Menopause and Your Gut!


Many women suffer from abdominal symptoms before, during, and after menopause.  Intense gas pains, bloating, reflux, pelvic pains, constipation, diarrhea, nausea, belching, eructations, and generalized discomfort that come and go are very common during this time of transition. Often, women go from doctor to doctor, doing tests, ultrasounds, CT scans and other imaging only to find out that there is nothing wrong but that they have lots of gas bubbles in their gut. What’s more frustrating is that most doctors tend to miss the connection between hormonal imbalances that occur during menopause and the gut – a connection that is vital for our overall health and is often the cause of abdominal pain and discomfort.

Estrogen and the Gut

Hormonal and autonomic nervous system signals to and from the gut play a vital role in the health of the digestive tract and our overall wellness. The gut has many estrogen and hormone receptors.  As hormones fluctuate, the motility of the gut, the bile acids release from the gallbladder, and the microbiome of the gut become affected. The rhythmic peristalsis of the intestines turns erratic, creating gas, bloating, eructations, and abnormal bowel movements.  Furthermore, the microbiome of the gut regulates circulating estrogens. Alterations in the microbiome, causing estrogen metabolism dysfunction, lead to estrogen-related illnesses overtime.  Hormone-related cancers, such as breast, lung, brain, and colon cancers, as well as autoimmune diseases, inflammatory bowel disease, migraines, fibromyalgia, are examples of estrogen-related conditions which may develop as a result of altered estrogen metabolism. So it’s no surprise that as hormones fluctuate during menopause, the confused signals to and from the gut affect ones overall health.

The Microbiome Affects Menopause

The microbiome is the colony of bacteria and fungi in the intestines. For optimum health, the microbiome must contain a diverse population of bacteria. The microbiome alterations occur as a result of antibiotic use, diet, low hydrochloric acid, emotional and physical stress, hormone fluctuations, and chronic infections, such as lyme disease and bartonellosis to name a few.  It is well known that antibiotics destroy the microbiome. Eating junk food and processed foods produces bacterial imbalance which promote chronic inflammation in both the gut and the whole body. Stress inhibits hydrochloric acid production in the stomach, reducing one of our first defenses against infections, while minimizing the secretion of pancreatic enzymes to digest carbohydrates and fats,  and bile acids from the gallbladder to breakdown fats. Larger undigested food particles then pass into the intestinal system providing feed for the bacteria and fungi which causes gas, bloating, maldigestion, malabsorption, and a multitude of other symptoms and inflammatory processes. The final result is gas pains, belching, nausea, constipation, diarrhea, and abdominal discomfort which culminates during this transitory period and leads to chronic disease systemically.

Our Gut, Our Second Brain

Our gut is our second brain; though in reality, it is our first brain. Embryonically, the gut’s nervous system develops first. There are 400 times more of our mood neurotransmitters produced in the gut than in our brain. We sense things with that ‘gut feeling’. When we stress, our gut nerves (our autonomic nervous system – our fight or flight nerves) are activated and influence the microbiome balance, our digestion, our hormone metabolism and our mood – all which affect our abdominal symptoms. During menopause, we are much more sensitive to the stressors within and around us. One of our goals during this transition, is to clear out and process the emotional and physical toxins that we have accumulated throughout our life. Our gut signals us to let go of the past within the deepest layers of our cells and being. We are meant to close a lifelong chapter of learning, growing, and experiencing and allow new opportunities to be welcomed as we enter the next chapter of our powerful lives.

What To Do To Relieve Abdominal Symptoms During Menopause

Here are a few naturopathic pointers to help reduce gut symptoms during this transitory menopausal period:
  1. Eat and chew food slowly. Eat small frequent meals.
  2. Eat a whole foods diet, minimizing processed foods and junk foods. Increase intake of wild salmon, cod, trout, sardines. Include phytoestrogens, such as fermented certified organic soy (such as tempeh and miso) which balance estrogens. Plant-based diet including eating fermented veggies (sauer kraut, kimchi, etc.) stimulate microbiome diversity. Eat cooked foods and avoid gas forming foods such as garlic, onions, legumes, broccoli and other brassica forming foods. Avoid heavy fats and fried foods as well as raw salads and cold drinks.
  3. Use ginger, cumin, fennel seeds,  cardamon, dill seeds in your recipes and as tea to help reduce intestinal gas build-up.
  4. Keep hydrated – drink lots of filtered water.
  5. Exercise: intermittent or aerobic exercise helps process the abnormal estrogen metabolism and establish balanced microbiome.
  6. Try Hydrochloric acid stimulants such as lemon in water, gentian drops, and other bitters before meals.
  7. Stress management: meditate daily to help your nervous system relax. Ask your Holistique physicians about neural therapy, homeopathy, Bach flower remedies, EFT (emotional freedom technique), brain spotting, constellation therapy, and emotional clearing, and more. Anything to help you learn to release and process old subconscious and generational emotional baggage will help reduce your internal stress response and reduce the stress on the gut nerves.
  8. Acupuncture : I personally have found acupuncture to be one of the most effective treatments for menopausal symptoms.
  9. Have your microbiome tested through comprehensive stool testing such as GI Map from Diagnostic Solutions Laboratory or Comprehensive Stool Analysis from Genova Laboratories.
  10. Bio-identical hormone balancing  : Finally, get your hormones tested and evaluated by a bio-identical hormone specialist. For a comprehensive evaluation, have your estrogen metabolism and a full panel of hormones tested through saliva or urine test.  Make sure your physician is well-versed using herbs, bio-identical hormones, homeopathic hormone drops, detox and drainage, diet and supplements to balance your hormones.

Please do keep in mind that if you are suffering from abdominal symptoms, it is important to get a complete evaluation by a physician to make sure you do not have a more serious condition. Please contact me or one of our Holistique physicians for a comprehensive evaluation and individualized treatment plan to address your abdominal concerns and to balance your hormones to ease your way through menopause.



Dr. Nooshin K. Darvish is a Washington board-licensed Naturopathic Doctor, certified in Anti-Aging and Regenerative Medicine with a Fellowship in Integrative Cancer Therapies. She is the founder and Chief Medical Officer of Holistique Naturopathic Medical Center and Holistique IV Lounge. A 1995 graduate, former Chief Resident, and an Affiliate Faculty of Bastyr University, with more than 25 years of clinical practice, Dr. Darvish practices Regenerative, Naturopathic, and Integrative medicine with a passion to assist patients in their transformation towards physical, mental, emotional, and spiritual wellness. As a physician, writer, educator, lecturer, and speaker, her mission is to inspire others to become 'agents of transformation'.

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