Why Am I So Bloated?

Reviewed by Dr. Lisa Czanko MD, MPH

If you're one of the 15-30% of people in the US who experiences bloating, you know just how uncomfortable it can be. Your pants are tighter, you feel hungry but somehow full, and your bathroom habits may even change. 

While bloating can occur at any age, people going through perimenopause may experience bloating even more often. With so many other symptoms also occurring during this transitional phase, bloating is often overlooked or ignored. But, it doesn't have to be. Luckily, there are simple perimenopause bloating remedies that may help alleviate the discomfort that comes with abdominal bloating. 

Before we jump in, keep in mind that it’s important to first speak to a medical provider about your individual situation with perimenopause and bloating before implementing any dietary changes or starting any supplements.

How are hormones and digestive symptoms connected?

While not always talked about, there is a connection between reproductive hormones and the gastrointestinal tract that can affect periods as well as perimenopausal symptoms. 

Menstruation

Many people are all too familiar with digestive issues prior to getting their period. Bloating and diarrhea are common symptoms of premenstrual syndrome (PMS). It is thought that these GI symptoms are triggered by the change in hormones, such as estrogen and progesterone, that occur prior to getting a period.

Perimenopause

The gut-hormone connection doesn’t stop there. Perimenopause, defined as the transition phase leading up menopause, can also conjure up some abdominal trouble too. Most people experience perimenopause in their forties, with symptoms including bloating, hot flashes, sleep problems, and irregular periods. 

The changing hormone levels (and the digestive symptoms that accompany them) during one’s cycle can occur more frequently and less predictably during perimenopause. Additionally, people who already have bowel problems, such as irritable bowel syndrome, are more likely to experience bloating during perimenopause.

The good news is that bloating associated with perimenopause often improves after menopause, because hormone levels are more stable after periods stop.

What is bloating?

Bloating is somewhat vaguely defined as a feeling of a full distended belly and it can be very uncomfortable for some people. There are multiple possible causes of bloating. In addition to changing hormone levels, other causes may include:

• Abnormal gut bacteria
• Dietary intolerances
• Constipation
• Slowed digestion

What are some perimenopause bloating remedies?

There are simple things one can do that can help the discomfort that comes with perimenopause and bloating, and many of them are in the kitchen. Here are some natural perimenopause bloating remedies.

Avoid Bloat-Causing Foods

Sometimes, dietary changes can be helpful in preventing bloating. The following foods can be associated with excessive bloating:

• Fatty foods
• Some fruits and vegetables that increase gas (e.g. cabbage, broccoli)
• Dairy products
• Some carbohydrates
• Foods with a high sugar content 
• Chewing gum 
• Carbonated beverages

One strategy is to try cutting out one type of food at a time to see if this improves symptoms. If unsuccessful, then the next type of food can be eliminated, and so on. For example, if someone drinks a lot of diet soda, they can try to cut this out and see if symptoms improve.

FODMAP Elimination Diet

You may have heard of the “low FODMAP” diet, but what does this mean exactly? The term FODMAP refers to carbohydrates that can be hard to digest. 

Types of foods that are high in FODMAPs include:

• Apples, mango, pears, watermelon, and some berries
• Beans, garlic, onions, beans, and mushrooms
• Dairy products
• Wheat and rye grains
• Honey
• High fructose corn syrup
• Many artificial sweeteners

If this class of foods is thought to be contributing to symptoms, an elimination diet is often recommended. To begin an elimination diet, a person cuts out all of these foods for four to six weeks, then if symptoms have improved, they can gradually reintroduce each type of food and watch to see if any symptoms return.

Medication

Keep in mind that if bloating is caused by an underlying medical condition (that is, not simply related to perimenopause), it’s important to first treat that condition. Be sure to talk to a medical provider about your individual situation and what, if any, medications, might be right for you.

For example, depending on the cause of bloating, types of medications that may be used include:

• Antibiotics 
• Medications that help move the bowels
• Medications that help prevent spasms of the bowel
• Peppermint Oil
• Anti-gas medications
• Some classes of antidepressant medications

Probiotics

There is a delicate mix of good bacteria in the gut, and there is evidence to suggest that some bloating and other digestive symptoms may be caused by this bacteria being out of balance.

Because of this, replenishing the good bacteria with probiotics can sometimes be helpful for bloating. Probiotics contain live bacteria that are similar to the “good” bacteria that live in our bodies. 

There are whole aisles at the grocery store dedicated to probiotics, but it is important to note that not all probiotics are created equally. Probiotics contain different kinds and amounts of bacteria. Here’s a quick guide on what to look for.

One of the most common types of bacteria in probiotics is Lactobacillus, which has been shown to help with abdominal symptoms when used as part of a combination probiotic.

There are also studies that indicate that Bifidobacterium lactis and Bifidobacterium longum can be helpful for other symptoms such as constipation.

Overall, probiotics appear to be safe when used to treat and prevent bloating, but it is important to always discuss your individual situation with a medical provider prior to starting any.

Other Solutions

Drinking plenty of water and getting regular exercise can often help decrease perimenopause bloating symptoms. Staying active and hydrated helps to keep the bowels moving so gas cannot stay in one place and build up. The combo can also help prevent constipation, which can worsen the sensation of bloating for some people. 

When to Seek Help for Perimenopause and Bloating

For anyone experiencing bloating, especially bloating that has not responded to dietary changes or medications, it is very important to speak to a medical provider. In some cases, bloating can be a sign of a more serious medical condition. For instance, while ovarian cancer is relatively rare, the early symptoms are often vague, and can include bloating, constipation, diarrhea, feeling full, or a decreased appetite. 

In Case You Skimmed 

• Bloating is a common symptom of perimenopause. 
• Even though a lot of people experience perimenopause and bloating, it shouldn’t be brushed off as “normal.” 
• Some common perimenopause bloating remedies can include diet, lifestyle, and medication

Our Simple Note:

Entering into perimenopause can sometimes bring on feelings of uncertainty. We want you to know that we’re here for you. The unknown can be daunting, which is why we are taking the time to pause and help you understand what your body may be going through. We hope to leave you feeling empowered through knowledge and understanding.

Citations

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Chang, L. Eating, Diet & Nutrition for Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Department of Health and Human Services National Institutes of Health, Updated November 2017. Accessed January 29, 2022. 

Ducrotté P, Sawant P, Jayanthi V. Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World J Gastroenterol. 2012;18(30):4012-4018. doi:10.3748/wjg.v18.i30.4012

Heitkemper M, Chang L. Do Fluctuations in Ovarian Hormones Affect Gastrointestinal Symptoms in Women With Irritable Bowel Syndrome? Gend Med. 2009; 6(Suppl 2): 152–167. doi: 10.1016/j.genm.2009.03.004

Hungin APS et al, Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice -- an updated evidence-based international consensus. Aliment Pharmacol Ther. 2018 Apr;47(8):1054-1070. doi: 10.1111/apt.14539

Seo AY, Kim N, Oh DH. Abdominal Bloating: Pathophysiology and Treatment. J Neurogastroenterol Motil. 2013 Oct; 19(4): 433–453. Published online 2013 Oct 7. doi: 10.5056/jnm.2013.19.4.433

Wang Y, Shurtleff D. Probiotics: What You Need to Know. National Center for Complementary and Integrative Health. U.S. Department of Health and Human Services National Institutes of Health. Updated July 2019. Accessed January 15, 2022. https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know

Williams EA, Stimpson J, Wang D, et al. Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Aliment Pharmacol Ther. 2009;29(1):97-103. doi:10.1111/j.1365-2036.2008.03848.x