from above- mentioned tips. These may help to prevent bloating from worsening.

Also, home remedies like herbal teas, ginger, cardamom, turmeric etc., are beneficial in reducing perimenopausal bloating.

Although, if bloating persists for long, at least more than a week, consultation with an expert is mandatory.